Institute for Geriatric Research at AGAPLESION Bethesda Ulm, Ulm University Medical Center, Ulm, Germany.
Geriatric Center Ulm, Ulm, Germany.
PLoS One. 2023 Jun 16;18(6):e0287230. doi: 10.1371/journal.pone.0287230. eCollection 2023.
Geriatric co-management is known to improve treatment of older adults in various clinical settings, however, widespread application of the concept is limited due to restricted resources. Digitalization may offer options to overcome these shortages by providing structured, relevant information and decision support tools for medical professionals. We present the SURGE-Ahead project (Supporting SURgery with GEriatric co-management and Artificial Intelligence) addressing this challenge.
A digital application with a dashboard-style user interface will be developed, displaying 1) evidence-based recommendations for geriatric co-management and 2) artificial intelligence-enhanced suggestions for continuity of care (COC) decisions. The development and implementation of the SURGE-Ahead application (SAA) will follow the Medical research council framework for complex medical interventions. In the development phase a minimum geriatric data set (MGDS) will be defined that combines parametrized information from the hospital information system with a concise assessment battery and sensor data. Two literature reviews will be conducted to create an evidence base for co-management and COC suggestions that will be used to display guideline-compliant recommendations. Principles of machine learning will be used for further data processing and COC proposals for the postoperative course. In an observational and AI-development study, data will be collected in three surgical departments of a University Hospital (trauma surgery, general and visceral surgery, urology) for AI-training, feasibility testing of the MGDS and identification of co-management needs. Usability will be tested in a workshop with potential users. During a subsequent project phase, the SAA will be tested and evaluated in clinical routine, allowing its further improvement through an iterative process.
The outline offers insights into a novel and comprehensive project that combines geriatric co-management with digital support tools to improve inpatient surgical care and continuity of care of older adults.
German clinical trials registry (Deutsches Register für klinische Studien, DRKS00030684), registered on 21st November 2022.
老年共管理在各种临床环境下改善老年人的治疗效果已得到证实，然而，由于资源有限，该理念的广泛应用受到限制。数字化可能通过为医疗专业人员提供结构化、相关的信息和决策支持工具来提供选择，以克服这些短缺。我们提出了 SURGE-Ahead 项目（通过老年共管理和人工智能支持外科手术）来应对这一挑战。
将开发一个具有仪表板式用户界面的数字应用程序，该程序将显示 1）老年共管理的循证建议，2）人工智能增强的连续性护理（COC）决策建议。SURGE-Ahead 应用程序（SAA）的开发和实施将遵循医学研究委员会对复杂医疗干预的框架。在开发阶段，将定义一个最小的老年数据集（MGDS），该数据集将来自医院信息系统的参数化信息与简明评估电池和传感器数据相结合。将进行两次文献综述，为共管理和 COC 建议创建循证基础，这些建议将用于显示符合指南的建议。机器学习原理将用于进一步处理数据和术后 COC 提案。在一项观察性和人工智能开发研究中，将在一家大学医院的三个外科部门（创伤外科、普通和内脏外科、泌尿科）收集数据，用于人工智能培训、MGDS 的可行性测试以及共管理需求的识别。将在一个有潜在用户的研讨会上测试可用性。在随后的项目阶段，将在临床常规中测试和评估 SAA，通过迭代过程进一步改进其性能。
该大纲提供了一个新颖而全面的项目的见解，该项目将老年共管理与数字支持工具相结合，以改善住院手术护理和老年人的连续性护理。
德国临床试验注册处（Deutsches Register für klinische Studien，DRKS00030684），于 2022 年 11 月 21 日注册。
