Wiener F, Fayman M, Teitelman U, Bursztein S
Crit Care Med. 1983 Jun;11(6):470-5. doi: 10.1097/00003246-198306000-00018.
A system is described for aiding the clinician in the management of acid-base disorders. The medical knowledge required for interpretation of blood gas measurements, etiologic diagnosis, and treatment selection for acid-base disorders is structured into decision pathways consisting of a series of inferences. Each inference is defined by a medical logic module which specifies the different combinations of criteria, patient data and/or previously confirmed inferences, sufficient for confirming or rejecting the inference. A method is provided for converting numerical observations to the appropriate logical statement used in the modules. Patient data are compared to the medical logic and a status report lists the input data, acid-base diagnosis, and the suggested therapy. After initial testing on patient data, the medical logic was updated to express the medical policy of our clinical specialists. The system was applied to 54 patients and the system's conclusions were in full agreement with our staff in 93% of the cases, and in partial agreement in the other cases. The modular structure of the system's medical knowledge allows full expression of all the nuances of medical policy in our unit and facilitates updating to encompass the latest developments in acid-base management. The system can be integrated readily into existing computerized patient monitoring systems.
本文描述了一种协助临床医生管理酸碱平衡紊乱的系统。用于解释血气测量、病因诊断以及酸碱平衡紊乱治疗选择的医学知识被构建成由一系列推理组成的决策路径。每个推理由一个医学逻辑模块定义，该模块指定了足以确认或否定该推理的标准、患者数据和/或先前已确认的推理的不同组合。提供了一种将数值观测结果转换为模块中使用的适当逻辑语句的方法。将患者数据与医学逻辑进行比较，状态报告会列出输入数据、酸碱诊断和建议的治疗方法。在对患者数据进行初步测试后，更新了医学逻辑以体现我们临床专家的医疗策略。该系统应用于54例患者，在93%的病例中系统得出的结论与我们工作人员的结论完全一致，在其他病例中部分一致。该系统医学知识的模块化结构能够充分体现我们科室医疗策略的所有细微差别，并便于更新以涵盖酸碱平衡管理的最新进展。该系统可轻松集成到现有的计算机化患者监测系统中。
