Ιατρικοί αλγόριθμοι – Συστήματα υποστήριξης απόφασης
Θυμάμαι που στο μεταπτυχιακό έπρεπε να υλοποιήσουμε ένα έμπειρο σύστημα – expert system, βασισμένο σε κάποιον ιατρικό αλγόριθμο – medical algorithm. Για ένα “μη γιατρό” έχουν πολύ ενδιαφέρον τα μονοπάτια σκέψης που πρέπει να πάρει o ειδικός-γιατρός προκειμένου να διαγνώσει κάποια ασθένεια ή να πάρει μια ιατρική απόφαση. Οι παραπάνω αλγόριθμοι χρησιμοποιούνται για την κατασκευή medical expert systems, όπως τα CADUCEUS, Mycin, STD Wizard είτε για την κατασκευή ιατρικών συστημάτων υποστήριξης απόφασης – Decision Support System (DSS), των Clinical Decision Sypport Systems (CDSS). Πριν δώσω link με resources για τα παραπάνω, μερικά λόγια για αυτά:
A medical algorithm is any computation, formula, statistical survey, nomogram, or look-up table, useful in healthcare. Medical algorithms include decision tree approaches to healthcare treatment (i.e., if symptoms A, B, and C are evident, then use treatment X) and also less clear-cut tools aimed at reducing or defining uncertainty. Medical algorithms are part of a broader field which is usually fit under the aims of medical informatics and medical decision making. Medical decisions occur in several areas of medical activity including medical test selection, diagnosis, therapy and prognosis, and automatic control of medical equipment.
An expert system is a software system that attempts to reproduce the performance of one or more human experts, most commonly in a specific problem domain, and is a traditional application and/or subfield of artificial intelligence. A wide variety of methods can be used to simulate the performance of the expert however common to most or all are 1) the creation of a so-called “knowledgebase” which uses some knowledge representation formalism to capture the subject matter experts (SME) knowledge and 2) a process of gathering that knowledge from the SME and codifying it according to the formalism, which is called knowledge engineering. Expert systems may or may not have learning components but a third common element is that once the system is developed it is proven by being placed in the same real world problem solving situation as the human SME, typically as an aid to human workers or a supplement to some information system.
Clinical (or diagnostic) decision support systems (CDSS) are interactive computer programs, which are designed to assist physicians and other health professionals with decision making tasks. The basic components of a CDSS include a dynamic (medical) knowledge base and an inferencing mechanism (usually a set of rules derived from the experts and evidence-based medicine) and implemented through medical logic modules based on a language such as Arden syntax. It could be based on Expert systems or artificial neural networks or both (connectionist expert systems).
Τέτοιους ιατρικούς αλγόριθμους, καθώς και υλοποιήσεις τους μπορεί να βρει κάποιος στα παρακάτω link:
- Medal.org: “The Medical Algorithms Project”
- TMAP: “Texas Medication Algorithm Project“
- Lists of Psychopharmacology Algorithms
- OpenClinical – Clinical Zone: The Clinical zone currently focuses on computerised applications (particularly decisions support systems) and technologies for healthcare.
- OpenClinical – Decision Support Systems background: Clinical decision support systems (CDSSs) form a significant part of the field of clinical knowledge management technologies through their capacity to support the clinical process and use of knowledge, from diagnosis and investigation through treatment and long-term care.