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使用决策树作为COVID-19临床决策支持的专家系统。

Using Decision Trees as an Expert System for Clinical Decision Support for COVID-19.

作者信息

Chrimes Dillon

机构信息

School of Health Information Science, Human and Social Development, University of Victoria, Victoria, BC, Canada.

出版信息

Interact J Med Res. 2023 Jan 30;12:e42540. doi: 10.2196/42540.

Abstract

COVID-19 has impacted billions of people and health care systems globally. However, there is currently no publicly available chatbot for patients and care providers to determine the potential severity of a COVID-19 infection or the possible biological system responses and comorbidities that can contribute to the development of severe cases of COVID-19. This preliminary investigation assesses this lack of a COVID-19 case-by-case chatbot into consideration when building a decision tree with binary classification that was stratified by age and body system, viral infection, comorbidities, and any manifestations. After reviewing the relevant literature, a decision tree was constructed using a suite of tools to build a stratified framework for a chatbot application and interaction with users. A total of 212 nodes were established that were stratified from lung to heart conditions along body systems, medical conditions, comorbidities, and relevant manifestations described in the literature. This resulted in a possible 63,360 scenarios, offering a method toward understanding the data needed to validate the decision tree and highlighting the complicated nature of severe cases of COVID-19. The decision tree confirms that stratification of the viral infection with the body system while incorporating comorbidities and manifestations strengthens the framework. Despite limitations of a viable clinical decision tree for COVID-19 cases, this prototype application provides insight into the type of data required for effective decision support.

摘要

新冠病毒病(COVID-19)已对全球数十亿人口和医疗保健系统产生了影响。然而,目前尚无面向患者和医护人员的公开可用聊天机器人,用于确定COVID-19感染的潜在严重程度,或可能导致COVID-19重症病例发展的生物系统反应及合并症。本初步调查在构建按年龄和身体系统、病毒感染、合并症及任何表现进行分层的二元分类决策树时,考虑了缺乏针对COVID-19具体病例的聊天机器人这一情况。在查阅相关文献后,使用一套工具构建了一个决策树,以建立聊天机器人应用程序并与用户进行交互的分层框架。共建立了212个节点,这些节点沿着身体系统、医疗状况、合并症以及文献中描述的相关表现在从肺部疾病到心脏疾病的范围内进行了分层。这产生了63360种可能的情况,提供了一种理解验证决策树所需数据的方法,并突出了COVID-19重症病例的复杂性。该决策树证实,将病毒感染与身体系统分层,同时纳入合并症和表现,可加强该框架。尽管针对COVID-19病例的可行临床决策树存在局限性,但该原型应用程序为有效决策支持所需的数据类型提供了见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a3a/9888422/b27103283ec5/ijmr_v12i1e42540_fig1.jpg

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