Automated Conflict Resolution in Clinical Pathways

据估计，到2018年，英国患有三种或三种以上长期疾病（也称为多发性硬化症）的人数将从190万增加到290万。各种慢性病是由于吸烟、饮食、衰老和缺乏活动等共同风险因素而同时发展起来的。四种最常见的慢性病是癌症、慢性阻塞性肺病、冠心病和糖尿病。最近的一项研究发现，超过97%的中度至重度COPD患者至少有一种伴随慢性疾病。 在临床环境中，过程是复杂的，并受到许多社会，技术和组织因素的影响。这种复杂性可能导致医生如何实践，记录适当的护理以及管理医疗保健成本的变化。为了减少不一致，临床指南已经出现了基于现有的最佳证据，旨在支持临床工作人员和提高医疗质量。目前的指南几乎完全集中在单一的条件。因此，对患者应用多个指南可能会导致相互矛盾的护理建议。在软件系统设计和开发中，我们创建能够支持环境/用户和系统之间的各种交互的计算机系统。这些互动往往反映不同的和可能相互冲突的观点，如不同用户或利益相关者提出的观点。虽然软件系统规范和患者护理指南看起来不同，但本质上它们有一些共同之处。在这两种情况下，我们都有（部分）有序的动作序列（也称为活动或任务）的过程和执行，在计算机科学中称为“执行痕迹”，在临床实践中称为“路径”。在基于计算机的系统的情况下，动作由用户或计算机（更具体地，系统中的各个组件或对象）执行。在护理指南方面，由医生、病人和护理人员采取行动。在这两种情况下，当个别处决和途径不相容时，可能会产生冲突。在这项提案中，我们研究了多病临床路径中冲突检测的自动化方法，并提出了解决方案。

By 2018, it is estimated that the number of people in the UK with three or more long-term conditions, also known as multimorbidity , will have grown from 1.9 million to 2.9 million. Various chronic diseases develop simultaneously in response to common risk factors such as smoking, diet, ageing and inactivity. The four most common chronic diseases are cancer, chronic obstructive pulmonary disease (COPD), coronary heart disease and diabetes. A recent study found that over 97% of patients with moderate to severe COPD had at least one concomitant chronic disease. In clinical settings processes are complex and are influenced by a number of social, technical and organisational factors. This complexity can result in variation in how physicians practice, appropriate care is documented, and healthcare costs managed. To reduce inconsistencies, clinical guidelines have emerged based on the best existing evidence, with the aim to support clinical staff and improve the quality of healthcare. Current guidelines almost entirely focus on single conditions. As a result, applying multiple guidelines to a patient may potentially result in conflicting recommendations for care. In software system design and development, we create computer systems capable to support diverse interactions between the environment/users and the system. These interactions often reflect different and possibly conflicting viewpoints, such as those presented by different users or stakeholders. Although software system specification and patient care guidelines seem different, inherently they have something in common. In both cases we have procedures and executions of (partially) ordered sequence of actions (aka activities or tasks) called "traces of execution" in computer science or "pathways" in clinical practice. In the case of computer-based systems, actions are carried out by users or computers (more specifically individual components or objects in the system). In the case of care guidelines, actions are carried out by physicians, patients and carers. In both cases, conflict may arise when individual executions and pathways are incompatible. In this proposal, we investigate automated methods of detection of conflicts in clinical pathways for multimorbidities and propose solutions that resolve them .