CN117409922A - Evidence-based method for clinical aid decision making - Google Patents
Evidence-based method for clinical aid decision making Download PDFInfo
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- CN117409922A CN117409922A CN202311414817.9A CN202311414817A CN117409922A CN 117409922 A CN117409922 A CN 117409922A CN 202311414817 A CN202311414817 A CN 202311414817A CN 117409922 A CN117409922 A CN 117409922A
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Abstract
A evidence-based method for clinical aid decision making, the evidence-based method for clinical aid decision making characterized by: the method comprises a meta evidence base establishing step and an auxiliary decision making step; specifically, a meta-evidence library for inputting meta-evidence is established; structuring medical document content related to traditional Chinese medicine and structuring medical document content related to Western medicine; inputting the data for auxiliary decision and the data for comparison into a meta-evidence library in a periodic and/or instant mode; taking the data for auxiliary decision as a retrieval item to carry out evidence retrieval on the meta-evidence library; the META-evidence library adopts a dot line topology mode to correlate clinical manifestation, intervention measures, comparison measures, ending indexes and data for auxiliary decision making in the search result, and a system evaluation result is obtained through META analysis to assist decision making. The western medicine evidence is better used by comparing the result of the Chinese and western medicine evidence with the evaluation result, and effective auxiliary diagnosis evidence is provided for Chinese medicine diagnosis.
Description
Technical Field
The invention relates to the technical field of medical diagnosis evidence-based methods, in particular to an evidence-based method for clinical auxiliary decision making.
Background
Evidence-based medicine is a very important means for diagnosis assistance, particularly for traditional Chinese medicine, the intervention of evidence-based medicine is very important, and the prior traditional Chinese medicine clinical assistance decision-making is generally adopted as an expert system, namely, analysis summary is carried out through technical means according to the clinical experience of ancient doctors, and the expert system is taken as a decision basis. The method does not accord with the evidence-based principle, and does not effectively utilize a great amount of existing clinical research results which are scientifically designed and implemented, which is not beneficial to the modern development of the clinical science of traditional Chinese medicine to a certain extent.
The system comprises a data preprocessing module, a data importing and updating module, an electronic medical record module, a diagnosis decision module, a treatment decision module, a system auxiliary module, a result output module and a database. The invention integrates the decision mechanism of evidence-based medicine into a CDSS decision scheme, takes evidence utilization as a core, embeds an electronic medical record technology in an acupuncture clinical diagnosis and treatment process, integrates an evidence-based database and a data mining model, builds an acupuncture clinical evidence-based auxiliary support system integrating evaluation, storage, analysis and utilization of acupuncture research evidence, and provides a convenient and rapid human-computer interaction platform for effective utilization of the acupuncture research evidence. The main emphasis of the technology is still on the evidence leading-in mode of the traditional Chinese medicine, and western medicine evidence cannot be effectively used as evidence support of the traditional Chinese medicine evidence-based system.
Disclosure of Invention
The invention aims to provide a evidence-based method and a system for clinical auxiliary decision making, which are used for better providing effective auxiliary diagnosis evidence for traditional Chinese medicine diagnosis by reasonably managing the data of traditional Chinese medicine evidence and western medicine evidence and fusing the result of the traditional Chinese medicine evidence and the western medicine evidence with the evaluation result.
The technical aim of the invention is realized by the following technical scheme: a evidence-based method for clinical aid decision making, characterized by: the method comprises a meta evidence base establishing step and an auxiliary decision making step;
the meta-evidence library building step comprises the following steps,
establishing a meta-evidence library for entering meta-evidence;
structuring medical literature content related to traditional Chinese medicine to obtain data for auxiliary decision making comprising disease names, clinical manifestations, intervention measures and ending indexes to form data for auxiliary decision making, and structuring medical literature content related to Western medicine to obtain data for comparison comprising disease names, clinical manifestations, comparison measures and comparison ending indexes;
inputting the auxiliary decision data and the comparison data into the meta-evidence library in a periodic and/or instant mode;
the auxiliary decision step comprises the steps of,
performing evidence retrieval on the meta-evidence library by taking at least one or more than two of the clinical manifestation, the intervention measure, the control measure and the ending index as retrieval items;
the META-evidence library is used for associating the clinical manifestation, the intervention measures, the comparison measures, the ending indexes and the data for auxiliary decision making in the retrieval result in a dot line topology mode, and a system evaluation result is obtained through META analysis to assist decision making.
Preferably, the system evaluation result uses decision result selection conditions as priority judgment basis, uses each selection condition as a result major class, and orders and outputs the auxiliary decision data in the result major class.
Preferably, the system evaluation result output includes at least evidence quality, the intervention measure, the comparison measure and the ending index.
Preferably, the output of the ending index includes the control ending index.
Preferably, the decision-making assisting step further comprises the step of establishing an evidence map, wherein the evidence map comprises a coordinate system formed by curative effect comparison and evidence quality, the ending indexes corresponding to each intervention measure or comparison measure are displayed in a coordinate axis in a regular graph mode, and the occupied area of the regular graph in the coordinate system is determined by the corresponding RCT number.
Preferably, the position of the rule pattern corresponding to the ending index in the evidence map is determined by the auxiliary decision data corresponding to the system evaluation result.
Preferably, the curative effect comparison axis of the evidence map is formed by comparing the ending index corresponding to the intervention measure with the comparison ending index corresponding to the comparison measure, and sequentially sorting the comparison results from top to bottom, and the evidence quality axis of the evidence map is formed by sequentially sorting the system evaluation results from top to bottom.
As the preferable mode of the invention, the dot line topology mode is to take disease points, intervention points, result points and test points as nodes to be arranged transversely in sequence, and take the relevance in the data for auxiliary decision as a connecting line basis to carry out dot line connection.
Preferably, the disease point includes the clinical manifestation and the disease name, the intervention point is only an intervention measure, the result point includes the ending index and the comparison ending index, and the test point is only data for auxiliary decision.
In summary, the invention has the following beneficial effects:
according to the invention, the traditional Chinese medicine evidence and the western medicine evidence are structured and then input into the meta-evidence library, so that the data analysis work of the back-end meta-evidence library is facilitated, and the reading efficiency of a user in use can be improved.
According to the invention, the evaluation results sequenced according to the use demands of the user can be output, so that the evaluation results obtained by the user are more fit with the use environment, and the use efficiency is improved.
The invention reasonably constructs the Chinese and Western evidence, and is used for assisting the use of the Chinese medicine evidence by using the Western evidence, thereby improving the readability of the Chinese medicine evidence, and simultaneously, the Western evidence can be used for improving the clinical evidence of the Chinese medicine evidence more systematically.
Drawings
FIG. 1 is a block diagram of the method of the present invention;
FIG. 2 is a diagram of a search term sample;
FIG. 3 is a dotted line topology sample graph;
FIG. 4 is a diagram of data samples for aid decision making;
FIG. 5 is a diagram of data samples for aid decision making;
FIG. 6 is a diagram of data samples for aid decision making;
FIG. 7 is a diagram of an evidence map sample;
FIG. 8 is a sample graph of system evaluation results.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings.
As shown in FIG. 1, in order to solve the problem of unilateral diagnosis result caused by single use of traditional Chinese medicine evidence for clinical auxiliary decision making, the method implemented by the application comprises a meta-evidence library establishment step and an auxiliary decision making step;
the meta-evidence library building step includes the steps of,
establishing a meta-evidence library for entering meta-evidence;
structuring medical literature content relevant to traditional Chinese medicine to obtain auxiliary decision data comprising disease names, clinical manifestations, intervention measures and ending indexes to form auxiliary decision data, wherein recorded information of literature is also in a structuring processing range and is integrated into the auxiliary decision data, and auxiliary decision data samples are shown in fig. 4, 5 and 6, and structuring medical literature content relevant to Western medicine to obtain control data comprising disease names, clinical manifestations, control measures and control ending indexes, wherein the medical literature content relevant to traditional Chinese medicine and Western medicine can be respectively indicated by traditional Chinese medicine evidence and Western medicine evidence;
inputting the data for auxiliary decision and the data for comparison into a meta-evidence library in a periodic and/or instant mode;
the auxiliary decision step comprises the steps of,
at least one or more than two of clinical manifestations, intervention measures, comparison measures and ending indexes are used as search items to search evidence of a meta evidence library, as shown in fig. 2, obesity is used as an example for searching, wherein during searching, different expressions of the same actual expression of traditional Chinese medicine and western medicine are respectively integrated in the clinical manifestations, and a user can select the traditional Chinese medicine expression or the western medicine expression according to habits when using the Chinese medicine and western medicine expression, so that the actual corresponding expression does not generate errors;
the META-evidence library adopts a dot line topology mode to correlate clinical manifestation, intervention measures, comparison measures, ending indexes and data for auxiliary decision making in the search result, and a system evaluation result is obtained through META analysis to assist decision making. In this embodiment, the data for auxiliary decision making is evidence, which is referred to as evidence.
The system evaluation results are based on the decision result selection conditions as the priority judgment basis, each selection condition is used as the result major class, and the auxiliary decision data are ordered and output in the result major class as shown in fig. 8, wherein the decision result selection conditions can be determined according to the problems raised by the main doctor in specific implementation, such as effectiveness, price, side effect and the like, and can be classified into a major class a for effectiveness and value reduction arrangement, a major class B for price and a major class C for side effect and value increase arrangement. The result output mode of the embodiment is convenient for the main doctor to quickly determine the priority evidence according to the main requirement of the patient when the auxiliary decision evidence is called, and is more accurate. And the system evaluation result output at least comprises evidence quality, intervention measures, comparison measures and ending indexes. The output of the ending index comprises comparison of ending indexes, namely, when the expressions of the same result representation in traditional Chinese medicine and Western medicine are inconsistent, the two result expressions are output as ending indexes.
The auxiliary decision step further comprises the step of establishing an evidence map, wherein the evidence map comprises a coordinate system formed by curative effect comparison and evidence quality, the ending indexes corresponding to each intervention measure or comparison measure are displayed in a coordinate axis in a regular graph mode, the larger the area occupied by the regular graph in the coordinate system is, the larger the corresponding graph area is determined by the corresponding RCT number, and meanwhile, in the embodiment shown in fig. 7, the regular graph is implemented in a round mode. The position of the rule graph corresponding to the ending index in the evidence map is determined by the system evaluation result corresponding to the data for auxiliary decision where the ending index is located, as shown in fig. 7, the quality of the evidence of the data for auxiliary decision where the ending index is located in the serum level is determined in the system evaluation, and the specific scheme is as follows. The curative effect comparison shaft of the evidence map is formed by sequentially sequencing the ending index corresponding to the intervention measure and the comparison ending index corresponding to the comparison measure from top to bottom according to the comparison result, and the evidence quality shaft of the evidence map is formed by sequentially sequencing the system evaluation result from top to bottom.
The dot line topology mode is to take disease points, intervention points, result points and test points as nodes to be arranged transversely in sequence, as shown in fig. 3, and to take the relevance in the data for auxiliary decision as a connecting line basis to connect the dot lines. Disease points comprise clinical manifestations and disease names, intervention points are only intervention measures, result points comprise ending indexes and comparison ending indexes, and test points are only data for auxiliary decision making.
The embodiment can further record the comparison content of each evidence map, and record the disease name, clinical manifestation, intervention measure and ending index in the medical literature content related to traditional Chinese medicine and the medical literature content related to Western medicine to obtain the comparison result comprising the disease name, clinical manifestation, comparison measure and comparison ending index, so as to obtain the data association comparison table of the traditional Chinese medicine evidence and the Western medicine evidence, which can help doctors to know the association and difference of the traditional Chinese medicine and the Western medicine more conveniently, and provide effective data assistance for improving the traditional Chinese medicine theory system and guiding the modern medical theory system.
The present embodiment is only for explanation of the present invention and is not to be construed as limiting the present invention, and modifications to the present embodiment, which may not creatively contribute to the present invention as required by those skilled in the art after reading the present specification, are all protected by patent laws within the scope of claims of the present invention.
Claims (9)
1. A evidence-based method for clinical aid decision making, characterized by: the method comprises a meta evidence base establishing step and an auxiliary decision making step;
the meta-evidence library building step comprises the following steps,
establishing a meta-evidence library for entering meta-evidence;
structuring medical literature content related to traditional Chinese medicine to obtain data for auxiliary decision making comprising disease names, clinical manifestations, intervention measures and ending indexes to form data for auxiliary decision making, and structuring medical literature content related to Western medicine to obtain data for comparison comprising disease names, clinical manifestations, comparison measures and comparison ending indexes;
inputting the auxiliary decision data and the comparison data into the meta-evidence library in a periodic and/or instant mode;
the auxiliary decision step comprises the steps of,
performing evidence retrieval on the meta-evidence library by taking at least one or more than two of the clinical manifestation, the intervention measure, the control measure and the ending index as retrieval items;
the META-evidence library is used for associating the clinical manifestation, the intervention measures, the comparison measures, the ending indexes and the data for auxiliary decision making in the retrieval result in a dot line topology mode, and a system evaluation result is obtained through META analysis to assist decision making.
2. A evidence-based method for clinical aid decision making according to claim 1, wherein: and the system evaluation result takes decision result selection conditions as priority judgment basis, takes each selection condition as a result major class, and sorts and outputs the auxiliary decision data in the result major class.
3. A evidence-based method for clinical aid decision making according to claim 1 or 2, characterized in that: the system evaluation result output at least comprises evidence quality, the intervention measures, the comparison measures and the ending index.
4. A evidence-based method for clinical aid decision making according to claim 3, wherein: the ending index comprises the comparison ending index when being output.
5. A evidence-based method for clinical aid decision making according to claim 2, wherein: the auxiliary decision step also comprises the step of establishing an evidence map, wherein the evidence map comprises a coordinate system formed by curative effect comparison and evidence quality, the ending indexes corresponding to each intervention measure or contrast measure are displayed in a coordinate axis in a regular graph mode, and the occupied area of the regular graph in the coordinate system is determined by the corresponding RCT number.
6. A evidence-based method for clinical aid decision making according to claim 5, wherein: the position of the rule graph corresponding to the ending index in the evidence map is determined by the data for auxiliary decision corresponding to the system evaluation result of the ending index.
7. A evidence-based method for clinical aid decision making according to claim 5, wherein: the curative effect comparison shaft of the evidence map is formed by comparing the ending index corresponding to the intervention measure with the comparison ending index corresponding to the comparison measure, and sequentially sequencing the comparison results from top to bottom, and the evidence quality shaft of the evidence map is formed by sequentially sequencing the system evaluation results from top to bottom.
8. A evidence-based method for clinical aid decision making according to claim 1, wherein: the point line topology mode is to take disease points, intervention points, result points and test points as nodes to be arranged transversely in sequence, and the relevance in the data for auxiliary decision is taken as a connecting line basis to carry out point line connection.
9. A evidence-based method for clinical aid decision making according to claim 1, wherein: the disease points comprise the clinical manifestation and the disease name, the intervention points are only intervention measures, the result points comprise the ending indexes and the comparison ending indexes, and the test points are only data for auxiliary decision making.
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117747092A (en) * | 2024-02-20 | 2024-03-22 | 天津医科大学总医院 | Orthopedics image auxiliary detection system and method based on data analysis |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117747092A (en) * | 2024-02-20 | 2024-03-22 | 天津医科大学总医院 | Orthopedics image auxiliary detection system and method based on data analysis |
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