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个体化诊断与处方在传统医学中的应用:决策过程分析与基于机器学习的分析工具开发。

Individualized Diagnosis and Prescription in Traditional Medicine: Decision-Making Process Analysis and Machine Learning-Based Analysis Tool Development.

机构信息

KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.

Department of Ophthalmology, Otolaryngology, and Dermatology, Kyung Hee University College of Korean Medicine, Kyung Hee University, Hospital at Gangdong, Seoul, Republic of Korea.

出版信息

Am J Chin Med. 2022;50(7):1827-1844. doi: 10.1142/S0192415X2250077X. Epub 2022 Sep 4.

DOI:10.1142/S0192415X2250077X
PMID:36056467
Abstract

While pattern identification (PI) is an essential process in traditional medicine (TM), it is difficult to objectify since it relies heavily on implicit knowledge. Therefore, this study aimed to propose a machine learning (ML)-based analysis tool to evaluate the clinical decision-making process of PI in terms of explicit and implicit knowledge, and to observe the actual process by which this knowledge affects the choice of diagnosis and treatment in individual TM doctors. Clinical data for the development of the analysis tool were collected using a questionnaire administered to allergic rhinitis (AR) patients and the diagnosis and prescription results of TM doctors based on the completed AR questionnaires. Explicit knowledge and implicit knowledge were defined based on the doctors' explicit scoring and feature evaluations of ML models, respectively. There were many differences between the explicit and implicit importance scores in this study. Implicit importance is more closely related to explicit importance in prescription than in diagnosis. The analysis results for eight doctors showed that our tool could successfully identify explicit and implicit knowledge in the PI process. This is the first study to evaluate the actual process by which explicit and implicit knowledge affect the choice of individual TM doctors and to identify assessment tools for the definition of the decision-making process in diagnosing PI and prescribing herbal treatments by TM clinicians. The assessment tool suggested in this study could be broadly used for the standardization of precision medicine, including TM therapeutics.

摘要

虽然模式识别 (PI) 是传统医学 (TM) 中的一个重要过程,但由于它严重依赖于隐性知识,因此很难客观化。因此,本研究旨在提出一种基于机器学习 (ML) 的分析工具,以评估 PI 的临床决策过程中的显性和隐性知识,并观察这种知识如何影响个体 TM 医生的诊断和治疗选择的实际过程。该分析工具的开发临床数据是通过向过敏性鼻炎 (AR) 患者发放问卷,并根据完成的 AR 问卷收集 TM 医生的诊断和处方结果获得的。显性知识和隐性知识是根据医生对 ML 模型的显性评分和特征评估来定义的。在这项研究中,显性和隐性重要性评分之间存在许多差异。隐性重要性与处方中的显性重要性比诊断更密切相关。对 8 位医生的分析结果表明,我们的工具可以成功识别 PI 过程中的显性和隐性知识。这是第一项评估显性和隐性知识如何影响个体 TM 医生选择的实际过程的研究,并确定了评估工具,用于定义 TM 临床医生诊断 PI 和开草药治疗的决策过程。本研究中提出的评估工具可以广泛用于包括 TM 治疗在内的精准医学的标准化。

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