Román-Villarán Esther, Alvarez-Romero Celia, Martínez-García Alicia, Escobar-Rodríguez German Antonio, García-Lozano María José, Barón-Franco Bosco, Moreno-Gaviño Lourdes, Moreno-Conde Jesús, Rivas-González José Antonio, Parra-Calderón Carlos Luis
Computational Health Informatics Group, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Consejo Superior de Investigaciones Científicas, University of Seville, Seville, Spain.
Primary Care, Camas Clinical Management Unit, Seville, Spain.
JMIR Form Res. 2022 Aug 2;6(8):e27990. doi: 10.2196/27990.
Due to an increase in life expectancy, the prevalence of chronic diseases is also on the rise. Clinical practice guidelines (CPGs) provide recommendations for suitable interventions regarding different chronic diseases, but a deficiency in the implementation of these CPGs has been identified. The PITeS-TiiSS (Telemedicine and eHealth Innovation Platform: Information Communications Technology for Research and Information Challenges in Health Services) tool, a personalized ontology-based clinical decision support system (CDSS), aims to reduce variability, prevent errors, and consider interactions between different CPG recommendations, among other benefits.
The aim of this study is to design, develop, and validate an ontology-based CDSS that provides personalized recommendations related to drug prescription. The target population is older adult patients with chronic diseases and polypharmacy, and the goal is to reduce complications related to these types of conditions while offering integrated care.
A study scenario about atrial fibrillation and treatment with anticoagulants was selected to validate the tool. After this, a series of knowledge sources were identified, including CPGs, PROFUND index, LESS/CHRON criteria, and STOPP/START criteria, to extract the information. Modeling was carried out using an ontology, and mapping was done with Health Level 7 Fast Healthcare Interoperability Resources (HL7 FHIR) and Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT; International Health Terminology Standards Development Organisation). Once the CDSS was developed, validation was carried out by using a retrospective case study.
This project was funded in January 2015 and approved by the Virgen del Rocio University Hospital ethics committee on November 24, 2015. Two different tasks were carried out to test the functioning of the tool. First, retrospective data from a real patient who met the inclusion criteria were used. Second, the analysis of an adoption model was performed through the study of the requirements and characteristics that a CDSS must meet in order to be well accepted and used by health professionals. The results are favorable and allow the proposed research to continue to the next phase.
An ontology-based CDSS was successfully designed, developed, and validated. However, in future work, validation in a real environment should be performed to ensure the tool is usable and reliable.
由于预期寿命的增加，慢性病的患病率也在上升。临床实践指南（CPG）针对不同慢性病提供了适当干预措施的建议，但已发现这些CPG在实施方面存在不足。PITeS-TiiSS（远程医疗和电子健康创新平台：卫生服务研究和信息挑战中的信息通信技术）工具是一种基于个性化本体的临床决策支持系统（CDSS），旨在减少变异性、预防错误，并考虑不同CPG建议之间的相互作用等。
本研究的目的是设计、开发并验证一个基于本体的CDSS，该系统提供与药物处方相关的个性化建议。目标人群是患有慢性病和多种药物治疗的老年患者，目标是减少与这些类型疾病相关的并发症，同时提供综合护理。
选择了一个关于心房颤动和抗凝治疗的研究场景来验证该工具。在此之后，确定了一系列知识来源，包括CPG、PROFUND指数、LESS/CHRON标准和STOPP/START标准，以提取信息。使用本体进行建模，并与健康等级7快速医疗保健互操作性资源（HL7 FHIR）和医学临床术语系统命名法（SNOMED CT；国际健康术语标准开发组织）进行映射。一旦开发出CDSS，便通过回顾性案例研究进行验证。
该项目于2015年1月获得资助，并于2015年11月24日获得罗西奥圣母大学医院伦理委员会批准。进行了两项不同的任务来测试该工具的功能。首先，使用了符合纳入标准的真实患者的回顾性数据。其次，通过研究CDSS为被卫生专业人员良好接受和使用必须满足的要求和特征，对采用模型进行了分析。结果是有利的，使所提出的研究能够进入下一阶段。
成功设计、开发并验证了一个基于本体的CDSS。然而，在未来的工作中，应在真实环境中进行验证，以确保该工具可用且可靠。
