ABSTRACT
Clinical expertise, patient preference, and the best evidence are the three elements of evidence-based medicine. Based on high-level and high-quality evidence, qualitative and quantitative analysis of the prescribing decisions of physicians is beneficial to improving clinical efficacy. A mature methodological system is available for the retrieval, analysis, summary, evaluation, and recommendation of the evidence, but there are still few studies on physicians' prescribing decisions. How to analyze the trend of physicians' prescribing decisions based on the priority ranking in addition and subtraction of prescriptions? Analytic hierarchy process(AHP) is a method for decision making, which arranges the elements of the decision problem into overall goal, criteria, and operational sub-criteria, and uses the matrix eigenvector method to solve the problem. This study aims to analyze the priority of physicians' prescribing decisions for diabetes mellitus with deficiency of both Qi and Yin based on AHP. To be specific, a database of diabetes mellitus cases with deficiency of both Qi and Yin was established and AHP was used to yield the priority ranking of Chinese patent medicine prescriptions in specific clinical scenarios. In the selected cases of diabetes mellitus with deficiency of both Qi and Yin, Xiaoke Pills was the best prescription for the treatment of type 2 diabetes mellitus(deficiency of both Qi and Yin)(normalized=0.388), followed by Liuwei Dihuang Pills(normalized=0.269), Qishen Capsules(normalized=0.230), and Shengmai Injection(normalized=0.113). According to the analysis the available data, for type 2 diabetes mellitus(deficiency of both Qi and Yin), Xiaoke Pills was the most effective prescription in specific scenarios. When the physicians' prescribing decisions are consistent with the evidence, quantitative analysis of physicians' cognition will boost the evidence-based medical decision-making. However, the research results are also affected by the quality of literature, evidence level and priority, which are thus have some limitations. It is recommended that further small data research based on individual cases be carried out to lay a evidence-based basis for the clinical decision-making of type 2 diabetes mellitus.
Subject(s)
Humans , Analytic Hierarchy Process , China , Diabetes Mellitus, Type 2/drug therapy , Drug Prescriptions , Medicine, Chinese Traditional , Nonprescription Drugs/therapeutic use , Qi , Syndrome , Yin Deficiency/drug therapyABSTRACT
Introducción: El Centro Nacional de Toxicología de Cuba, supervisa y controla la información de eventos atribuibles a la inmunización, vacunación e intoxicaciones con medicamentos y plaguicidas. Los casos que llegan al centro, se justifican mayormente por el uso de plaguicidas que tienen un alto nivel de toxicidad y riesgo de muerte. Los especialistas en toxicología, requieren facilidad para revisar las hojas de seguridad, el listado oficial de plaguicidas autorizados en Cuba y los casos anteriores. Esto permite analizar y emitir un diagnóstico, que salve la vida del afectado. Objetivo: Presentar un sistema para la gestión y el análisis de los casos intoxicados por plaguicidas. Métodos: El desarrollo se sustentó en la metodología de software Extreme Programming, modelado con la herramienta CASE Visual Paradigm 8.0 y lenguaje UML 2.0. Se utilizó Java con NetBeans 8.0.2 y como gestor de base de datos PostgreSQL 9.3. Resultados: Se desarrolló una herramienta de gestión de la información toxicológica, así como una base de casos de los síntomas, plaguicidas y diagnóstico por plaguicida. Los especialistas en toxicología cuentan con una herramienta de apoyo a la toma de decisiones, que reduce la ocurrencia de errores humanos(AU)
Introduction: The Cuban National Toxicology Center supervises and controls the information of events attributable to immunization, vaccination and poisonings with medications and pesticides. The cases that arrive at the center are mainly justified by the use of pesticides that have a high level of toxicity and risk of death. Specialists in toxicology require ease to review the safety sheets, the official list of authorized pesticides in Cuba and the above cases. This allows analyzing and issuing a diagnosis that saves the life of the affected person. Objective: To present a system for the management and analysis of cases poisoned by pesticides. Methods: The development was based on the Extreme Programming software methodology, modeled with the CASE Visual Paradigm 8.0 tool and the UML 2.0 language. Java was used with NetBeans 8.0.2 and as PostgreSQL 9.3 database manager. Results: A toxicological information management tool was developed, as well as a case database of symptoms, pesticides and pesticide diagnosis. Toxicology specialists have a decision support tool that reduces the occurrence of human errors(AU)
Subject(s)
Humans , Male , Female , Pesticides/adverse effects , Pesticides/poisoning , Software/standards , CubaABSTRACT
ABSTRACT The present article focuses on the construction of an Intelligent System for the Project Start-Stop Logic of Hydropower Plants, work carried out as master dissertation, allowing the retention of knowledge of previous cases which set a valuable intellectual capital, organizing knowledge generated by specialists and consultants of the area. The tool aims at saving time as well as standardizing solutions, allowing future developments for the construction of other necessary logic (such as those related to asset management and tools to aid the operation and maintenance of hydroelectric power plants). The MyCBR, software that proved to be of easy programming, but with some limitations, is used for such an attempt of a shell of current use. The recovery of the cases based on calculations of global and local similarity allows the selection of solutions already used in hydroelectric plants with analogous technological solutions. The results were satisfactory in view of the periodicity of the use of the tool and the possibility of increasing the case base as the logics are implemented in other projects, besides allowing the inclusion of other logics and documentation pertinent to the Hydropower Plants.
Subject(s)
Artificial Intelligence , Hydroelectric Power Plants (Environmental Health)/economics , Logic , Case-Control StudiesABSTRACT
La Hipertensión Arterial (HTA) es uno de los problemas de salud complejos frecuentes en nuestro Cuba y el mundo, pues constituye el principal factor de riesgo en las enfermedades cardiovasculares y cerebrales. El presente trabajo aborda una herramienta informática que ayuda a la determinación de acciones de salud relacionadas con la Hipertensión Arterial en la Atención Primaria de Salud a través del Procesamiento Analítico en Línea y el Razonamiento Basado en Casos. El sistema es validado mediante análisis de criterio de expertos, los cuales concuerdan en un 99 por ciento de confianza(AU)
Hypertension (HTA) is one of the complex health problems prevalent in Cuba and the world. It is the main risk factor for cardiovascular disease and stroke. This paper deals with a software tool that helps determine health actions related to hypertension in primary health care through the Online Analytical Processing and Case Based Reasoning. The system is validated through expert analysis approaches, which consider it is 99 percent reliable(AU)
Subject(s)
Humans , Male , Female , Medical Informatics Applications , Software/standards , Community Health Services , Hypertension/diagnosis , CubaABSTRACT
Real world clinical diagnosis and treatment activity is a complicated decision-making task. The effective clinical cases of traditional Chinese medicine (TCM) of highly experienced physicians play an important role in the routine diagnosis and treatment and the formulation of medical knowledge . Based on TCM electronic medical record data, this paper proposed a decision support prototype system on TCM clinical diagnosis and treatment based on TCM effective clinical cases and case-based reasoning (CBR) algorithm, which is used to assist inexperienced clinicians to make more reliable clinical decisions, and thereafter to improve the clinical curative effectiveness. The system integrates TCM clinical cases data set from a TCM clinical data warehouse, and retrieves the similar cases based on CBR method. In particular, according to the underlying personalized diagnosis and treatment for patients in TCM, this system implemented a flexible diagnosis and treatment modification mechanism based on correlation analysis among symptoms, diagnoses (syndrome or pattern in TCM) and medicine. Finally, through a demonstration of clinical application, we made an initial evaluation of the usefulness and practical effects of the system.