Evaluation of an architecture for intelligent query and exploration of time-oriented clinical data
Evaluation of an architecture for intelligent query and exploration of time-oriented clinical data
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DOI：
10.1016/j.artmed.2008.03.006
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发表时间：
2008-05-01
影响因子：
7.5
通讯作者：
Goldstein, Mary K.
中科院分区：
文献类型：
--
作者：
Martins, Susana B.;Shahar, Yuval;Goldstein, Mary K.
目的：评估KNAVE-II，一个基于知识的框架，用于可视化，解释和探索纵向临床数据，临床概念和模式。KNAVE-II将查询中介到分布式时间抽象架构（IDAN），该架构使用专门用于临床查询的实时计算的基于知识的问题解决方法。一项两阶段、平衡交叉研究，旨在比较一组临床医生使用KNAVE-II与标准方法回答关于时间导向临床数据的不同复杂性查询时的效率和满意度，这些查询通常用于肿瘤学方案：在第一阶段中使用纸质图表和流行的电子表格（ESS）;在第二阶段中使用ESS。这些测量包括回答每个查询和每个复杂性类别所需的时间和答案的正确性，以及所有查询，与由领域专家设定的预定黄金标准进行评估。用户满意度通过标准可用性评分（SUS）工具特定问卷和为本研究开发的“Toot可用性比较”比较问卷进行评估。在两次评估中，受试者使用KNAVE-II回答更高复杂性的问题比使用纸质图表或ESS时明显更快，每个问题与ESS回答硬问题的平均差异高达255 s（p = 0.0003）在第二次评价中。在第一阶段，使用KNAVE-II与纸质图表相比，在第二阶段，使用ESS的平均正确性得分在所有查询中均显着较高。在第二次评估中，使用KNAVE-II，所有级别查询中提出的所有问题中有91.6%（110/120）给出了正确答案，而使用ESS时只有57.5%（69/120）给出了正确答案（p < 0.0001）。与使用纸质图表或ESS相比，使用KNAVE-II的用户满意度显著上级（p = 0.006）。临床医生排名KNAVE-II上级的纸张和ESS.Conclusions：KNAVE-II及其支持的知识为基础的时间调解架构的功能和可用性的评价产生了非常令人鼓舞的结果，节省医生的时间，提高临床评估的准确性，和用户满意度。(c)2008 Elsevier B. V.保留所有权利。
Objective: Evaluate KNAVE-II, a knowledge-based framework for visualization, interpretation, and exploration of longitudinal clinical data, clinical concepts and patterns. KNAVE-II mediates queries to a distributed temporal-abstraction architecture(IDAN), which uses a knowledge-based problem-solving method specializing in on-the-fly computation of clinical queries.Methods: A two-phase, balanced cross-over study to compare efficiency and satisfaction of a group of clinicians when answering queries of variable complexity about time-oriented clinical data, typical for oncology protocols, using KNAVE-II, versus standard methods: both paper charts and a popular electronic spreadsheet (ESS) in Phase 1; an ESS in Phase II. The measurements included the time required to answer and the correctness of answer for each query and each complexity category, and for all queries, assessed versus a predetermined gold standard set by a domain expert. User satisfaction was assessed by the Standard Usability Score (SUS) tool-specific questionnaire and by a "Usability of Toot Comparison" comparative questionnaire developed for this study.Results: In both evaluations, subjects answered higher-complexity queries significantly faster using KNAVE-II than when using paper charts or an ESS up to a mean of 255 s difference per query versus the ESS for hard queries (p = 0.0003) in the second evaluation. Average correctness scores when using KNAVE-II versus paper charts, in the first phase, and the ESS, in the second phase, were significantly higher over all queries. In the second evaluation, 91.6% (110/120) of all of the questions asked within queries of all levels produced correct answers using KNAVE-II, opposed to only 57.5% (69/120) using the ESS (p < 0.0001). User satisfaction with KNAVE-II was significantly superior compared to using either a paper chart or the ESS (p = 0.006). Clinicians ranked KNAVE-II superior to both paper and the ESS.Conclusions: An evaluation of the functionality and usability of KNAVE-II and its supporting knowledge-based temporal-mediation architecture has produced highly encouraging results regarding saving of physician time, enhancement of accuracy of clinical assessment, and user satisfaction. (c) 2008 Elsevier B.V. All rights reserved.