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由专家系统支持的高血压护理方案。

Protocol care for hypertension supported by an expert system.

作者信息

Takahashi E, Yoshida K, Izuno T, Miyakawa M, Sugimori H

机构信息

Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Shinjuku, Tokyo 160, Japan.

出版信息

Medinfo. 1995;8 Pt 2:954.

PMID:8591597
Abstract
  1. PURPOSE. Hypertension if one of the major prevalent diseases that influences the prognosis of chronic diseases. Primary care should attract much attention in the management of hypertension. The management of hypertension includes not only the use of antihypertensiove drugs, but also the modification of unhealthy lifestyles. Multi-dimensional approaches are required for the management of hypertensive patients. This system supports the standard protocol care for hypertensive patients and the database for clinical epidemiology. 2. DESIGN CONSIDERATIONS. This system has several functions that support the appropriate management of hypertensive patients. The first one is clinical database management. The second is the evaluation of the clinical conditions in hypertension. The third is the decision support system for the selection of treatments for hypertension. 3. SYSTEM DESCRIPTION. This system administers the clinical database, which includes symptoms and signs, laboratory data, and prescriptions. The database deals with the temporal course of the patient's status. The system that evaluates the patient's condition and the decision support system have some knowledge bases. The knowledge bases consist of the evaluation of the patient's condition, the appropriate selection of laboratory examinations, and suggestions for treatments, which involve a life-style modification and the proper prescription of medication. 4. STATUS REPORTS. The relational database was developed for handling the patient's records. These records were displayed on the terminal according to the temporal sequence. The graphical representations of the medical data were displayed in order to understand the patient's status. 5. LESSON LEARNED. This kind of protocol care system is expected to support the proper medical care of patients. Excess medications and laboratory examinations will be excluded under the protocol care, thus reducing unnecessary medical expense. The system will enhance the randomized clinical trials that verify the effects of the treatments. Violation of the protocol care is treated according to the several levels. 6. FUTURE PLANS. This system will be introduced to the occupational health care fields. The efficacy of improving the clinical quantity, and the effect of reducing the medical budget concerning hypertension will be verified.
摘要
  1. 目的。高血压是影响慢性病预后的主要常见疾病之一。基层医疗在高血压管理中应受到高度重视。高血压管理不仅包括使用降压药物,还包括改变不健康的生活方式。高血压患者的管理需要多维度方法。该系统支持高血压患者的标准规范护理及临床流行病学数据库。2. 设计考量。该系统具有多项支持高血压患者恰当管理的功能。第一个是临床数据库管理。第二个是高血压临床状况评估。第三个是高血压治疗选择的决策支持系统。3. 系统描述。该系统管理临床数据库,其中包括症状体征、实验室数据和处方。该数据库处理患者病情的时间进程。评估患者病情的系统和决策支持系统有一些知识库。这些知识库包括患者病情评估、实验室检查的恰当选择以及治疗建议,其中涉及生活方式改变和药物的合理处方。4. 状态报告。开发了关系数据库来处理患者记录。这些记录按时间顺序显示在终端上。显示医疗数据的图形表示以便了解患者状况。5. 经验教训。这种规范护理系统有望支持对患者的恰当医疗护理。在规范护理下将排除过度用药和实验室检查,从而减少不必要的医疗费用。该系统将加强验证治疗效果的随机临床试验。违反规范护理将按几个级别进行处理。6. 未来计划。该系统将引入职业健康护理领域。将验证其改善临床质量的功效以及降低高血压医疗预算的效果。

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引用本文的文献

1
Using health information technology to improve hypertension management.利用健康信息技术改善高血压管理。
Curr Hypertens Rep. 2008 Jun;10(3):201-7. doi: 10.1007/s11906-008-0038-6.
2
HyperCare: a prototype of an active database for compliance with essential hypertension therapy guidelines.HyperCare:一个用于遵循原发性高血压治疗指南的主动数据库原型。
Proc AMIA Annu Fall Symp. 1997:288-92.