Séroussi B, Morice V, Dreyfus F, Boisvieux J F
Service d'Informatique Médicale, DIAM, Paris, France.
Artif Intell Med. 1995 Apr;7(2):155-77. doi: 10.1016/0933-3657(94)00030-v.
Monitoring patients hospitalized in hemato-oncology departments to undergo clinical protocols of therapy is a complex task. The main difficulty arises in the management of the oncology protocol as well as in the management of critical episodes of acute illness which frequently occur due to high toxicity of the used antimitotics. This problem of controlling a patient's condition can be conceptualized within the control theory paradigm as the task of controlling a process whose state changes over time and can deviate unacceptably from a normal range. Upon request of a French clinical department of hemato-oncology, we developed an intelligent patient monitor named SEPIA to assist clinicians in this task. Following the control theory analogy at the level of knowledge bases design, we have modeled the medical knowledge as control information to represent the medical actions, and state information is used as feedback control to characterize the patient's state. After a general presentation of SEPIA, the analogies between control theory actors and SEPIA's components are specified. The article then focuses on state variables representation. The data reduction process, activated as new data are given to the system, is described. A simulated running session is finally presented to illustrate the whole reasoning process.
对血液肿瘤科室住院患者进行临床治疗方案监测是一项复杂的任务。主要困难在于肿瘤治疗方案的管理以及急性疾病危急情况的管理，这些危急情况频繁发生是由于所用抗有丝分裂药物的高毒性。控制患者病情的这个问题可以在控制理论范式内概念化为控制一个过程的任务，该过程的状态随时间变化，并且可能会从正常范围出现不可接受的偏差。应法国血液肿瘤临床科室的要求，我们开发了一个名为SEPIA的智能患者监测器来协助临床医生完成这项任务。在知识库设计层面遵循控制理论类比，我们将医学知识建模为控制信息以表示医疗行为，而状态信息用作反馈控制来表征患者状态。在对SEPIA进行总体介绍之后，明确了控制理论参与者与SEPIA组件之间的类比。然后文章重点介绍状态变量表示。描述了在向系统提供新数据时激活的数据缩减过程。最后给出一个模拟运行会话以说明整个推理过程。
