智能辅助决策支持系统在临床诊疗决策中的应用研究  

Research on the Application of the Intelligent Decision-aid Support System in Clinical Diagnosis and Treatment Decision Support

作　　者：蔡秀军[1] 林辉[1] 乔凯[1] 洪玉才[1] 庞晓燕[1] 丁魏 唐渠 CAIXiu -jun;LIN Hui;QIAO Kai(Shao Yifu Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou 310016,Zhejiang Province,P.R.C.)

机构地区：[1]浙江大学医学院附属邵逸夫医院,浙江省杭州市庆春东路3号310016 [2]杭州市江干区卫生和计划生育局,浙江省杭州市庆春东路1号310016 [3]杭州朗通信息技术有限公司

出　　处：《中国数字医学》2019年第3期111-113,共3页China Digital Medicine

基　　金：浙江省认知医疗工程技术研究中心开放课题基金-基于深度学习的临床智能辅助诊疗决策系统(编号:2018KFJJ01)~~

摘　　要：目的:评估浙江大学医学院附属邵逸夫医院联合企业自主研发的智能辅助决策支持系统对临床辅助决策和病历规范方面的作用。方法:以杭州市江干区基层医疗机构8名全科医生为受试者,随机选取每位受试者使用智能辅助决策支持系统前后的10份病历进行评分;同时以浙江大学医学院附属邵逸夫医院急诊科为受试单位,随机选取急诊科实验前后各50例胸痛疑似急性冠状动脉综合征(Acute Coronary Syndromes,ACS)病例诊疗规范性进行比较分析。结果:应用智能辅助决策支持系统后医生病历总评分(85. 79±3. 70)较应用前(72. 49±4. 41)有明显提升(P<0.01);应用智能辅助决策支持系统后,主诉(4.34±0.67)、现病史(17. 74±1.52)、既往史(8.00±1.16)、查体与辅助检查(13.25±1.62)、诊疗措施(17.40±1.12)和其他(4. 35±0. 68)模块的评分较应用前(分别是3. 89±0. 89,13. 08±1.76,2. 49±1.65,12. 06±2. 51,16. 30±2. 30,3. 80±1. 00)均明显提升(P<0.01);患者基本信息、诊断、病历书写基本要求模块的评分与应用前相比均无统计学差异。应用智能辅助决策系统后,对胸痛疑似ACS的患者10 min内进行心电图检查的比率为96%,较之前(88%)明显提高;对胸痛疑似ACS患者在90 min6内进行急诊冠状动脉介入处理的比例(95.65%)较之前(85. 71%)明显提高。结论:智能辅助决策支持系统可提升临床病历质量,系统在症状问诊、病史问诊、查体和诊疗处置方面具有辅助支持作用,系统可提升胸痛疑似ACS患者的急诊诊疗规范性。Objective:To evaluate the role of the intelligent decision support system independently developed by Shao Yifu Hospital Affiliated to Zhejiang University School of Medicine together with an enterprise in clinical decision support and medical record standardization.Methods:8 general practitioners from basic-level medical institutions in Jianggan District of Hangzhou are selected as subjects,and 10 medical records of each subject before and after using the intelligent decision support system are randomly selected for scoring.At the same time,with the test unit of the Emergency Department of Shao Yifu Hospital Affiliated to Zhejiang University School of Medicine,50 cases of chest pain suspected of Acute Coronary Syndrome(ACS)are randomly selected before and after the experiment of the Emergency Department,and the comparative analysis is made on their standardization of diagnosis and treatment.Results:The total score of doctors’medical records(85.79±3.70)is significantly higher(P<0.01)after the application of the system than that before the application(72.49±4.41).After the application of the intelligent decision support system,the scores of complaint(4.34±0.67),history of present illness(17.74±1.52),previous medical history(8.00±1.16),physical examination and auxiliary examination(13.25±1.62),diagnosis and treatment measures(17.40±1.12)and other(4.35±0.68)modules are significantly higher(P<0.01)than those before the application(3.89±0.89,13.08±1.76,2.49±1.65,12.06±2.51,16.30±2.30 and 3.80±1.00,respectively).There is no statistic difference in the score of basic information of patient,diagnosis and basic requirements for writing of medical records compared to those before the application.After the application of the intelligent decision support system,the rate of electrocardiogram examination within10 min in patients with chest pain suspected of ACS is 96%,which is significantly higher than that before the application(88%).The rate of emergency coronary intervention in patients with chest pain suspect

关 键 词：人工智能 临床决策支持系统 应用实践 

分 类 号：R4[医药卫生—临床医学] R319