Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

Journal of Translational Medicine

Research

Luigi Ceccaroni¹  Magí Lluch-Ariet²  Filip Velickovski³  Felip Burgos⁴  Josep Roca⁴  Nuria Marina⁵  Juan B Galdiz⁶ 

[1] 1000001 Labs, 08024, Barcelona, Spain;Barcelona Digital Technology Centre, 5th floor, 08018, Barcelona, Spain;Departament d'Enginyeria Telemática (ENTEL), Universitat Politécnica de Catalunya (UPC), 08034, Barcelona, Spain;Barcelona Digital Technology Centre, 5th floor, 08018, Barcelona, Spain;ViCOROB, Universitat de Girona, Campus Montilivi, 17071, Girona, Spain;Hospital Clínic, IDIBAPS, Universitat de Barcelona, 08036, Barcelona, Spain;Centro de Investigacíon Biomédica en Red Enfermedades Respiratorias (CIBERES), 07110, Bunyola, Mallorca, Illes Balears, Spain;Servicio de Neumología, Hospital Universitario Cruces, 48903, Barakaldo, Bizkaia, Spain;Servicio de Neumología, Hospital Universitario Cruces, 48903, Barakaldo, Bizkaia, Spain;Centro de Investigacíon Biomédica en Red Enfermedades Respiratorias (CIBERES), 07110, Bunyola, Mallorca, Illes Balears, Spain;

关键词: decision support;    COPD;    service oriented architecture;    integrated care;    rule-based systems;   

DOI  :  10.1186/1479-5876-12-S2-S9

来源: Springer

【 摘 要 】

BackgroundThe use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway.ObjectivesThe objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow.MethodsThe software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team.ResultsA suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms.ConclusionsSpecialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

【 授权许可】

CC BY   
© Velickovski et al.; licensee BioMed Central Ltd. 2014