SOFTWARE ARCHITECTURE FOR GUIDELINE DIRECTED THERAPY

指南指导治疗的软件架构

• 批准号: 2392814
• 负责人: Mark A Musen
• 金额: $ 50.8万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-04-01 至 1999-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2392814
• 关键词: AIDS; computer assisted medical decision making; computer program /software; computer system design /evaluation; hypertension; oncology; problem solving

We propose to develop a novel computer architecture that will support automated reasoning about protocol-based care. We will build on our previous experience in developing the ONCOCIN and T-HELPER systems to create a highly integrated set of computer programs that will significantly ease the construction of new automated systems that can use knowledge of clinical protocols and guidelines to interpret electronically stored patient data and to monitor patient management. Our approach will allow a wide range of clinical information systems to determine when clinical practice guidelines and protocols may apply to given patients, to recommend therapy in accordance with those guidelines, and to critique patient care that deviates from recommended practice patterns. The goal of our research is to address fundamental deficiencies in existing automated approaches to guideline-directed therapy by developing both new data models that can capture the necessary temporal distinctions in patient data and new problem-solving methods for reasoning about guideline- directed therapy. Our research plan consists of a four-step process that defines our specific aims. (1) We will create a domain model of medical concepts that is sufficient to represent the elements of clinical medicine required for a subset of protocol-based care in three areas of medicine: oncology, HIV infection, and hypertension. (2) We will create a temporal data management system that will derive automatically time-related abstractions from primary clinical data. This system will support a new database query language that will allow software clients to query for the presence of time-related abstractions in clinical data, in addition to the primary data themselves. (3) We will develop several extensible problem-solving methods for protocol-based care that will be reusable within the three clinical domains that we will explore. These methods will automate the tasks of therapy planning, of determining patient eligibility for protocols and guidelines, and of critiquing provider's management of patients when practice guidelines apply. (4) We will evaluate the applicability of our problem-solving architecture to different classes of clinical protocols. We will reintegrate our architecture into the T-HELPER medical workstation, and will test the architecture's ability to support reasoning about guidelines and protocols in the three clinical application areas that we will explore. At the conclusion of our work, we will have developed a validated software architecture that can support temporal-data management and automated reasoning about complex clinical protocols and guidelines. Because of our commitment to industry standards such as UNIX, C, TCP/IP, and SQL, our system will be usable as an open "server" for temporal-data management within a variety of application programs.

我们建议开发一种新颖的计算机架构来支持 关于基于协议的护理的自动推理。我们将在我们的基础上再接再厉 以前开发 ONCOCIN 和 T-HELPER 系统的经验 创建一套高度集成的计算机程序 大大简化了可以使用的新自动化系统的构建 了解以电子方式解释的临床方案和指南 存储患者数据并监控患者管理。我们的方法将 允许广泛的临床信息系统确定何时 临床实践指南和方案可能适用于特定患者，以 根据这些指南推荐治疗，并批评 偏离推荐实践模式的患者护理。目标是 我们的研究是为了解决现有自动化技术的根本缺陷 通过开发新数据来实现指南导向治疗的方法 可以捕捉患者必要的时间差异的模型 用于推理指南的数据和新的问题解决方法- 定向治疗。 我们的研究计划由四个步骤组成，该过程定义了我们的 具体目标。 (1) 我们将创建一个医学概念的领域模型 足以代表临床医学所需的要素 三个医学领域基于方案的护理的一个子集：肿瘤学、艾滋病毒 感染、高血压等。 (2)我们将创建一个时态数据管理 系统将自动从中导出与时间相关的抽象 主要临床数据。该系统将支持新的数据库查询 允许软件客户端查询是否存在的语言 除了主要数据之外，临床数据中与时间相关的抽象 数据本身。 (3)我们将开发几种可扩展的问题解决方案 基于协议的护理方法将在三个范围内重复使用 我们将探索的临床领域。这些方法将自动化 治疗计划的任务，确定患者资格的任务 协议和指南，以及批评提供商的管理 当实践指南适用时的患者。 (4) 我们将评估 我们的问题解决架构对不同类别的适用性 临床方案。我们将把我们的架构重新集成到 T-HELPER 中 医疗工作站，并将测试架构的支持能力 三种临床应用指南和方案的推理 我们将探索的领域。 在我们的工作结束时，我们将开发出经过验证的软件 可以支持时态数据管理和自动化的架构 推理复杂的临床方案和指南。因为我们的 我们对 UNIX、C、TCP/IP 和 SQL 等行业标准的承诺 系统将可用作时态数据管理的开放“服务器” 在各种应用程序中。