ABSTRACT
An influence diagram (ID) is a method of graphical representation of uncertain knowledge, which can be employed to support decisions in health care using probabilistic reasoning. We aimed to describe the development of an ID to support the decision-making process in phase II at Cardiopulmonary and Metabolic Rehabilitation Program (CPMR). The development of the ID was carried out through the identification of relevant variables and their possible values, as well as the identification of details of each variable, in order to find a network structure that appropriately connects the nodes that represent the variables, with arcs linking acyclic graphs, and to build the graph using specialized knowledge and the conditional probability table for each node in the graph. In spite of the complexity of the interactions, the model obtained with the ID seems to contribute in the decision-making process in phase II CPMR, providing a second opinion to the health pratictioner and helping in diagnostic, therapeutic and decision-making processes, since it is useful in situations with non-linear modeling or with absent or uncertain information.
Subject(s)
Cardiac Rehabilitation , Decision Support Systems, Clinical/organization & administration , Electronic Health Records/organization & administration , Lung Diseases/rehabilitation , Metabolic Diseases/rehabilitation , Software , Brazil , Cardiovascular Diseases/diagnosis , Humans , Lung Diseases/diagnosis , Metabolic Diseases/diagnosis , Therapy, Computer-Assisted/methodsABSTRACT
Distance education has grown in importance with the advent of the internet. An adequate evaluation of students in this mode is still difficult. Distance tests or occasional on-site exams do not meet the needs of evaluation of the learning process for distance education. Bayesian networks are adequate for simulating several aspects of clinical reasoning. The possibility of integrating them in distance education student evaluation has not yet been explored much. The present work describes a Simulator based on probabilistic networks built to represent knowledge of clinical practice guidelines in Family and Community Medicine. The Bayesian Network, the basis of the simulator, was modeled to playable by the student, to give immediate feedback according to pedagogical strategies adapted to the student according to past performance, and to give a broad evaluation of performance at the end of the game. Simulators structured by Bayesian Networks may become alternatives in the evaluation of students of Medical Distance Education.
Subject(s)
Bayes Theorem , Computer-Assisted Instruction/methods , Educational Measurement/methods , High Fidelity Simulation Training/methods , Models, Statistical , Software , Algorithms , Computer Simulation , HumansABSTRACT
A hiperplasia adrenal congênita é um distúrbio enzimático das supra-renais resultante da deficiência de uma das diversas enzimas necessárias para a biossíntese dos esteróides adrenais a partir do colesterol. A deficiência da enzima 21-hidroxilase é responsável pela grande maioria dos casos. Neste trabalho säo revisadas as características clínicas e laboratoriais , o tratamento e o acompanhamento das crianças com hiperplasia adrenal congênita por deficiência da 21-hidroxilase. Discute-se também a importância do conhecimento das bases genéticas para o diagnóstico e tratamento intra-uterino
Subject(s)
Humans , Female , Child , Adrenal Hyperplasia, Congenital/diagnosis , Adrenal Hyperplasia, Congenital/therapy , /deficiency , Prenatal Diagnosis , Virilism/prevention & controlABSTRACT
Alguns equivocos de traducao e o uso inadequado de novos termos descrevendo os ruidos adventicios na ausculta pulmonar sao responsaveis pela falta de padronizacao desta nomenclatura, dificultando a comunicacao na pratica e ensino medicos. Em 382 prontuarios revisados quanto ao registro de ruidos adventicios no momento da internacao no HCPA, foram tabulados 18 termos didtintos utilizados, independentemente da sua frequencia de aparecimento. Em apenas 8 dos 165 prontuarios com registro de ausculta alterada, houve caracterizacao correta dos ruidos quanto ao tempo no ciclo respiratorio. A variabilidade de termos encontrada sugere a falta de padronizacao da nomenclatura da ausculta em nosso meio, bem como a nao utilizacao da terminologia internacional de sons respiratorios existente. Os autores discutem a importancia da uniformizacao destes termos e apresentam a classificacao atualmente proposta
