基于电子健康记录的知识图系统,用于协作临床决策支持,使用多中心碎片化医疗数据:设计和应用研究
Yong Shang1, Yu Tian2,3, Kewei Lyu2,3
1Research Center for Data Hub and Security, Zhejiang Laboratory, Hangzhou, China.
Journal of medical Internet research
|July 5, 2024
概括
这项研究开发了一种保护隐私的电子健康记录 (EHR) 知识图系统. 它可以在碎片化的多中心患者数据上进行协作推理,以改善临床决策支持,识别被忽视的慢性病 (CKD) 病例.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的人工智能
- 数据 隐私 数据 隐私 数据
背景情况:
- 医学知识图提供决策支持,但与分散的,多医院的患者数据作斗争.
- 数据安全问题和碎片化限制了知识图在现实世界临床环境中的应用.
- 将知识图集成到多中心环境中需要方法来保护数据隐私和安全.
研究的目的:
- 提出一个以电子健康记录 (EHR) 为导向的知识图表系统,用于协作推理.
- 在保护数据隐私的同时,利用多中心碎片化的患者医疗数据.
- 通过安全的数据集成来加强临床决策支持.
主要方法:
- 开发了一个EHR知识图框架,并采用了协作推理过程.
- 使用统一的语义结构和OMOP词汇标准化的本地EHR数据.
- 利用区块链网络同步中间发现和哈希加密身份,以保护隐私的多中心协作.
主要成果:
- 使用多中心碎片化EHR数据评估系统,以识别被忽视的慢性病 (CKD) 患者.
- 在3家医院的1185名患者中成功发现了124例CKD病例,这些病例被个别医院遗漏了.
- 临床评估证实,86%的确诊患者确实呈CKD阳性.
结论:
- 拟议的系统有效地利用多中心碎片化EHR数据用于临床应用.
- 通过迅速和全面的决策支持,证明了临床益处,改善了患者护理.
- 该系统成功地解决了多中心医疗数据集成中的隐私和安全问题.
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