• Title/Summary/Keyword: Clinical decision support

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Development of Medical Image Processing Algorithm for Clinical Decision Support System Applicable to Patients with Cardiopulmonary Function (심폐기능 재활환자용 임상의사결정지원시스템을 위한 의료영상 처리 기술 개발)

  • Park, H.J.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.1
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    • pp.61-66
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    • 2015
  • Chest X-ray images is the most common and widely used in clinical findings for a wide range of anatomical information about the prognosis of the disease in patients with cardiopulmonary rehabilitation. Many analysis algorithm was developed by a number of studies regarding the region segmentation and image analysis, there are specific differences due to the complexity and diversity of the image. In this paper, a diagnosis support system of the chest X-ray image based on image processing and analysis methods to detect the cardiopulmonary disease. The threshold value and morphological method was applied to segment the pulmonary region in a chest X-ray image. Anatomical measurements and texture analysis was performed on the segmented regions. The effectiveness of the proposed method is shown through experiments and comparison with diagnosis results by clinical experts to show that the proposed method can be used for decision support system.

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Usability Testing of a Prototype Personal Digital Assistant (PDA)-based Decision Support System for the Management of Obesity

  • Lee, Nam-Ju;Bakken, Suzanne
    • Perspectives in Nursing Science
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    • v.5 no.1
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    • pp.17-31
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    • 2008
  • Purpose: The purpose of this study was to evaluate the usability of a prototype personal digital assistant (PDA)-based decision support system for the management of obesity through usability testing with end-users (Advanced Practice Nurses [APNs]) prior to its implementation in clinical settings. Methods: This descriptive study used observational and think aloud techniques to address the research question: what usability problems are perceived by end-users? Five APNs were provided with the scenarios and the list of tasks to evaluate the application. Their verbalizations were recorded through Morae usabil ity software. Data analysis was based on the data captured through Morae, transcriptions, notes, and the end-user survey. Results: End-users completed all the required tasks without encountering a severe usability problem, and agreed that the system was easy to use. clear, concise, and useful. Usability issues that were unrecognized by the developer or usability experts were identified by APNs. The usability problems were categorized according to positive characteristics, negative characteristics, and recommendations. The usability issues were discussed with the project team members, and solutions were suggested to improve the user interface of the PDA-based decision support system before the final implementation. Conclusions: This approach had an important impact on making the system easier to use and more useful from the perspective of design and content. The results of this evaluation provided iterative feedback regarding the design and implementation of the PDA-based decision support system for the management of obesity.

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Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

Trends of Clinical Decision Support System(CDSS) (임상의사결정지원시스템(CDSS) 기술동향)

  • Lee, D.H.;Jung, H.Y.;Kim, M.H.;Lim, M.E.;Kim, D.H.;Han, Y.W.;Lee, Y.W.;Choi, J.H.;Kim, S.H.
    • Electronics and Telecommunications Trends
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    • v.31 no.4
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    • pp.77-85
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    • 2016
  • 구글 딥마인드 알파고와 이세돌 선수와의 바둑대결 후 인공지능의 활용처로 의료분야가 거론되면서 임상의사결정지원시스템(Clinical Decision Support System: CDSS)이 최근 주목받고 있다. 기본적으로 CDSS는 환자 진료에 있어 예방, 진단, 치료, 처방 그리고 예후의 각 단계에서 임상의의 의사결정을 도와주는 시스템을 말한다. 본고에서는 CDSS의 국내외 도입 및 시장현황과 관련 기술현황을 검토하여 의료현장에서 CDSS의 활용이 활성화되기 위한 방안을 도출하고자 한다.

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Implementation of Meta Data-based Clinical Decision Support System for the Portability (이식성을 위한 메타데이터 기반의 CDSS 구축)

  • Lee, Sang Young;Lee, Yoon Hyeon;Lee, Yoon Seok
    • Journal of Korea Society of Digital Industry and Information Management
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    • v.8 no.1
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    • pp.221-229
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    • 2012
  • A model for expressing meta data syntax in the eXtensible Markup Language(XML) was developed to increase the portability of the Arden Syntax in medical treatment. In this model that is Arden syntax uses two syntax checking mechanisms, first an XML validation process, and second, a syntax check using an XSL style sheet. Two hundred seventy-seven examples of MLMs were transformed into MLMs in ArdenML and validated against the schema and style sheet. Both the original MLMs and reverse-parsed MLMs in ArdenML were checked using a Arden Syntax checker. The textual versions of MLMs were successfully transformed into XML documents using the model, and the reverse-parse yielded the original text version of MLMs.

Active Clinical Decision Support System for Operations Management in Hospital (병원 운영 관리를 위한 능동형 임상의사결정지원시스템)

  • Kim, Jun-Woo;Park, Sang-Chan
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2014.01a
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    • pp.279-280
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    • 2014
  • 정보통신기술의 발달로 말미암아 병의원에서도 다양한 정보시스템의 도입이 활발하고, 초기에는 데이터의 전자적 관리 및 공유를 위한 시스템이 주를 이루었으나 점차 병의원 운영관리에 대한 직접적인 의사결정지원 기능이 강조되고 있다. 그러나 기존의 시스템들은 대부분 의료 전문가들의 지식에 기반하여 진료행위가 정해진 절차를 벗어나지 않도록 하는 데에만 초점을 맞추었고, 환자나 경영자 입장을 충분히 고려하지 못하였다. 이에 본 논문에서는 전문적 의료 지식 베이스가 아닌 병의원에서 수집된 데이터를 기반으로 다양한 참여자들에게 유용한 기능을 제공하기 위한 능동형 임상의사결정지원시스템의 개념과 구조에 대하여 논의하고자 한다.

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Query Expansion based on Knowledge Extraction and Latent Dirichlet Allocation for Clinical Decision Support (의학 문서 검색을 위한 지식 추출 및 LDA 기반 질의 확장)

  • Jo, Seung-Hyeon;Lee, Kyung-Soon
    • Annual Conference on Human and Language Technology
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    • 2015.10a
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    • pp.31-34
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    • 2015
  • 본 논문에서는 임상 의사 결정 지원을 위한 UMLS와 위키피디아를 이용하여 지식 정보를 추출하고 질의 유형 정보를 이용한 LDA 기반 질의 확장 방법을 제안한다. 질의로는 해당 환자가 겪고 있는 증상들이 주어진다. UMLS와 위키피디아를 사용하여 병명과 병과 관련된 증상, 검사 방법, 치료 방법 정보를 추출한다. UMLS와 위키피디아를 사용하여 추출한 의학 정보를 이용하여 질의와 관련된 병명을 추출한다. 질의와 관련된 병명을 이용하여 추가 증상, 검사 방법, 치료 방법 정보를 확장 질의로 선택한다. 또한, LDA를 실행한 후, Word-Topic 클러스터에서 질의와 관련된 클러스터를 추출하고 Document-Topic 클러스터에서 초기 검색 결과와 관련이 높은 클러스터를 추출한다. 추출한 Word-Topic 클러스터와 Document-Topic 클러스터 중 같은 번호를 가지고 있는 클러스터를 찾는다. 그 후, Word-Topic 클러스터에서 의학 용어를 추출하여 확장 질의로 선택한다. 제안 방법의 유효성을 검증하기 위해 TREC Clinical Decision Support(CDS) 2014 테스트 컬렉션에 대해 비교 평가한다.

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Pharmaceutical Care for Medication Safety in Critically Ill Neonates (신생아중환자의 안전한 약물사용을 위한 약료서비스)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.143-148
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    • 2020
  • Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

Impact of critical thinking disposition and clinical decision making on dental hygienists' job performance (치과위생사의 비판적 사고성향과 임상적 의사결정능력이 직무수행능력에 미치는 영향)

  • Hwang, Yeon-Ho;Kim, Yun-Jeong;Moon, Sang-Eun;Kim, Seon-Yeong;Cho, Hye-Eun;Kang, Hyun-Joo
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.3
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    • pp.369-378
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    • 2020
  • Objectives: The purpose of this study is to examine the correlation between the critical thinking disposition of dental hygienists and the variables associated with clinical decision making and job performance to analyze factors affecting job performance. Methods: A questionnaire survey was administered to 166 dental hygienists from June 24 to August 8, 2019. We analyzed results with t-test, Mann-Whitney U test, ANOVA, Pearson's correlation analysis and a multiple regression analysis using the SPSS Windows version 23.0(SPSS Inc. IL, USA). Results: Critical thinking disposition was the highest for open-mindedness and clinical decision making ranked highest for canvassing of objectives and values. Job performance ranked highest in terms of assist with dental treatment. Factors affecting dental hygienists' job performance were clinical decision making and critical thinking disposition(p<0.001, adj. R2 =31.4). Conclusions: It is expected that this study will provide basic data for the development of programs to enhance the job performance of dental hygienists. Furthermore, it is necessary to actively support plans such as conducting seminars at dental institutions and providing educational participation opportunities.

Effects of Major Satisfaction of Dental Hygiene Students and Career Decision Self-Efficacy and Career Preparation Behavior (치위생과 학생들의 전공만족도가 진로결정 자기효능감 및 진로준비행동에 미치는 영향)

  • Sung, Mi-Ae;Choi, Sung-Suk
    • Journal of Korean Clinical Health Science
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    • v.6 no.2
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    • pp.1180-1188
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    • 2018
  • Purpose. This study was to effects of major satisfaction of dental hygiene students and students on self-efficacy and career preparation behavior by investigation to provide basic data for developing a systematic career customized employment support program. Methods. The data were collected from 249 students from December 1 to 10 day 2016 in Yeongnam region. Data analysis was performed using descriptive statistics frequency, t-test(One-way ANOVA), logistic regression by SPSS WIN 18.0 program. Results. According to the general characteristics department dental hygiene students were major satisfied with 59.8%. Satisfaction with career decision self-efficacy and career preparation self-efficacy was found to $68.30{\pm}10.21$ statistically significant(p<.001). Satisfaction was also found to statistically significant ($32.65{\pm}6.05$) in career preparation behavior(p<.05). Satisfactory scores were found to 1.306 times higher than the dissatisfied students in the career decision self-efficacy goal setting. It was found that 8.423 times in satisfaction of career planning in career preparation. Conclusion. Considering the effects of dental hygiene students' major satisfaction on career decision self - efficacy and career preparation behavior, it would be good if we could develop and use various programs to improve the satisfaction of students in their majors.