AN AUTOMATED DATABASE-EXPERT SYSTEM FOR ACUTE STROKE

本申请中提出的工作的目的是演示 将计算机化病历(CMR)与 医疗问题解决系统为临床医生提供有用的建议 处于急诊护理环境中。申请书描述了一个五年计划，以 开发并实现一个原型CMR和一组决策支持 帮助医生诊断和管理的系统 脑血管疾病。 本研究拟开发的决策支持系统包括 系统将根据体征和 入院时出现症状，这一计划将决定哪种类型 一个人中风的风险，以及几个有助于 短暂性脑缺血发作和卒中患者的管理。用于创建 并测试这些系统将来自各种来源，包括 NINCDS中风数据库和西奈山中风数据库。每个人 系统将在使用实际患者数据之前进行广泛评估 被纳入综合系统。 这些程序在做出决定时使用的信息 将由医生在对患者进行初步评估时获得 住进了急性中风病房。一个计算机接口将是 它将允许医生通过以下方式输入该信息 填写屏幕上显示的结构化神经学评估表 在一个航站楼。根据这些信息，计算机系统将生成 一张常规的录取通知书，以及代表信息 由医生以可由 计算机，从而为医生提供了一种有效的记录方式 解决问题所需的数据和相应的输入信息 系统自动运行。然后，问题解决系统将 使用这些信息来表达他们的“意见”，而不需要 与医生的其他互动。

The purpose of the work proposed in this application is to demonstrate the feasibility of linking a computerized medical record (CMR) with medical problem-solving systems to provide useful advice to clinicians in an acute care setting. The application describe a five year plan to develop and implement a prototype CMR and a set of decision-support systems that aid physicians in the diagnosis and management of cerebrovascular disease. The decision-support systems to be developed in this study include a system that will localize stroke lesions on the basis of the signs and symptoms present on admission, a program that will determine what kind of stroke a person has had, and several programs that will aid in the management of TIA and stroke patients. The information used to create and test these systems will come from a variety of sources, including the NINCDS Stroke Data Bank and the Mount Sinai Stroke Data Bank. Each system will be evaluated extensively, using actual patient data, before being incorporated into the comprehensive system. The information used by these programs in making their determinations will be garnered by physicians during the initial assessment of patients admitted to an acute stroke unit. A computer interface will be developed which will allow the physicians to input this information by completing a structured neurologic assessment form represented onscreen at a terminal. From this information, the computer system will generate a conventional admitting note as well as represent the information entered by the physician in a manner that can be processed by the computer, thus providing an efficient way for the physician to record data and concomitantly input information needed for problem-solving systems to function automatically. The problem-solving systems will then use this information to render their "opinions" without requiring additional interaction with the physician.