Decision support system for the diagnosis and management of pneumonia patients

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Publication Type dissertation
School or College School of Medicine
Department Biomedical Informatics
Author Aronsky, Dominik
Title Decision support system for the diagnosis and management of pneumonia patients
Date 2001-05
Description Diagnostic decision support systems have a long tradition in medicine, but have not typically been integrated with clinical information systems. I describe five studies that were performed during the development, implementation, and evaluation efforts for a real time diagnostic decision support system. The system's objective was to automatically identify patients likely to have pneumonia. The real time system used only data routinely collected in the computerized patient record during a patient's encounter in the emergency department. The automatic identification of pneumonia patients was used to initiate the computerized calculation of a pneumonia risk assessment instrument. The first study describes the development of the diagnostic system using an emergency department data set from the HELP clinical information system at LDS Hospital, Salt Lake City, Utah. The second study describes the implementation of the system and illustrates the operational functions. The third study examined whether data from the HELP System could be used for the computerized evaluation of the pneumonia risk assessment instrument. This study showed that computerized evaluation generated an accurate risk class for 86 percent of hospitalized pneumonia patients. The fourth study reports the design and planning of the system's prospective evaluation in a clinical environment. The paper addresses important issues that influenced the study design, such as verification bias and disease prevalence. Different study designs were discussed with respect to the targeted users and the clinical setting, and a feasible approach for the creation of a valid gold standard diagnosis for pneumonia was proposed. The final study describes the system's prospective clinical evaluation. During a 5-month study period, the system computed a probability of pneumonia in real time for 10,828 patients, of whom 265 patients had pneumonia. The diagnostic accuracy, determined by the area under the receiver operating characteristic curve, was 0.942. In summary, this project describes the development, implementation, and evaluation of a fully automatic, real time, diagnostic system that is integrated with a clinical information system. The system can be used to initiate pneumonia specific risk assessment tools and guidelines and to support the computerized guideline implementation for delivering recommendations at the point of patient care.
Type Text
Publisher University of Utah
Subject Pneumonia Risk Assessment; HELP System; Utah
Subject MESH Pneumonia; Automatic Data Processing; Information Systems
Dissertation Institution University of Utah
Dissertation Name PhD
Language eng
Relation is Version of Digital reproduction of "A decision support system for the diagnosis and management of pneumonia patients Spencer S. Eccles Health Sciences Library. Print version of "A decision support system for the diagnosis and management of pneumonia patients" available at J. Willard Marriott Library Special Collections, RA4.5 2001 .A76.
Rights Management © Dominik Aronsky.
Format Medium application/pdf
Format Extent 2,063,632 bytes
Identifier undthes,4121
Source Original: University of Utah Spencer S. Eccles Health Sciences Library (no longer available)
Master File Extent 2,063,690 bytes
ARK ark:/87278/s6w66nhh
Setname ir_etd
ID 190661
Reference URL https://collections.lib.utah.edu/ark:/87278/s6w66nhh