Streamlining patient consultations for sleep disorders with a knowledge-based CDSS

© 2015 Elsevier Ltd. Objectives This paper examines the workflow of sleep physicians during a patient consultation and how an innovative clinical decision support system (CDSS) provides efficiency and effectiveness gains. Methods The CDSS tools consisted of two input applications for patient data, with a knowledge based decision support system developed participatively with physicians and an international panel. An argument tree approach was used to produce diagnostic explanations and an evidence-based report for the physician using medically correct and shared terminology. A usability evaluation using a qualitative approach was carried out to ensure that the CDSS met the physicians information needs, as well as the wider needs of a Sleep Investigation Unit. Results The physicians found the CDSS both useful and usable with clear applications in triage and diagnostic decision-making, and in patient education. Conclusion The CDSS both reduces the time and number of visits needed for consultations, and helps focus consultation on better individual patient care through informed explanation of diagnostic and treatment decisions

Meta-design Knowledge for Clinical Decision Support Systems

Knowledge gained from a Decision Support Systems (DSS) design should ideally be reusable by DSS designers and researchers. The majority of existing DSS research has mainly focused on empirical problem solving rather than on developing principles that could inform solution approaches for other user contexts. Design Science Research (DSR) has contributed to effective development of various innovative DSS artifacts and associated knowledge development, but there has been limited progress on new knowledge development from a practical problem context, going beyond product and process descriptions. For DSS applications such as Clinical Decision Support Systems (CDSS) design and development, relevant reusable prescriptive knowledge is of significance not only to understand mutability but also to extend application of theory across domains. In this paper, we develop new design knowledge abstracted from the approach taken in a representative case of innovative CDSS development, specified as an architecture and six design principles. The CDSS design artifact was initially designed for a specific clinical need is shown to be flexible for meeting demands of knowledge production both for diagnosis and treatment. It is argued that the proposed general strategy is applicable to designing CDSS artifacts in similar problem domains representing an important contribution of design knowledge both in DSS and DSR fields

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

An investigation into inductive parameter learning in complex hierarchical knowledge structures representing clinical expertise

This dissertation investigates the very important and current problem of modelling human expertise. This is an apparent issue in any computer system emulating human decision making. It is prominent in Clinical Decision Support Systems (CDSS) due to the complexity of the induction process and the vast number of parameters in most cases. Other issues such as human error and missing or incomplete data present further challenges. In this thesis, the Galatean Risk Screening Tool (GRiST) is used as an example of modelling clinical expertise and parameter elicitation. The tool is a mental health clinical record management system with a top layer of decision support capabilities. It is currently being deployed by several NHS mental health trusts across the UK. The aim of the research is to investigate the problem of parameter elicitation by inducing them from real clinical data rather than from the human experts who provided the decision model. The induced parameters provide an insight into both the data relationships and how experts make decisions themselves. The outcomes help further understand human decision making and, in particular, help GRiST provide more accurate emulations of risk judgements. Although the algorithms and methods presented in this dissertation are applied to GRiST, they can be adopted for other human knowledge engineering domains

An investigation into inductive parameter learning in complex hierarchical knowledge structures representing clinical expertise

This dissertation investigates the very important and current problem of modelling human expertise. This is an apparent issue in any computer system emulating human decision making. It is prominent in Clinical Decision Support Systems (CDSS) due to the complexity of the induction process and the vast number of parameters in most cases. Other issues such as human error and missing or incomplete data present further challenges. In this thesis, the Galatean Risk Screening Tool (GRiST) is used as an example of modelling clinical expertise and parameter elicitation. The tool is a mental health clinical record management system with a top layer of decision support capabilities. It is currently being deployed by several NHS mental health trusts across the UK. The aim of the research is to investigate the problem of parameter elicitation by inducing them from real clinical data rather than from the human experts who provided the decision model. The induced parameters provide an insight into both the data relationships and how experts make decisions themselves. The outcomes help further understand human decision making and, in particular, help GRiST provide more accurate emulations of risk judgements. Although the algorithms and methods presented in this dissertation are applied to GRiST, they can be adopted for other human knowledge engineering domains.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

An investigation into inductive parameter learning in complex hierarchical knowledge structures representing clinical expertise

This dissertation investigates the very important and current problem of modelling human expertise. This is an apparent issue in any computer system emulating human decision making. It is prominent in Clinical Decision Support Systems (CDSS) due to the complexity of the induction process and the vast number of parameters in most cases. Other issues such as human error and missing or incomplete data present further challenges. In this thesis, the Galatean Risk Screening Tool (GRiST) is used as an example of modelling clinical expertise and parameter elicitation. The tool is a mental health clinical record management system with a top layer of decision support capabilities. It is currently being deployed by several NHS mental health trusts across the UK. The aim of the research is to investigate the problem of parameter elicitation by inducing them from real clinical data rather than from the human experts who provided the decision model. The induced parameters provide an insight into both the data relationships and how experts make decisions themselves. The outcomes help further understand human decision making and, in particular, help GRiST provide more accurate emulations of risk judgements. Although the algorithms and methods presented in this dissertation are applied to GRiST, they can be adopted for other human knowledge engineering domains.EThOS - Electronic Theses Online ServiceGBUnited Kingdo