Research on knowledge reasoning of TCM based on knowledge graphs / 数字中医药（英文）

@#With the widespread use of Internet, the amount of data in the field of traditional Chinese medicine (TCM) is growing exponentially. Consequently, there is much attention on the collection of useful knowledge as well as its effective organization and expression. Knowledge graphs have thus emerged, and knowledge reasoning based on this tool has become one of the hot spots of research. This paper first presents a brief introduction to the development of knowledge graphs and knowledge reasoning, and explores the significance of knowledge reasoning. Secondly, the mainstream knowledge reasoning methods, including knowledge reasoning based on traditional rules, knowledge reasoning based on distributed feature representation, and knowledge reasoning based on neural networks are introduced. Then, using stroke as an example, the knowledge reasoning methods are expounded, the principles and characteristics of commonly used knowledge reasoning methods are summarized, and the research and applications of knowledge reasoning techniques in TCM in recent years are sorted out. Finally, we summarize the problems faced in the development of knowledge reasoning in TCM, and put forward the importance of constructing a knowledge reasoning model suitable for the field of TCM.

Research on application of intelligent assistant decision-making in the five-level triage of pediatric emer-gency department / 中国小儿急救医学

Objective To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department. Methods The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month. In March 2018,17 900 cases were in the traditional group,and in April 2018,18 590 cases were in the intelligent group. The traditional group conducted manual triage accord-ing to the five-level pre-screening and triage standard. The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system. Intelligent assistant decision-making included au-tomatic identification of whether vital signs data was abnormal and automatic provision of basis for triage lev-el to help nurses confirm two major functions. The patients′information were collected according to the estab-lished content,and the system would automatically identify and present according to the corresponding triage basis to determine the triage level. The two groups of children were compared and analyzed in terms of dis-ease distribution,triage level,triage accuracy. The clinical application effect of the emergency pediatric pre-check triage system was evaluated. Results There was no significant difference in disease distribution be-tween the two groups. The top three were respiratory diseases,infectious diseases and digestive diseases. In the comparison of waiting time between the two groups,the waiting time of grade Ⅲ,Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group,the difference was statistically significant (P<0. 05). The consistency of triage grade in the intelligent group was higher than that in the traditional group. The family satisfaction of children in the intelligent group ofⅢ,Ⅳ,andⅤgrade was higher than that in the traditional group. Conclusion The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses,ensure the effectiveness of the triage and the safety of the children,and improve the satisfaction of family members.

Research on application of intelligent assistant decision-making in the five-level triage of pediatric emergency department / 中国小儿急救医学

Objective@#To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department.@*Methods@#The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month.In March 2018, 17 900 cases were in the traditional group, and in April 2018, 18 590 cases were in the intelligent group.The traditional group conducted manual triage according to the five-level pre-screening and triage standard.The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system.Intelligent assistant decision-making included automatic identification of whether vital signs data was abnormal and automatic provision of basis for triage level to help nurses confirm two major functions.The patients′ information were collected according to the established content, and the system would automatically identify and present according to the corresponding triage basis to determine the triage level.The two groups of children were compared and analyzed in terms of disease distribution, triage level, triage accuracy.The clinical application effect of the emergency pediatric pre-check triage system was evaluated.@*Results@#There was no significant difference in disease distribution between the two groups.The top three were respiratory diseases, infectious diseases and digestive diseases.In the comparison of waiting time between the two groups, the waiting time of grade Ⅲ, Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group, the difference was statistically significant (P<0.05). The consistency of triage grade in the intelligent group was higher than that in the traditional group.The family satisfaction of children in the intelligent group of Ⅲ, Ⅳ, and Ⅴ grade was higher than that in the traditional group.@*Conclusion@#The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses, ensure the effectiveness of the triage and the safety of the children, and improve the satisfaction of family members.

Public Health Informatics: A Brief Review of the Field.

In the global community of today, the importance of accessing timely and relevant information has increased in value. However, with the exponential increase in data and data sources, innovations to monitor, control, and effectively manipulate data are required, especially to resolve current mysteries. In addition, with the sophistication of informatics systems, consumers are becoming curious to learn about the technology for their own benefit. In learning information technology, tools become available that gives the consumers ideas and knowledge in conducting research about their health and other health information data. For clinicians it is highly useful to become knowledgeable about health information system as well as larger public health issues. PHI is highly utilized in many global health organizations, government agencies, and medical organizations across the United States as well as in the world.

Expert System Shells for Rapid Clinical Decision Support Module Development: An ESTA Demonstration of a Simple Rule-Based System for the Diagnosis of Vaginal Discharge / 대한의료정보학회지

OBJECTIVES: This study demonstrates the feasibility of using expert system shells for rapid clinical decision support module development. METHODS: A readily available expert system shell was used to build a simple rule-based system for the crude diagnosis of vaginal discharge. Pictures and 'canned text explanations' are extensively used throughout the program to enhance its intuitiveness and educational dimension. All the steps involved in developing the system are documented. RESULTS: The system runs under Microsoft Windows and is available as a free download at http://healthcybermap.org/vagdisch.zip (the distribution archive includes both the program's executable and the commented knowledge base source as a text document). The limitations of the demonstration system, such as the lack of provisions for assessing uncertainty or various degrees of severity of a sign or symptom, are discussed in detail. Ways of improving the system, such as porting it to the Web and packaging it as an app for smartphones and tablets, are also presented. CONCLUSIONS: An easy-to-use expert system shell enables clinicians to rapidly become their own 'knowledge engineers' and develop concise evidence-based decision support modules of simple to moderate complexity, targeting clinical practitioners, medical and nursing students, as well as patients, their lay carers and the general public (where appropriate). In the spirit of the social Web, it is hoped that an online repository can be created to peer review, share and re-use knowledge base modules covering various clinical problems and algorithms, as a service to the clinical community.

Análise computacional da textura de tumores de mama em imagens por ultrassom de pacientes submetidas a cirurgia conservadora / Computer-assisted analysis of breast tumors texture on sonographic images of patients submitted to breast-conserving surgery

OBJETIVO: Avaliar as características de textura de lesões de mama em imagens por ultrassom de pacientes submetidas a cirurgia conservadora que apresentaram, ou não, recidiva. MATERIAIS E MÉTODOS: As imagens de ultrassom de 36 pacientes submetidas a cirurgia conservadora, com 12 tendo apresentado recidiva local e 24 que não apresentaram recidiva no local da cirurgia, foram divididas em: 3 malignas na mama oposta, 7 nódulos benignos, 5 hiperplasias atípicas e 9 alterações fibrocísticas. A textura das lesões foi quantificada utilizando-se dez parâmetros calculados da matriz de coocorrência e da curva de complexidade. Análise discriminante linear foi aplicada aos parâmetros para discriminação de lesões de mama em pacientes submetidas a cirurgia conservadora que apresentaram, ou não, recidiva. RESULTADOS: Avaliando-se a capacidade dos parâmetros em distinguir as recidivas do grupo composto por lesões não recidivas benignas e hiperplasias atípicas, obteve-se especificidade de 100 por cento, com valores de acurácia e sensibilidade superiores a 91 por cento. Num segundo teste, foi possível distinguir as cinco hiperplasias, das lesões não recidivas benignas. CONCLUSÃO: Apesar do número reduzido de casos, os resultados obtidos são encorajadores, sugerindo que o uso da quantificação da textura pode auxiliar na diferenciação entre lesões benignas, hiperplasias atípicas e lesões malignas de origem recidiva.

OBJECTIVE: The purpose of this study was to assess the features of breast lesion texture on sonographic images of patients submitted to breast-conserving surgery, with or without tumor recurrence. MATERIALS AND METHODS: Sonographic images of 36 patients submitted to conservative surgery for breast cancer, 12 of them with, and 24 without local recurrence, included 3 contralateral malignant lesions, 7 benign lumps (3 cysts and 4 fibroadenomas), 5 atypical hyperplasias and 9 fibrocystic changes. The quantification of features of breast lesion texture was based on ten parameters calculated from gray-level co-occurrence matrix and complexity curve. Linear discriminant analysis was applied to the texture parameters for differentiating between breast lesions in women submitted to conservative surgery with and without tumor recurrence. RESULTS: The assessment of performance of texture parameters in distinguishing lesion recurrences in a group including benign lumps and atypical hyperplasias demonstrated specificity of 100 percent, and accuracy and sensitivity > 91 percent. Another test demonstrated that texture parameters were useful in the differentiation between atypical hyperplasias and benign lumps. CONCLUSION: Despite the limited number of cases, the present results can be considered as promising, suggesting that texture parameters may help in the differentiation among benign lumps, atypical hyperplasias and recurrent malignant lesions.

Modelos empleados para la toma de decisiones en el cuidado de la salud / Models used for decision-making in health care

El análisis de decisiones es un grupo de herramientas que permiten apoyar y manejar un proceso de evaluación estructurado. Esta metodología se usa ampliamente en la evaluación económica para planeación o programas de salud. Este artículo delinea algunas características de las decisiones complejas y muestra los fundamentos y etapas que deben considerarse cuando se toman decisiones en un escenario de incertidumbre (definición del problema, selección de un marco temporal de análisis adecuado, estructuración del problema, desarrollo de un modelo para análisis, selección de la mejor alternativa y realización de análisis de sensibilidad). Finalmente se presentan algunas críticas que se han hecho a esta metodología.

Decision analysis consists of a set of tools supporting and handling structured evaluation. Such methodology is widely used for the economic evaluation of health care planning and programmes. This article outlines some characteristics regarding complex decision-making and shows the fundamental issues and stages considered when making decisions in an uncertain scenario (problem definition, choosing an appropriate time-frame, structuring the problem, developing a model for analysing it, selecting the best alternative and analysing sensitivity). Some criticism of this decision-making method is then made.