Design of meta-DSS to support the decision-making process: supporting activities on a clinical pathway in the emergency department

设计元 DSS 以支持决策过程：支持急诊科临床路径上的活动

• 批准号: 6776-2008
• 负责人: Michalowski, Wojtek
• 金额: $ 1.46万
• 依托单位: University of Ottawa
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2012
• 资助国家: 加拿大
• 起止时间: 2012-01-01 至 2013-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=497716
• 关键词: Design; meta; DSS; support; decision

In clinical decision-making there are many situations where a final outcome is a result of multiple intertwined tasks. Managing a patient in the Emergency Department (ED) comes to mind. In order to facilitate patient management and to follow evidence-based medicine, hospitals introduce clinical pathways as tools to ensure that patients receive the most appropriate care. These pathways are developed from clinical practice guidelines and they outline a sequence of temporal clinical evaluations and interventions. In that sense a pathway is a prescriptive model of a decision-making process with individual tasks corresponding to different, time-dependent activities. While there are clinical DSS created to support one activity at a time, there is no design methodology that provides comprehensive support for a set of activities. The purpose of the research described in this proposal is to develop a methodology for designing a meta-DSS that brings together different support requirements and capabilities so that entire decision-making process is supported. We will create a meta-DSS design using the Organizational-based Multiagent System Engineering (O-MaSE) methodology that allows for modeling changes to the problem structure as a result of interactions between agents (common situation for patient management where treatment changes depending on latest assessment and previous actions). We will be looking at individual tasks comprising a pathway as independent agents (entities), each with its own requirements and capabilities. We will model these agents, as "services" that should be brought together in order to accomplish a common goal. We will use the Service-Oriented Architecture (SOA) paradigm for connecting on demand loosely coupled tasks from a clinical pathway as well as support capabilities provided by stand-alone clinical DSS. The implementation of the SOA will involve identification and description of tasks (service requestors) that invoke individual support requirements associated with some specific clinical DSS (service providers). We are planning to evaluate the capabilities of a meta-DSS design using clinical pathways for ED management of pediatric head trauma and asthma.

在临床决策中，有许多情况下，最终结果是多个相互交织的任务的结果。我想到了急诊科（艾德）的病人管理。为了促进患者管理和遵循循证医学，医院引入临床路径作为工具，以确保患者获得最适当的护理。这些途径是根据临床实践指南制定的，它们概述了一系列时间临床评价和干预措施。在这个意义上，路径是决策过程的规定性模型，其中各个任务对应于不同的、依赖时间的活动。虽然有临床DSS创建支持一次一个活动，没有设计方法，提供全面的支持一组活动。本提案中所述研究的目的是开发一种设计元DSS的方法，该方法汇集了不同的支持需求和能力，从而支持整个决策过程。我们将创建一个元DSS设计，使用基于语义的多智能体系统工程（O-MaSE）方法，允许建模的问题结构的变化，作为代理之间的相互作用的结果（常见的情况下，患者管理的治疗变化取决于最新的评估和以前的行动）。我们将研究由独立代理人（实体）组成的路径的各个任务，每个任务都有自己的要求和能力。我们将把这些代理建模为“服务”，这些服务应该放在一起以实现共同的目标。我们将使用面向服务的体系结构（SOA）范式，用于连接来自临床路径的松耦合任务以及独立临床DSS提供的支持功能。SOA的实现将涉及任务（服务请求者）的识别和描述，这些任务调用与某些特定临床DSS（服务提供者）相关的个体支持需求。我们正计划使用儿科头部创伤和哮喘的艾德管理的临床路径来评估元DSS设计的能力。