Monday, June 17, 2013

Artificial Intelligence in Medicine


Clinical Decision Support System (CDSS)



Today computerised power is moving towards assisting in medical diagnosis.
Computer software designed to assist physicians and other health professionals with quick guidance in decision making into the diagnosis of patients' condition and treatment.

A clinical decision support system is an active knowledge system which uses two or more items of patient data to generate case-specific advice. A CDSS makes suggestions of outputs or a set of clinical outputs from the patient data for the clinician to make appropriate diagnoses.  Doctors use these systems at point of care to help them as either in pre-diagnoses, during diagnoses, or post diagnoses.

Pre-diagnoses CDSS systems are used to help the physician prepare the diagnoses. CDSS used during diagnoses help review and filter the physician’s preliminary diagnostic choices to improve their final results. And post-diagnoses CDSS systems are used to mine data to derive connections between patients and their past medical history and clinical research to predict future events.

Knowledge-Based CDSS

Most CDSS consist of three parts, the knowledge base, inference engine, and mechanism to communicate.

The knowledge base contains the rules and associations of compiled data which most often take the form of IF-THEN rules. If this was a system for determining drug interactions, then a rule might be that IF drug X is taken AND drug Y is taken THEN alert user. Using another interface, an advanced user could edit the knowledge base to keep it up to date with new drugs.

The inference engine combines the rules from the knowledge base with the patient’s data.

The communication mechanism will allow the system to show the results to the user as well as have input into the system

Non-Knowledge-Based CDSS

CDSS uses a form of  artificial intelligence called machine learning, which allow computers to learn from past experiences and/or find patterns in clinical data.


Electronic Medical Records (EMR) and CDSS

By incorporating EMR and CDSS it has the potential to change the way medicine has been taught and practiced . As it is said that, “the highest level of the EMR is a CDSS”.
Since “CDSS are computer systems designed to impact clinician decision making about individual patients at the point in time that these decisions are made”, the reasons can be seen why it would be beneficial to have a fully integrated CDSS and EMR.

Even though the benefits can be seen, to fully implement a CDSS within an EMR, it will require significant planning by the healthcare facility/organisation, in order for the purpose of the CDSS to be successful and effective. The success and effectiveness can be measured by the increase in patient care being delivered and reduced adverse events occurring. In addition to this, there would be a saving of time, resources, autonomy and financial benefits to the healthcare facility/organisation.


Benefits of CDSS and EMR

There has always been errors that occur within the healthcare industry, thus trying to minimise them as much as possible in order to provide quality patient care. Three areas that can be addressed with the implementation of CDSS and Electronic Medical Records (EMRs), are:
  1. Medical error
  2. Medication error
  3. Adverse drug events
CDSS will be most beneficial once the healthcare facility is 100% electronic thus simplifying the number of modifications that have to occur to ensure that all the systems are up to date.


Reference: en.wikipedia,org/wiki/clinical_decision_support_system