Integration and Evaluation of Clinical Decision Support Systems for Diagnosis Idopathics Pulmonary Fibrosis (IPF)
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Objectives: The purpose of this study was to develop clinical decision support systems (CDSS) that are integrated with hospital information systems for the differential diagnosis of idiopathic pulmonary fibrosis (IPF). Methods: The integrated CDSS were validated and evaluated by physicians. Knowledge modeling for diagnosing IPF was performed by knowledge working groups, composed of radiologists and respiratory specialists. In order to develop the model for CDSS diagnosis, the clinical cases were collected from 290 cases from Seoul National University Hospital and Sevrance Hospital of Yonsei University. For the evaluation of integrated CDSS, interviews were conducted with respiratory specialists and radiologist 2 weeks after applying CDSSs in clinical settings. The CDSS was integrated with the computer vision system (CVS) and diffuse parenchymal lung diseases (DPLD), CDSS developed in our previous project. Results: Eighteen cases diagnosed as IPF were applied to the collection of diagnostic knowledge and the refined knowledge, the former diagnosed 1 case (6%) and the latter diagnosed 14cases (78%). Therefore, the refined knowledge performed better than collected knowledge. The validation results of integrated CDSSs showed that 81 cases (74.3%) were diagnosed correctly. Conclusions: There were 109 cases of IPF diagnosed and initiated on treatment. The significance of this study is in developing integrated CDSS with PACS by acquiring and redefining the knowledge needed for IPF diagnosis. In addition, it is significant for the integration of CDSS to verification and clinical evaluation.
Abstract
Objectives: The purpose of this study was to develop clinical decision support systems (CDSS) that are integrated with hospital information systems for the differential diagnosis of idiopathic pulmonary fibrosis (IPF). Methods: The integrated CDSS were validated and evaluated by physicians. Knowledge modeling for diagnosing IPF was performed by knowledge working groups, composed of radiologists and respiratory specialists. In order to develop the model for CDSS diagnosis, the clinical cases were collected from 290 cases from Seoul National University Hospital and Sevrance Hospital of Yonsei University. For the evaluation of integrated CDSS, interviews were conducted with respiratory specialists and radiologist 2 weeks after applying CDSSs in clinical settings. The CDSS was integrated with the computer vision system (CVS) and diffuse parenchymal lung diseases (DPLD), CDSS developed in our previous project. Results: Eighteen cases diagnosed as IPF were applied to the collection of diagnostic knowledge and the refined knowledge, the former diagnosed 1 case (6%) and the latter diagnosed 14cases (78%). Therefore, the refined knowledge performed better than collected knowledge. The validation results of integrated CDSSs showed that 81 cases (74.3%) were diagnosed correctly. Conclusions: There were 109 cases of IPF diagnosed and initiated on treatment. The significance of this study is in developing integrated CDSS with PACS by acquiring and redefining the knowledge needed for IPF diagnosis. In addition, it is significant for the integration of CDSS to verification and clinical evaluation.
참고문헌 (24)
- Macedo P, "Is there a uniform approach to the management of diffuse parenchymal lung disease (DPLD) in the UK? A national benchmarking exercise", BMC Pulm Med, 7, pp.3~ (2007)
- "Approach to the adult with interstitial lung diseases"[URL]
- Demedts M, "Interstitial lung diseases: an epidemiological overview", Eur Respir J Suppl, 32, pp.2s~16s (2001)
- British Thoracic Society, "The diagnosis, assessment and treatment of diffuse parenchymal lung disease in adults", Thorax, 54, pp.S1~S28 (1999)
- Khalil N, "Idiopathic pulmonary fibrosis: current understanding of the pathogenesis and the status of treatment", CMAJ, 171, pp.153~160 (2004)
- American Thoracic Society, "Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement", Am J Respir Crit Care Med, 161, pp.646~664 (2000)
- Goh NS, "Idiopathic pulmonary fibrosis and related disorders in Respiratory medicine", pp.1557~1566 (2003), Saunders
- Drent M, "Recent advances in the diagnosis and management of nonspecific interstitial pneumonia", Curr Opin Pulm Med, 9, pp.411~417 (2003)
- Demedts M, "ATS", ERS international multidisciplinary consensus classification of the idiopathic interstitial pneumonias, 2002, pp.19, 794~796
- Swensen SJ, "Diffuse lung disease: diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung", Radiology, 205, pp.229~234 (1997)
- American Thoracic Society; European Respiratory Society, "American Thoracic Society", European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias, 2002, pp.165, 277~304
- Liebowitz J, "The handbook of applied expert ssstems", pp.1~20 (1998), CRC Press
- Lee YH, "Integration of clinical decision support system and the computer vision module for the diagnosis of Diffuse interstitial lung disease (DILD)", Journal of Korean Society of Medical Informatics, 11(Supp 1), pp.S65~S69 (2005)
- Geissbuhler A, "Clinical application of the UMLS in a computerized order entry and decisionsupport system", Proc AMIA Symp, pp.320~324 (1998)
- Bontempo C, "The IBM data warehouse architecture", Commun ACM, 41, pp.38~48 (1998)
- "The diagnosis, assessment and treatment of diffuse parenchymal lung disease in adults", Thorax, 54, pp.S1~S14 (1999)
- Hunninghake GW, "Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia", Chest, 124, pp.1215~1223 (2003)
- du Bois RM, "Cryptogenic fibrosing alveolitis", idiopathic pulmonary fibrosis, 2001, pp.32, 43s~55s
- Churg A, "Transbronchial biopsy and usual interstitial pneumonia: a new paradigm?", Chest, 129, pp.1117~1118 (2006)
- White ES, "Pathogenetic mechanisms in usual interstitial pneumonia", idiopathic pulmonary fibrosis, 2003, pp.201, 343~354
- Berbescu EA, "Transbronchial biopsy in usual interstitial pneumonia", Chest, 129, pp.1126~1131 (2006)
- Flaherty KR, "The role of pulmonary function testing in pulmonary fibrosis", Curr Opin Pulm Med, 6, pp.404~410 (2000)
- Erbes R, "Lung function tests in patients with idiopathic pulmonary fibrosis. Are they helpful for predicting outcome?", Chest, 111, pp.51~57 (1997)
- Hunninghake GW, "Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis", Am J Respir Crit Care Med, 164, pp.193~196 (2001)
