AUTOMATED DATABASE-EXPERT SYSTEM FOR ACUTE STROKE

本申请中提出的工作的目的是证明 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 在一个急性护理环境中。 申请书描述了一个五年计划， 开发和实施CMR原型和一套决策支持系统 帮助医生诊断和管理的系统 脑血管疾病 本研究中开发的决策支持系统包括 系统，将定位中风病变的基础上的迹象， 入院时出现的症状，一个程序，将确定什么样的 中风的人已经有，和几个程序，将有助于在 TIA和中风患者的管理。用于创建的信息 和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 将使用实际患者数据对系统进行广泛评估， 纳入综合体系。 这些程序在做出决定时所使用的信息 将由医生在对患者进行初步评估时收集 住进了急性中风病房 计算机接口将 这将允许医生输入这些信息， 完成屏幕上显示的结构化神经评估表 在一个终端。 根据这些信息，计算机系统将生成 一个传统的录取通知，以及代表的信息， 由医生以可以被处理的方式输入 计算机，从而为医生提供了一种有效的方式来记录 解决问题所需的数据和伴随的输入信息 系统自动运行。解决问题的系统将 使用这些信息来表达他们的“意见”，而不需要 与医生的额外互动。

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.