CN111584095B - Auxiliary support system for participating in treatment decision of primary liver cancer patient - Google Patents
Auxiliary support system for participating in treatment decision of primary liver cancer patient Download PDFInfo
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- CN111584095B CN111584095B CN202010316408.5A CN202010316408A CN111584095B CN 111584095 B CN111584095 B CN 111584095B CN 202010316408 A CN202010316408 A CN 202010316408A CN 111584095 B CN111584095 B CN 111584095B
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- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H80/00—ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
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Abstract
The invention discloses an auxiliary support system for the participation of a primary liver cancer patient in treatment decision, which presents information data of different treatment schemes of the primary liver cancer to the patient through a data storage device by means of a mobile technology, assists the patient in participating in treatment decision path selection according to different treatment schemes selectable by each patient, makes the patient clear the self tendency selection in a plurality of selectable treatment schemes, and makes the treatment scheme selection most suitable for the patient by combining the opinions and suggestions of a clinician. The invention provides detailed information data of the patient about liver cancer treatment, can help the patient to communicate with a doctor more easily, promote accurate communication between doctors and patients, help the patient to grow into an intelligent patient, empower the patient and improve the ability of the patient to participate in treatment decision; the health promotion capability of an authoritative liver cancer treatment institution is improved, a reference is provided for promoting the domestic doctor-patient shared decision concept and the construction of other disease decision platforms, and the method has good social benefits and popularization values.
Description
Technical Field
The invention relates to a decision support system for assisting patients in participating in treatment, in particular to a decision support system for assisting patients with primary liver cancer in participating in clinical treatment.
Background
Primary liver cancer, liver cancer for short, is the fifth most common malignant tumor in the world, and China is a liver cancer high-incidence area, so that patients are younger, more men than women, uncertain treatment effects and the like bring huge psychological pressure to the patients.
The world health organization patient safety alliance has advocated that patients actively participate in medical and health decisions, the participation and sharing of patients is regarded as an important mark for measuring the quality of medical care, and with the development of diagnosis and treatment technologies, the treatment modes of liver cancer are gradually diversified, including operations, radio frequency, intervention, liver transplantation and the like, so that on one hand, the hope of more lives is brought to the patients, but meanwhile, the sign of authorized committee book, the lack of doctor-patient communication, insufficient information acquisition, short clinical decision time and the like cause the patients not to effectively participate in the treatment decisions, and hidden dangers are buried in doctor-patient disputes.
In the 'current situation of participation of primary liver cancer patients in treatment decision and analysis of influence factors' of muirecloud et al, the authors found that liver cancer patients who have a willingness to participate in treatment decision account for 78.2% of the total number of patients to be investigated, but only 21.8% of patients actually participate in the treatment decision. Therefore, the practical situation that PLC patients participate in treatment decision is not ideal, and how to promote participation of patients with participation will be a problem facing the practice.
Decision assistance as a tool for shared decision-making helps patients to understand the risks and benefits of each treatment regimen by providing them with information support for different treatment regimens related to their health status, making them clear their own views of value and preferences. And multiple studies prove that the decision assistance can not only promote doctor-patient conversation, but also assist doctors and patients to make high-quality treatment decisions together.
Currently, decision assistance for various diseases worldwide has been developed in various forms, mainly including network interaction, paper edition, video multimedia and the like, and the forms are various, but clinical application of the decision assistance is limited by various factors, and the patient participation degree is low due to patient factors, medical staff factors, and the form and content of decision assistance, and the like, and the decision assistance still faces the treatment decision dilemma.
In the construction and application research of an auxiliary scheme for the treatment decision of an early primary liver cancer patient of Liyu et al, a simple auxiliary manual for the treatment decision of the primary liver cancer patient is constructed, but because the clinical decision time is short, the use mode of a paper edition is limited, the content is various, the patient lacks a large amount of time to read, and the extractable effective information is insufficient, the clinical application effect is poor, and the popularization and use are not realized.
With the improvement of global informatization level and the rapid Development of mobile medicine, the mobile medicine can help us to solve the problem to a certain extent, in Development and use reliability Testing of a Computer-aided diagnosis Support Tool for Lung Cancer Screening of student Protocol of Lisa et al, an author designs a Lung Talk which is Decision-making auxiliary software for promoting a Lung Cancer Screening process, helps a screener to know relevant Lung Cancer Screening knowledge, educes Lung health, is convenient to use, and provides satisfactory experience for Decision making of the patient. However, no development in the aspect of mobile phone application program for decision assistance of liver cancer patients exists in China.
Disclosure of Invention
Aiming at the problems and the defects in the prior art, the invention provides a novel auxiliary support system for participating in treatment decision of patients with primary liver cancer.
The invention solves the technical problems through the following technical scheme:
the invention provides a primary liver cancer patient participation treatment decision auxiliary support system which is characterized by comprising a platform server, a plurality of medical care terminals, a plurality of patient terminals, a data server and a communication network, wherein the platform server is in communication connection with the medical care terminals, the patient terminals and the data server through the communication network respectively;
the platform server comprises a score storage part, a patient information storage part, a patient data control part, a patient information receiving part, a parameter screening part, a decision-making participation path design part, a risk benefit calculation evaluation part, a risk benefit monitoring judgment part, a task generation part, a reminding generation part, a disease knowledge information retrieval acquisition part, a decision-making participation result analysis generation part, a decision-making participation state information generation part, an information input accumulation part, a patient decision-making participation evaluation part, a medical care task storage part, a processing measure storage part, a disease knowledge generation part, a data storage part, a term association storage part, a retrieval acquisition part, a platform side communication part, a data retrieval desensitization part and a platform side control part;
the platform side communication part is used for exchanging data among all the components of the platform server and between the platform server and other terminals, and the platform side control part is used for controlling the work of all the components of the platform server;
the scoring storage part is used for storing scoring methods for presetting a plurality of risks and benefits of different treatment schemes, each scoring method corresponds to one treatment scheme and a plurality of parameters, and the scoring methods for the risks and benefits of the different treatment schemes are used for judging and scoring the risks and benefits of the different treatment schemes by patients;
the patient information storage part is used for storing patient information, and the patient information comprises patient identification information, patient basic information, patient collection information, patient medication information and patient decision information;
the treatment measure storage part stores a plurality of preset different treatment schemes;
the data storage part correspondingly stores the risk benefit difference calculated by the score storage part, the assistant patient decision path designed by the treatment decision path design part, the patient information stored by the patient information storage part and the patient task generated by the task generation part;
the patient data control part is used for receiving patient request participation treatment decision state information which is sent by the patient terminal and contains the basic information of the patient and the selectable treatment scheme, controlling the patient information receiving part to receive the patient request participation treatment decision state information and controlling the task generating part, and the participation decision path designing part processes different treatment scheme information;
the patient data control part is used for controlling the parameter screening part to screen the information parameters of the treatment scheme which can be selected by the patient, and classifying the parameters as selectable parameters according to the treatment scheme risk and benefit scoring method stored by the scoring storage part;
the patient data control part is used for controlling the patient to participate in the decision path design part to retrieve and obtain the part according to the patient knowledge information after the information parameters of the treatment scheme which can be selected by the patient are screened out by the parameter screening part, the risk benefit calculation and evaluation part calculates and evaluates the risk benefit of each treatment scheme, and the risk benefit monitoring and judgment part and the risk benefit score of each treatment scheme stored by the score storage part measure the importance degree of different treatment schemes in the heart of the patient;
the participation decision path design part compares and generates basic information of different treatment schemes selected by the patient according to the Canada Ottawa website network auxiliary decision support path based on the currently selected treatment mode of the patient, and the disease knowledge generation part receives the basic information;
after the patient information receiving part receives the comparison of the basic information of different treatment schemes fed back by the disease knowledge generating part, the risk benefit monitoring and judging part screens and extracts risk benefit parameters of different treatment schemes and feeds back the parameters to the patient data receiving part, the patient scores the importance degrees of the different treatment schemes in the heart, the risk benefit calculation and evaluation part counts the scores and feeds back the scores to the information input accumulating part;
after the risk benefit calculation and evaluation part evaluates the rating condition of the patient, namely after the importance degree of the patient selecting the risk benefits of different treatment schemes is ranked, the patient generates a treatment preference selection in mind and feeds the treatment preference selection back to the patient participation decision state information generation part;
the disease knowledge generation base automatically generates a test question related to liver cancer treatment, feeds the test question back to the patient information receiving part to enable a patient to answer, scores the correctness of the question by the scoring storage part and feeds the score back to the patient information storage part, and the patient participates in the decision state information generation part and the information input accumulation part;
the medical care task storage part receives the patient participation decision state information fed back by the patient data control part, analyzes the information, performs face-to-face treatment scheme decision conversation with the patient based on the information, and jointly selects the treatment scheme most suitable for the patient;
after receiving a patient participation treatment decision completion instruction sent by the medical care terminal, the patient data control part is used for controlling the patient to participate in the post-decision evaluation part and evaluating the post-decision psychological state of the patient and the external decision support degree of the patient;
the disease knowledge information retrieval acquisition part is used for retrieving disease knowledge, the reminder generation part is used for reminding a patient to take medicine, and the patient information storage part is used for storing patient general information, disease information, collection information and decision information;
the patient data control part controls the data retrieval desensitization part mainly to control the data retrieval desensitization part to retrieve all data information of the data storage part and desensitize the data information to obtain desensitized data information, and further the control platform side communication part sends the desensitized data information to the data server;
the term association storage part stores a semantic association method which can associate synonyms and semantics of medical terms contained in the data information stored in the data storage part by using an NLP natural language processing engine;
the retrieval acquisition unit retrieves the data storage unit and acquires the query data based on the query information and the semantic association method.
Preferably, the medical care terminal comprises a medical care side picture storage part, a medical care side input display part, a medical care side updating part, a medical care side communication part and a medical care side control part;
the medical care side communication part is used for exchanging data among all the components of the medical care terminal and between the medical care terminal and other terminals;
the medical care side control part is used for controlling the work of each component of the medical care terminal;
the medical care side picture storage part stores an operation selection picture, a reminding picture, a patient information list picture, a patient decision path picture, a patient decision result picture and a patient information statistical picture;
the medical care side input display part is used for displaying the pictures, so that medical care personnel can perform corresponding human-computer interaction through the pictures.
The medical care side updating part is used for updating the content of the data storage part by medical care personnel.
Preferably, the operation selection screen is used for displaying when the medical staff enters the system and enabling the medical staff to select the operation to be executed next so as to enter the function screen corresponding to each operation;
the reminding picture is used for displaying the reminding information when the reminding information sent from the platform server is received, so that medical staff can select the reminding information to further enter a task display picture, and the task display picture reminds the medical staff to confirm after a patient completes a decision task;
the patient information list screen is used for displaying the patient state information in a list form for the medical staff to view when the patient basic state information sent from the platform server is received, and the patient information list screen displays the personal basic information of the patient, and the patient information list screen comprises the following steps: name, ID number, gender, age, marital status, payment mode, medical and economic burden, cultural degree, occupation, religious belief, character, whether to enter our hospital for the first time, mobile phone number and disease information;
the patient decision path picture is used for making treatment decision conversation with the patient after the patient decision is completed and the medical staff evaluates the participation of the patient in the decision process, and making optimal selection together;
the patient decision result picture is used for evaluating the decision participation state of the medical staff after the decision of the patient is finished;
the patient information statistical picture is used for counting the decision making situation of the doctor and the patient for the batch patient participation and the system browsing situation of the patient.
Preferably, the patient terminal comprises a data acquisition part, a patient side communication part, a patient side control part, a patient decision path part and a patient side information storage part;
the patient side communication part is used for exchanging data among all the components of the patient terminal and between the patient terminal and other terminals;
the patient side control part is used for controlling the work of each component of the patient terminal;
the data acquisition part acquires personal body information containing a plurality of parameters and patient decision information for patient personnel according to a preset acquisition frequency;
the patient decision path part guides the patient to participate in treatment selection according to an instruction sent by the patient side control part, the selection is evaluated, and relevant data after evaluation are uploaded to the patient side information storage part;
preferably, the data server includes a desensitization data storage section, a data-side communication section, and a data-side control section;
the data side communication part is used for exchanging data among all the components of the data server and between the data server and other terminals;
the data side control part is used for controlling the work of each component of the data server;
the desensitization data storage unit stores desensitization data information transmitted from the platform server.
Preferably, the risk benefit calculation and evaluation section and the risk benefit monitoring and judgment section share risk benefit scores for 10 treatment regimens involving liver cancer treatment, including: the method comprises the following steps of performing an abdominal operation on the liver cancer, performing laparoscopic hepatectomy, performing liver transplantation, performing liver cancer radio frequency ablation, performing liver cancer microwave ablation, performing liver cancer absolute alcohol injection, performing liver cancer percutaneous hepatic artery catheter chemoembolization, performing local liver cancer cryotherapy, performing liver cancer targeted therapy, and performing traditional Chinese medicine liver cancer treatment.
On the basis of the common knowledge in the field, the above preferred conditions can be combined randomly to obtain the preferred embodiments of the invention.
The positive progress effects of the invention are as follows:
according to the auxiliary support system for the participation of the primary liver cancer patient in the treatment decision, by means of a 'mobile' technology, different treatment scheme information data of the primary liver cancer are presented to the patient through the data storage device, the patient is assisted to participate in the treatment decision path selection according to different treatment schemes selectable by corresponding patients, the patient is enabled to make a treatment scheme selection which is most suitable for the patient in a plurality of selectable treatment schemes clearly, and then the suggestion and the suggestion of a clinician are combined to make the treatment scheme selection which is most suitable for the patient together.
The invention provides detailed information data of patients about liver cancer treatment, can help the patients to communicate with doctors more easily, promote accurate communication between doctors and patients, help the patients to grow into intelligent patients, give rights to the patients, really realize that my treatment is the owner, and improve the ability of the patients to participate in treatment decision; the health promotion capability of an authoritative liver cancer treatment institution is improved, reference is provided for promoting the domestic doctor-patient shared decision concept and the construction of other disease decision platforms, and good social benefit and popularization value are achieved.
Drawings
Fig. 1 is a block diagram of a primary liver cancer patient treatment decision support system according to an embodiment of the present invention.
Fig. 2 is a schematic structural diagram of a platform server according to an embodiment of the present invention.
Fig. 3 is a schematic structural diagram of a healthcare terminal according to an embodiment of the present invention.
Fig. 4 is a schematic structural diagram of a patient terminal according to an embodiment of the present invention.
Fig. 5 is a schematic structural diagram of a data server according to an embodiment of the present invention.
Fig. 6 is a schematic structural diagram of a patient participation treatment decision path according to an embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.
Fig. 1 is a block diagram of a primary liver cancer patient treatment decision support system according to an embodiment of the present invention.
As shown in fig. 1, the system 100 of the present embodiment for assisting in supporting treatment decision for a primary liver cancer patient includes a platform server 1, a plurality of healthcare terminals 2, a plurality of patient terminals 3, a data server 4, and a communication network 5.
The platform server 1 is in communication connection with the medical care terminal 2, the patient terminal 3 and the data server 4 through a communication network 5. Wherein the platform server 1 is provided in a hospital.
Fig. 2 is a schematic structural diagram of a platform server according to an embodiment of the present invention.
As shown in fig. 2, the platform server 1 includes a score storage unit 11, a patient information storage unit 12, a patient data control unit 13, a patient information receiving unit 14, a parameter screening unit 15, a decision-making participation path designing unit 16, a risk benefit calculation evaluating unit 17, a risk benefit monitoring judging unit 18, a task generating unit 19, a reminder generating unit 20, a disease knowledge information retrieval acquiring unit 21, a decision-making participation result analyzing and generating unit 22, a decision-making participation state information generating unit 23, an information entry accumulating unit 24, a patient decision-making participation evaluating unit 25, a medical care task storage unit 26, a treatment measure storage unit 27, a disease knowledge generating unit 28, a data storage unit 29, a term association storage unit 30, a retrieval acquiring unit 31, a platform-side communication unit 32, a data retrieval desensitizing unit 33, and a platform-side control unit 34.
Among them, the platform side communication unit 32 exchanges data between the respective components of the platform server 1 and between the platform server 1 and another terminal, and the platform side control unit 34 controls the operations of the respective components of the platform server 1.
The score storage unit 11 stores a plurality of score methods for the risk and benefit of different treatment plans, each of which corresponds to one treatment plan and a plurality of parameters, and the score methods for the risk and benefit of different treatment plans are used for judging and scoring the importance level of the risk and benefit of different treatment plans in the patient. For example, if a patient has liver cancer, the doctor, in combination with various examination indexes, advises the patient to select open surgery or percutaneous hepatic artery catheter chemoembolization (TACE), and the benefits of the open surgery excision: 1. the excision is complete, and the radical excision can be achieved partially, so that the survival rate is high after 2.5 years; risk: 1. large wound, many complications and slow postoperative recovery, 2, the risk of relapse is existed; benefits of TACE: 1. the wound is small, the recovery is fast, 2, the operation time is short, and 3, the cost is low; risk: 1. nausea, vomiting and liver and kidney function impairment, 2, multiple treatments are needed, and 3, the recurrence rate is high. Each point corresponds to 5 points, from none to very important, and patients are scored according to how important the benefit of risk is in their mind for different treatment regimens.
In this embodiment, the risk benefit scoring methods for different treatment regimens are preset based on the canadian ottawa web edition decision support process, with reference to clinical practice data, international literature standards, and medical guidelines for disease conditions.
The patient information storage unit 12 stores patient information including patient identification information, patient basic information, patient collection information, patient medication information, and patient decision information.
The treatment measure storage unit 27 stores a plurality of different preset treatment plans. Each treatment scheme comprises principles, treatment approaches, indications, contraindications, risks, benefits, time of operation, subsequent treatment, related complications after treatment, postoperative care, diet care and health promotion, and patients can extract different information according to needs.
The data storage unit 29 stores the risk benefit difference calculated by the score storage unit 11, the support patient decision path designed by the participation treatment decision path design unit 16, the patient information stored in the patient information storage unit 12, and the patient task generated by the task generation unit 19 in association with each other.
In the present embodiment, the data stored in the data storage unit 29 is used for archive storage to perform a subsequent history information inquiry.
The patient data control unit 13 is used for controlling operations of components related to patient data in the platform server 1, and includes a patient information receiving unit 14, a parameter screening unit 15, a participation treatment decision path designing unit 16, a risk benefit calculation and evaluation unit 17, a risk benefit monitoring and determination unit 18, a task generating unit 19, a reminder generating unit 20, a disease information retrieval and acquisition unit 21, a participation decision result generating unit 22, a patient participation decision state information generating unit 23, an information entry and accumulation unit 24, a post-patient participation decision evaluation unit 25, a medical care task storage unit 26, a treatment measure storage unit 27, a treatment disease information generating unit 28, and controls operations related to patient data.
The patient-specific participation treatment decision flow step, in which the patient data control unit 13 controls the patient information receiving unit 14 to receive the patient request status when receiving the patient request participation treatment decision status information transmitted from the patient terminal 3.
In this embodiment, the patient terminal 3 can collect the basic information and the selectable treatment plans of the patient, and the patient data control unit 13 controls the patient information receiving unit 14 to receive the selectable treatment mode information of the patient, controls the task generating unit 19, and participates in the decision path designing unit 16 to process the information of different treatment plans.
When the patient information receiving unit 14 receives the patient request participation treatment decision state information, the patient data control unit 13 controls the parameter screening unit 15 to screen information parameters of a treatment plan selectable by the patient, and classifies the parameters as selectable parameters according to a treatment plan risk benefit scoring method stored in the score storage unit 11.
After the parameter screening part 15 screens out the information parameters of the treatment plan which can be selected by the patient, the patient data control part 13 controls the patient participation decision path design part 16 to retrieve and obtain the information according to the patient knowledge, the risk benefit calculation and evaluation part 17 calculates and evaluates the risk benefit of each treatment plan, and the risk benefit monitoring and judgment part 18 and the score storage part 11 store the risk benefit score of each treatment plan to measure the importance degree of different treatment plans in the patient's heart.
In this embodiment, the liver cancer treatment plan information includes occurrence and development data of liver cancer, surgical treatment (laparotomy, laparoscopic liver resection, and liver transplantation) data of liver cancer, local treatment (liver cancer rf ablation, liver cancer microwave ablation, hepatic artery embolization chemotherapy, absolute alcohol injection therapy, and liver cancer radiotherapy) data of liver cancer, liver cancer system treatment (targeted therapy, immunotherapy, and chemotherapy) data, liver cancer traditional Chinese medicine treatment data, and common examination (symptom examination, laboratory examination, imaging examination, and pathology examination) data of liver cancer.
In this embodiment, the decision participation path designing unit 16 further includes a decision participation flow unit and a post-decision evaluation unit of the patient. The participation decision path designing unit 16 compares basic information (principle, treatment path, indication, advantage, disadvantage, time for surgery, follow-up treatment, average hospital stay after surgery, related complications after treatment, cost, and efficacy (5-year survival rate)) of different treatment plans selected by the patient by the disease knowledge generating unit 28 based on the treatment mode currently selected by the patient and according to the canadian ottawa website network-aided decision support path, generates, and receives the generated result by the patient information receiving unit 14. The patient can know the basic information contrast of the selectable treatment scheme through visual contrast.
After the patient information receiving part 14 receives the comparison of the basic information of different treatment schemes fed back by the disease knowledge generating part 28, the risk benefit monitoring and judging part 18 screens and extracts the risk benefit parameters of different treatment schemes, and feeds back the parameters to the patient data receiving part 14, the patient scores the importance degrees of the different treatment schemes in the center, and the risk benefit calculation and evaluation part counts the scores and feeds back the scores to the information recording and accumulating part 24.
In this embodiment, the risk benefit calculation and evaluation unit 17 and the risk benefit monitoring and determination unit 18 collectively relate to the risk benefit scores of 10 treatment plans for liver cancer treatment, and include: the method comprises the following steps of performing an abdominal operation on the liver cancer, laparoscopic hepatectomy, liver transplantation, liver cancer radio frequency ablation, liver cancer microwave ablation, liver cancer absolute alcohol injection, liver cancer percutaneous hepatic artery catheter chemoembolization, liver cancer local freezing treatment, liver cancer targeted treatment and liver cancer traditional Chinese medicine treatment.
In this embodiment, after the risk benefit calculation and evaluation unit 17 has evaluated the rating of the patient, that is, after the patient selects the ranking of the importance of the risk benefits of different treatment schemes in his mind, the patient may generate a treatment preference selection in his mind, and feed the treatment preference selection back to the patient participation decision state information generation unit 23. At this time, the disease knowledge generation library 28 will automatically guide the patient to the next stage of disease knowledge testing.
The disease knowledge generating base 28 automatically generates a test question of knowledge related to liver cancer treatment, feeds the test question back to the patient information receiving unit 14, allows the patient to answer the test question, scores the accuracy of the test question by the score storing unit 11, feeds the score back to the patient information storing unit 12, and the patient participation decision state information generating unit 23 and the information recording and accumulating unit 24.
The medical care task storage unit 26 receives the patient participation decision state information fed back from the patient data control unit 13, analyzes the information, performs a treatment plan decision conversation with the patient face to face based on the information, and collectively selects a treatment plan most suitable for the patient.
After receiving a patient participation treatment decision completion instruction sent by the medical care terminal 2, the patient data control part 13 controls the patient participation decision post-evaluation part 25 to evaluate the post-decision psychological state of the patient and the external decision support degree of the patient. The method mainly comprises the following steps: the treatment modality ultimately selected, how aggressive the decision is made, how confident the decision is made, the person who is discussing with the patient, whether he/she influences the patient's choice, who the patient wishes his/her treatment choice to be decided upon when making the decision? After evaluation, the information is collected by the information entry/accumulation unit 24 and sent to the patient participation decision state information generation unit 23, and fed back to the medical care task storage unit 26.
In this embodiment, the patient may also search for the disease knowledge by the disease knowledge information search acquisition unit 21 and remind the patient to take the medicine by the reminder generation unit 19, and the patient information storage unit 12 may store patient general information, disease information, collection information, and decision information.
In the present embodiment, the patient data control unit 13 controls the data retrieval desensitizing unit 33 mainly to control the data retrieval desensitizing unit 33 to retrieve all data information of the data storage unit 27 and desensitize the data information to obtain desensitized data information, and further control the platform-side communication unit 32 to transmit the desensitized data information to the data server 4.
The term association storage unit 30 stores a semantic association method capable of associating synonyms and semantics of medical terms included in the data information stored in the data storage unit 27 by using the NLP natural language processing engine.
The search acquisition unit 31 searches the data storage unit 27 based on the query information and the semantic association method, and acquires the query data.
Fig. 3 is a schematic structural diagram of a healthcare terminal according to an embodiment of the present invention.
As shown in fig. 3, the medical care terminal 2 includes a medical care side screen storage unit 41, a medical care side input display unit 42, a medical care side update unit 43, a medical care side communication unit 44, and a medical care side control unit 45.
The medical care side communication unit 44 exchanges data between the respective components of the medical care terminal 2 and between the medical care terminal 2 and another terminal, and the medical care side control unit 45 controls the operation of the respective components of the medical care terminal 2.
The medical care screen storage unit 41 stores an operation selection screen, a reminder screen, a patient information list screen, a patient decision path screen, a patient decision result screen, and a patient information statistic screen.
The operation selection screen is used for displaying when the medical staff enters the system and enabling the medical staff to select the operation to be executed next so as to enter the function screen corresponding to each operation.
The reminding picture is used for displaying the reminding information when the reminding information sent from the platform server 1 is received, so that medical staff can select the reminding information to further enter the task display picture.
The patient information list screen is used to display patient status information in a list form for medical staff to view when receiving the basic patient status information transmitted from the platform server 1. In this embodiment, the personal basic information of the patient displayed on the patient information list screen includes: name, ID number, gender, age, marital status, payment method, medical and economic burden, cultural degree, occupation, religious belief, character, whether to enter my hospital for the first time, cell phone number, and disease information.
The patient decision path picture is used for the medical staff to perform treatment decision conversation with the patient after the patient is decided, and the medical staff evaluates the participation of the patient in the decision process and then makes optimal selection together.
The patient decision result screen is used for the medical staff to evaluate the decision participation state after the patient decision is completed, in this embodiment, the patient decision result mainly includes: the treatment modality ultimately selected, how aggressive the decision is made, how confident the decision is made, the person who is discussing with the patient, whether he/she influences the patient's choice, who the patient wishes his/her treatment choice to be decided upon when making the decision?
The patient information statistics picture is used for statistics of the patient participation treatment decision conditions and the system browsing conditions of the patients by doctors and patients, and can find data and disease knowledge points which are interested by the patients, so that the medical care personnel can update and perfect the data in time.
The medical care side input display unit 42 is used to display the above-described screens, so that the medical care worker can perform corresponding human-computer interaction through these screens.
The medical care side update unit 43 is used for the medical care professional to update the contents of the data storage unit.
Fig. 4 is a schematic structural diagram of a patient terminal according to an embodiment of the present invention.
As shown in fig. 4, the patient terminal 3 includes a data acquisition unit 51, a patient-side communication unit 52, a patient-side control unit 53, a patient decision path unit 54, and a patient-side information storage unit 55.
The patient-side communication unit 52 exchanges data between the respective components of the patient terminal 3 and between the patient terminal and another terminal, and the patient-side control unit 53 controls the operation of the respective components of the patient terminal 3.
The data acquisition unit 51 acquires personal physical information including a plurality of parameters and patient decision information for a patient person according to a preset acquisition frequency.
The patient decision path unit 54 instructs the patient to participate in treatment selection according to an instruction from the patient side control unit 53, evaluates the selection, and uploads the evaluated relevant data to the patient side information storage unit 55.
Fig. 5 is a schematic structural diagram of a data server according to an embodiment of the present invention.
As shown in fig. 5, the data server 4 includes a desensitization data storage section 61, a data-side communication section 62, and a data-side control section 63.
The data-side communication unit 62 exchanges data between the respective components of the data server 4 and between the data server 4 and another terminal, and the data-side control unit 63 controls operations of the respective components of the data server 4.
The desensitization data storage section 61 stores desensitization data information transmitted from the platform server 1.
In this embodiment, the desensitization data is related data that does not contain information that may reveal privacy of the patient, including medical data, decision data, symptom data, treatment data, and treatment influence data, and is stored in the data server 4 and may be publicly called for medical research.
FIG. 6 is a flow chart of an embodiment of the present invention for assisting a patient in a treatment decision process.
As shown in fig. 6, the process of monitoring and calculating the decision data of the patient when the patient or the family member uses the assisted primary liver cancer patient of the present embodiment to participate in the treatment decision support system includes the following steps:
in step S1-1, the patient data control unit 13 controls the patient information receiving unit 14 to receive a request for participation in treatment decision information sent from the patient terminal, and then the process proceeds to step S1-2.
In step S1-2, the patient data control unit 13 controls the task generation unit 19, the participation decision path design unit 16 processes the different treatment plan information, and the process proceeds to step S1-3.
In step S1-3, the patient data control unit 13 controls the parameter filtering unit 15 to filter information parameters of the treatment plan selectable by the patient, generates contrast data of different treatment plans by the disease knowledge generating unit 28, transmits the contrast data to the patient terminal 3, and then proceeds to step S1-4.
In step S1-4, the patient data control unit 13 classifies the parameters as selectable parameters according to the treatment plan risk benefit scoring method stored in the score storage unit 11, and the patient data control unit 13 controls the risk benefit calculation and evaluation unit 17, the risk benefit monitoring and judgment unit 18, and the score storage unit 11 to measure the importance of different treatment plans in the patient' S mind, and then the process proceeds to step S1-5.
And S1-5, after the patient data control part 13 controls the task generation part 19 to complete the step S1-4, the disease knowledge generation base 28 is controlled to guide the patient to enter the next link, the patient disease knowledge is tested and fed back to the patient information receiving part, the patient answers, after the patient finishes testing, the step is finished, and the patient can repeat the steps S1-1 to S1-5 and make a decision repeatedly.
And S1-6, the patient data control part 13 controls the task generating part 19 to generate medical care tasks for patient personnel corresponding to the decision processes in the step S1-5 and the scores of the patients aiming at different treatment schemes in the patient participation decision state information generating part 23, the medical care personnel evaluate the medical care tasks, and then the step S1-7 is carried out.
And S1-7, the medical care task storage part 26 receives the patient participation decision state information fed back by the patient data control part 13, analyzes the information, performs treatment scheme decision conversation with the patient face to face on the basis of the analysis, jointly selects a treatment scheme most suitable for the patient, and then, the step S1-8 is carried out.
And S1-8, after receiving a patient participation treatment decision completion instruction sent by the medical care terminal 2, the patient data control part 13 controls the patient participation decision post-evaluation part 25 to evaluate the post-decision psychological state of the patient and the external decision support degree of the patient, and then the step S1-9 is carried out.
In step S1-9, the patient participation decision post-evaluation section 25 records the patient post-decision evaluation information and the task processing time of the patient task in step S1-8, and then proceeds to step S1-10.
Step S1-10, the medical care side communication part 44 sends the patient post-decision evaluation information and the task processing time recorded in step S1-9 to the platform server 1, and then the process goes to step S1-11.
And S1-11, the patient data control part 13 controls the medical care task storage part 26 to correspondingly store the patient participation decision information, the task processing time and the patient decision task, and then the step is finished.
Examples effects and effects
According to the decision support system for assisting the primary liver cancer patient in participating in the treatment provided by the embodiment, the decision dilemma problem of different treatment schemes of the liver cancer patient in China at present is focused, and based on the Ottawa decision theory framework, a mobile information support scheme and an assistant decision path which are authoritative and suitable for the liver cancer patient in China to participate in the treatment decision are constructed, so that the patient can be helped to know treatment information, and the patient can be enabled.
In the embodiment, doctor-patient interactive shared decision is realized by assisting the primary liver cancer patient to participate in the treatment decision auxiliary support system, different treatment scheme basic information and comparison tables can be selected by the patient through assisting the patient to participate in the decision path step, scattered data of the liver cancer treatment mode are filtered and summarized, the propaganda and education content is comprehensive, the patient can conveniently find at any time, accurate communication is realized, repeated propaganda and education for medical care is reduced, and the communication effect is improved.
In the embodiment, the importance degree of risk benefits of different treatment schemes selectable in the heart of a patient is respectively evaluated by assisting a primary liver cancer patient to participate in a treatment decision auxiliary support system and combining the actual condition of the patient's state of illness, and treatment selection of the most suitable patient is jointly made based on individual treatment selection preference of the patient and the best evidence-following medical evidence of a doctor, so that the treatment decision satisfaction degree of the patient is improved, doctor-patient harmony is promoted, the workload is reduced, the possibility of doctor-patient disputes can be reduced, the primary liver cancer patient can be nationally referred and used, and the practical application value is high.
Under the background of Chinese culture, family members sign 'authorization committee' at the time of admission in consideration of patients, and exercise decision rights instead of the patients, the family members participate in decision making and can not simply be regarded as deprivation of the autonomy of the patients, the family members participate in the sharing of the unfortunate and painful conditions of the patients and the communication with doctors is better realized, and therefore, the autonomy of the patients needs to be understood again by focusing on the important relationship between the patients and the family members. In this embodiment, the auxiliary support system for assisting the primary liver cancer patient in participating in the treatment decision includes two types, namely, patient and family, in role setting, seeks a balance mechanism among the patient, the family and the doctor in the medical decision process, establishes a medical decision mode in which the doctor, the patient and the family participate together, and enables the patient and the family to participate in the medical decision
In this embodiment, the medical-care side display part can display the basic condition of the patient and the decision-making path picture of the patient, so that medical-care personnel can visually check the decision-making condition of the patient in real time and the individual treatment selection preference of the patient, and can accurately find the decision-making problem of the patient, thereby improving the working efficiency of the medical-care personnel.
In the embodiment, the medical care side display part can display the psychological change condition and the social support condition of the patient after the patient participates in the decision, so that the medical care personnel can more conveniently and quickly identify the clinical risk and pertinently conduct psychological dispersion on the patient.
In this embodiment, the data storage unit further stores the basic information of the doctor in the hospital and the doctor's two-dimensional code contact information, so that the patient can communicate with the doctor conveniently, and the data storage unit further stores health propaganda and education materials, so as to help the patient and family members to popularize knowledge of liver cancer treatment, prognosis and rehabilitation.
In this embodiment, the patient-side display unit can display a patient information input screen, input patient information, and the patient can also supplement the information.
The reminding generation part can also set the medicine taking time, the medicine type and the medicine taking dosage by the patient to generate a task and remind the patient on time, thereby being beneficial to improving the medicine taking compliance of the patient.
In this embodiment, the data retrieval desensitization unit may perform desensitization processing on the data stored in the data storage unit, and send the desensitization processed data to the data server for public use in medical research.
In this embodiment, the retrieval acquisition unit can implement synonym and semantic association on the data in the data storage unit by a semantic association method, so that the data has more systematic and clinical reference meanings, and then query the associated data according to the query information input by the patient, thereby implementing quick and accurate therapeutic data query.
While specific embodiments of the invention have been described above, it will be understood by those skilled in the art that these are by way of example only, and that the scope of the invention is defined by the appended claims. Various changes and modifications to these embodiments may be made by those skilled in the art without departing from the spirit and scope of the invention, and these changes and modifications are within the scope of the invention.
Claims (6)
1. A primary liver cancer patient participation treatment decision auxiliary support system is characterized by comprising a platform server, a plurality of medical care terminals, a plurality of patient terminals, a data server and a communication network, wherein the platform server is in communication connection with the medical care terminals, the patient terminals and the data server through the communication network respectively;
the platform server comprises a score storage part, a patient information storage part, a patient data control part, a patient information receiving part, a parameter screening part, a decision-making participation path design part, a risk benefit calculation evaluation part, a risk benefit monitoring judgment part, a task generation part, a reminding generation part, a disease knowledge information retrieval acquisition part, a decision-making participation result analysis generation part, a decision-making participation state information generation part, an information input accumulation part, a patient decision-making participation evaluation part, a medical care task storage part, a processing measure storage part, a disease knowledge generation part, a data storage part, a term association storage part, a retrieval acquisition part, a platform side communication part, a data retrieval desensitization part and a platform side control part;
the platform side communication part is used for exchanging data among all the components of the platform server and between the platform server and other terminals, and the platform side control part is used for controlling the work of all the components of the platform server;
the scoring storage part is used for storing a plurality of scoring methods for the risks and benefits of different treatment schemes, each scoring method corresponds to one treatment scheme and a plurality of parameters, and the scoring methods for the risks and benefits of different treatment schemes are used for judging and scoring the risks and benefits of different treatment schemes by patients;
the patient information storage part is used for storing patient information, and the patient information comprises patient identification information, patient basic information, patient collection information, patient medication information and patient decision information;
the treatment measure storage part stores a plurality of preset different treatment schemes;
the data storage part correspondingly stores the risk benefit difference calculated by the score storage part, the assistant patient decision path designed by the treatment decision path design part, the patient information stored by the patient information storage part and the patient task generated by the task generation part;
the patient data control part is used for receiving patient request participation treatment decision state information which is sent by the patient terminal and contains the basic information of the patient and the selectable treatment scheme, controlling the patient information receiving part to receive the patient request participation treatment decision state information and controlling the task generating part, and the participation decision path designing part processes different treatment scheme information;
the patient data control part is used for controlling the parameter screening part to screen the information parameters of the treatment scheme which can be selected by the patient, and classifying the parameters as selectable parameters according to the treatment scheme risk and benefit scoring method stored by the scoring storage part;
the patient data control part is used for controlling the patient to participate in the decision path design part to retrieve and obtain the part according to the patient knowledge information after the information parameters of the treatment scheme which can be selected by the patient are screened out by the parameter screening part, the risk benefit calculation and evaluation part calculates and evaluates the risk benefit of each treatment scheme, and the risk benefit monitoring and judgment part and the risk benefit score of each treatment scheme stored by the score storage part measure the importance degree of different treatment schemes in the heart of the patient;
the participation decision path design part compares and generates basic information of different treatment schemes selected by the patient according to the Canada Ottawa website network auxiliary decision support path based on the currently selected treatment mode of the patient, and the disease knowledge generation part receives the basic information;
after the patient information receiving part receives the comparison of the basic information of different treatment schemes fed back by the disease knowledge generating part, the risk benefit monitoring and judging part screens and extracts risk benefit parameters of different treatment schemes and feeds back the parameters to the patient data receiving part, the patient scores the importance degrees of the different treatment schemes in the heart, the risk benefit calculation and evaluation part counts the scores and feeds back the scores to the information input accumulating part;
when the risk benefit calculation and evaluation part evaluates the scoring condition of the patient, namely after the importance degree of the patient selecting the risk benefits of different treatment schemes in the heart is ranked, a treatment preference selection is generated in the heart of the patient and is fed back to the patient participation decision state information generation part;
the disease knowledge generation base automatically generates a test question of liver cancer treatment related knowledge, the test question is fed back to the patient information receiving part to be answered by the patient, the score storage part scores the correct rate of the question and feeds the rate back to the patient information storage part, and the patient participates in the decision state information generation part and the information input accumulation part;
the medical care task storage part receives the patient participation decision state information fed back by the patient data control part, analyzes the information, performs face-to-face treatment scheme decision conversation with the patient based on the information, and jointly selects the treatment scheme most suitable for the patient;
after receiving a patient participation treatment decision-making completion instruction sent by the medical care terminal, the patient data control part is used for controlling the patient participation decision-making evaluation part to evaluate the psychological state of the patient after decision-making and the external decision-making support degree of the patient;
the disease knowledge information retrieval acquisition part is used for retrieving disease knowledge, the reminder generation part is used for reminding a patient to take medicine, and the patient information storage part is used for storing patient general information, disease information, collection information and decision information;
the patient data control part controls the data retrieval desensitization part mainly to control the data retrieval desensitization part to retrieve all data information of the data storage part and desensitize the data information to obtain desensitized data information, and further the control platform side communication part sends the desensitized data information to the data server;
the term association storage part stores a semantic association method which can associate synonyms and semantics of medical terms contained in the data information stored in the data storage part by using an NLP natural language processing engine;
the retrieval acquisition unit retrieves the data storage unit and acquires the query data based on the query information and the semantic association method.
2. The system of claim 1, wherein the healthcare terminal comprises a healthcare-side screen storage unit, a healthcare-side input display unit, a healthcare-side update unit, a healthcare-side communication unit, and a healthcare-side control unit;
the medical care side communication part is used for exchanging data among all the components of the medical care terminal and between the medical care terminal and other terminals;
the medical care side control part is used for controlling the work of each component of the medical care terminal;
the medical care side picture storage part stores an operation selection picture, a reminding picture, a patient information list picture, a patient decision path picture, a patient decision result picture and a patient information statistical picture;
the medical care side input display part is used for displaying the pictures, so that medical care personnel can carry out corresponding human-computer interaction through the pictures,
the medical care side updating part is used for updating the content of the data storage part by medical care personnel.
3. The system of claim 2, wherein the operation selection screen is used to display when the medical staff enters the system and let the medical staff select the operation to be executed next so as to enter the function screen corresponding to each operation;
the reminding picture is used for displaying the reminding information when the reminding information sent from the platform server is received, so that medical staff can select the reminding information to further enter a task display picture, and the task display picture reminds the medical staff to confirm after a patient completes a decision task;
the patient information list screen is used for displaying the patient state information in a list form for the medical staff to view when the patient basic state information sent from the platform server is received, and the patient information list screen displays the personal basic information of the patient, and the patient information list screen comprises the following steps: name, ID number, gender, age, marital status, payment mode, medical and economic burden, cultural degree, occupation, religious belief, personality, whether to enter our hospital for the first time, mobile phone number and disease information;
the patient decision path picture is used for making treatment decision conversation with the patient after the patient decision is completed and the medical staff evaluates the participation of the patient in the decision process, and making optimal selection together;
the patient decision result picture is used for evaluating the decision participation state of the medical staff after the decision of the patient is completed;
the patient information statistical picture is used for counting the treatment decision situations of the patients in batches and the browsing situations of the patients on the system.
4. The primary liver cancer patient participation treatment decision support system of claim 1, wherein the patient terminal comprises a data acquisition part, a patient side communication part, a patient side control part, a patient decision path part and a patient side information storage part;
the patient side communication part is used for exchanging data among all the components of the patient terminal and between the patient terminal and other terminals;
the patient side control part is used for controlling the work of each component of the patient terminal;
the data acquisition part acquires personal body information containing a plurality of parameters and patient decision information for patient personnel according to a preset acquisition frequency;
the patient decision path part guides the patient to participate in treatment selection according to the instruction sent by the patient side control part, the selection is evaluated, and relevant data after evaluation are uploaded to the patient side information storage part.
5. The participation of primary liver cancer patients in treatment decision support system of claim 1, wherein the data server comprises a desensitization data storage section, a data side communication section and a data side control section;
the data side communication part is used for exchanging data among all the components of the data server and between the data server and other terminals;
the data side control part is used for controlling the work of each component of the data server;
the desensitization data storage unit stores desensitization data information transmitted from the platform server.
6. The participation of primary liver cancer patients in the treatment decision support system of claim 1, wherein the risk benefit calculation and evaluation section and the risk benefit monitoring and determination section jointly relate to risk benefit scores of 10 treatment regimens for liver cancer treatment, comprising: the method comprises the following steps of performing an abdominal operation on the liver cancer, laparoscopic hepatectomy, liver transplantation, liver cancer radio frequency ablation, liver cancer microwave ablation, liver cancer absolute alcohol injection, liver cancer percutaneous hepatic artery catheter chemoembolization, liver cancer local freezing treatment, liver cancer targeted treatment and liver cancer traditional Chinese medicine treatment.
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| CN107145755A (en) * | 2017-05-16 | 2017-09-08 | 陈韵岱 | Cardiovascular chronic diseases management method based on Intelligent Decision Support Technology |
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