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Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

Velickovski F, Ceccaroni L, Roca J, Burgos F, Galdiz JB, Marina N, Lluch-Ariet M - J Transl Med (2014)

Bottom Line: Web services were integrated in existing health information system platforms.Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management.Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

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ABSTRACT

Background: The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway.

Objectives: The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow.

Methods: The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team.

Results: A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms.

Conclusions: Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

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Adapted incremental software development model for the CDSS.
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Figure 3: Adapted incremental software development model for the CDSS.

Mentions: The CDSS was constructed using an iterative and incremental development model adapted from [41]. Figure 3 shows the main development phases. After the initial requirements specification, and design phase, the framework containing the main CDSS components was developed. Three incremental cycles were completed to develop the CDSS web services, and within each cycle the following phases were executed:


Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

Velickovski F, Ceccaroni L, Roca J, Burgos F, Galdiz JB, Marina N, Lluch-Ariet M - J Transl Med (2014)

Adapted incremental software development model for the CDSS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4255917&req=5

Figure 3: Adapted incremental software development model for the CDSS.
Mentions: The CDSS was constructed using an iterative and incremental development model adapted from [41]. Figure 3 shows the main development phases. After the initial requirements specification, and design phase, the framework containing the main CDSS components was developed. Three incremental cycles were completed to develop the CDSS web services, and within each cycle the following phases were executed:

Bottom Line: Web services were integrated in existing health information system platforms.Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management.Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway.

Objectives: The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow.

Methods: The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team.

Results: A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms.

Conclusions: Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

Show MeSH
Related in: MedlinePlus