Lau F
Department of Accounting and Management Information Systems, Faculty of Business, University of Alberta, Canada.
Int J Clin Monit Comput. 1994 Aug;11(3):157-69. doi: 10.1007/BF01132364.
This paper describes the development and validation of a decision-support system prototype that can help manage hypovolemic hypotension in the Cardiovascular Intensive Care Unit (CVICU). The prototype uses physiologic pattern-matching, therapeutic protocols, computational drug-dosage response modeling and expert reasoning heuristics in its selection of intervention strategies and choices. As part of model testing, the prototype simulated real-time operation by processing historical physiologic and intervention data on a patient sequentially, generating alerts on questionable data, critiques of interventions instituted and recommendations on preferred interventions. Bench-testing with 399 interventions from 13 historical cases showed therapies for bleeding and fluid replacement proposed by the prototype were significantly more consistent (p < 0.0001) than those instituted by the staff when compared against expert critiques (80% versus 44%). This study has demonstrated the feasibility of formalizing hemodynamic management of CVICU patients in a manner that may be implemented and evaluated in a clinical setting.
本文描述了一种决策支持系统原型的开发与验证，该系统可帮助管理心血管重症监护病房（CVICU）中的低血容量性低血压。该原型在选择干预策略和选项时，采用生理模式匹配、治疗方案、计算药物剂量反应模型和专家推理启发法。作为模型测试的一部分，该原型通过依次处理患者的历史生理和干预数据来模拟实时操作，对可疑数据生成警报、对所采取的干预措施进行评判，并对首选干预措施提出建议。对来自13个历史病例的399项干预措施进行的基准测试表明，与专家评判相比，该原型提出的出血和液体替代疗法比工作人员实施的疗法一致性显著更高（p < 0.0001）（80%对44%）。本研究证明了以一种可在临床环境中实施和评估的方式将CVICU患者的血流动力学管理形式化的可行性。
