Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2011

Open Access 01-12-2011 | Research article

Development of a real-time clinical decision support system upon the web mvc-based architecture for prostate cancer treatment

Authors: Hsueh-Chun Lin, Hsi-Chin Wu, Chih-Hung Chang, Tsai-Chung Li, Wen-Miin Liang, Jong-Yi Wang Wang

Published in: BMC Medical Informatics and Decision Making | Issue 1/2011

Login to get access

Abstract

Background

A real-time clinical decision support system (RTCDSS) with interactive diagrams enables clinicians to instantly and efficiently track patients' clinical records (PCRs) and improve their quality of clinical care. We propose a RTCDSS to process online clinical informatics from multiple databases for clinical decision making in the treatment of prostate cancer based on Web Model-View-Controller (MVC) architecture, by which the system can easily be adapted to different diseases and applications.

Methods

We designed a framework upon the Web MVC-based architecture in which the reusable and extractable models can be conveniently adapted to other hospital information systems and which allows for efficient database integration. Then, we determined the clinical variables of the prostate cancer treatment based on participating clinicians' opinions and developed a computational model to determine the pretreatment parameters. Furthermore, the components of the RTCDSS integrated PCRs and decision factors for real-time analysis to provide evidence-based diagrams upon the clinician-oriented interface for visualization of treatment guidance and health risk assessment.

Results

The resulting system can improve quality of clinical treatment by allowing clinicians to concurrently analyze and evaluate the clinical markers of prostate cancer patients with instantaneous clinical data and evidence-based diagrams which can automatically identify pretreatment parameters. Moreover, the proposed RTCDSS can aid interactions between patients and clinicians.

Conclusions

Our proposed framework supports online clinical informatics, evaluates treatment risks, offers interactive guidance, and provides real-time reference for decision making in the treatment of prostate cancer. The developed clinician-oriented interface can assist clinicians in conveniently presenting evidence-based information to patients and can be readily adapted to an existing hospital information system and be easily applied in other chronic diseases.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG: Systematic Review: The Evidence That Publishing Patient Care Performance Data Improves Quality of Care. Annals of Internal Medicine. 2008, 148 (2): 111-123.CrossRefPubMed Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG: Systematic Review: The Evidence That Publishing Patient Care Performance Data Improves Quality of Care. Annals of Internal Medicine. 2008, 148 (2): 111-123.CrossRefPubMed
2.
go back to reference Bates DW, Cohen M, Leape LL, Overhage JM, Shabot MM, Sheridan T: Reducing the Frequency of Errors in Medicine Using Information Technology. J Am Med Inform Assoc. 2001, 8: 299-308.CrossRefPubMedPubMedCentral Bates DW, Cohen M, Leape LL, Overhage JM, Shabot MM, Sheridan T: Reducing the Frequency of Errors in Medicine Using Information Technology. J Am Med Inform Assoc. 2001, 8: 299-308.CrossRefPubMedPubMedCentral
3.
go back to reference Johnston ME, Langton KB, Haynes RB, Mathieu A: Effects of Computer-based Clinical Decision Support Systems on Clinician Performance and Patient Outcome: A Critical Appraisal of Research. Annals of Internal Medicine. 1994, 120: 135-142.CrossRefPubMed Johnston ME, Langton KB, Haynes RB, Mathieu A: Effects of Computer-based Clinical Decision Support Systems on Clinician Performance and Patient Outcome: A Critical Appraisal of Research. Annals of Internal Medicine. 1994, 120: 135-142.CrossRefPubMed
4.
go back to reference Hunt DL, Haynes RB, Hanna SE, Smith K: Effects of Computer-Based Clinical Decision Support Systems on Physician Performance and Patient Outcomes. JAMA. 1998, 280: 1339-1346. 10.1001/jama.280.15.1339.CrossRefPubMed Hunt DL, Haynes RB, Hanna SE, Smith K: Effects of Computer-Based Clinical Decision Support Systems on Physician Performance and Patient Outcomes. JAMA. 1998, 280: 1339-1346. 10.1001/jama.280.15.1339.CrossRefPubMed
5.
go back to reference Schwartz A, Millam G: A Web-based library consult service for evidence-based medicine: Technical development. BMC Med Inform Decis Mak. 2006, 6: 16-10.1186/1472-6947-6-16.CrossRefPubMedPubMedCentral Schwartz A, Millam G: A Web-based library consult service for evidence-based medicine: Technical development. BMC Med Inform Decis Mak. 2006, 6: 16-10.1186/1472-6947-6-16.CrossRefPubMedPubMedCentral
6.
go back to reference Wright A, Sittig DF: A four-phase model of the evolution of clinical decision support architectures. Int'l J Medical Informatics. 2008, 77 (10): 641-649.CrossRef Wright A, Sittig DF: A four-phase model of the evolution of clinical decision support architectures. Int'l J Medical Informatics. 2008, 77 (10): 641-649.CrossRef
7.
go back to reference Vickers AJ, Salz T, Basch E, Cooperberg MR, Carroll PR, Tighe F, Eastham J, Rosen RC: Electronic patient self-assessment and management (SAM): a novel framework for cancer survivorship. BMC Medical Informatics and Decision Making. 2010, 10: 34-10.1186/1472-6947-10-34.CrossRefPubMedPubMedCentral Vickers AJ, Salz T, Basch E, Cooperberg MR, Carroll PR, Tighe F, Eastham J, Rosen RC: Electronic patient self-assessment and management (SAM): a novel framework for cancer survivorship. BMC Medical Informatics and Decision Making. 2010, 10: 34-10.1186/1472-6947-10-34.CrossRefPubMedPubMedCentral
8.
go back to reference Chodak GW, Thisted RA, Gerber GS, Johansson JE, Adolfsson J, Jones GW, Chisholm GD, Moskovitz B, Livne PM, Warner J: Results of Conservative Management of Clinically Localized Prostate Cancer. New England J of Medicine. 1994, 330 (4): 242-248. 10.1056/NEJM199401273300403.CrossRef Chodak GW, Thisted RA, Gerber GS, Johansson JE, Adolfsson J, Jones GW, Chisholm GD, Moskovitz B, Livne PM, Warner J: Results of Conservative Management of Clinically Localized Prostate Cancer. New England J of Medicine. 1994, 330 (4): 242-248. 10.1056/NEJM199401273300403.CrossRef
9.
go back to reference O'Dowd GJ, Veltria RW, Orozcoa R, Millera MC, Oesterlinga JE: Update on the Appropriate Staging Evaluation for Newly Diagnosed Prostate Cancer. J Urology. 1997, 158 (3): 687-698.CrossRef O'Dowd GJ, Veltria RW, Orozcoa R, Millera MC, Oesterlinga JE: Update on the Appropriate Staging Evaluation for Newly Diagnosed Prostate Cancer. J Urology. 1997, 158 (3): 687-698.CrossRef
10.
go back to reference Holmes-Rovner M, Stableford S, Fagerlin A, Wei JT, Dunn RL, Ohene-Frempong J, Kelly-Blake K, Rovner DR: Evidence-based patient choice: a prostate cancer decision aid in plain language. BMC Medical Informatics and Decision Making. 2005, 5: 16-10.1186/1472-6947-5-16.CrossRefPubMedPubMedCentral Holmes-Rovner M, Stableford S, Fagerlin A, Wei JT, Dunn RL, Ohene-Frempong J, Kelly-Blake K, Rovner DR: Evidence-based patient choice: a prostate cancer decision aid in plain language. BMC Medical Informatics and Decision Making. 2005, 5: 16-10.1186/1472-6947-5-16.CrossRefPubMedPubMedCentral
11.
go back to reference Walter LC, Covinsky KE: Cancer Screening in Elderly Patients - A Framework for Individualized Decision Making. JAMA. 2001, 285: 2750-2756. 10.1001/jama.285.21.2750.CrossRefPubMed Walter LC, Covinsky KE: Cancer Screening in Elderly Patients - A Framework for Individualized Decision Making. JAMA. 2001, 285: 2750-2756. 10.1001/jama.285.21.2750.CrossRefPubMed
12.
go back to reference Huang HY, Wilkie DJ, Zong SP, Berry D, Hairabedian D, Niela J, Kay M, Farber S, Chabal C: Developing a Computerized Data Collection and Decision Support System for Cancer Pain Management. Computers, Informatics, Nursing. 2003, 21 (4): 206-217. 10.1097/00024665-200307000-00011.CrossRefPubMed Huang HY, Wilkie DJ, Zong SP, Berry D, Hairabedian D, Niela J, Kay M, Farber S, Chabal C: Developing a Computerized Data Collection and Decision Support System for Cancer Pain Management. Computers, Informatics, Nursing. 2003, 21 (4): 206-217. 10.1097/00024665-200307000-00011.CrossRefPubMed
13.
go back to reference Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E, Middleton R, Porterfield H, Sharp SA, Smith TJ, Taplin ME, Vogelzang NJ, Wade JL, Bennett CL, Scher HI: American Society of Clinical Oncology Recommendations for the Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer. J Clinical Oncology. 2004, 22 (14): 2927-2941. 10.1200/JCO.2004.04.579.CrossRef Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E, Middleton R, Porterfield H, Sharp SA, Smith TJ, Taplin ME, Vogelzang NJ, Wade JL, Bennett CL, Scher HI: American Society of Clinical Oncology Recommendations for the Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer. J Clinical Oncology. 2004, 22 (14): 2927-2941. 10.1200/JCO.2004.04.579.CrossRef
14.
go back to reference Dorfman CS, Williams RM, Kassan EC, Red SN, Dawson DL, Tuong W, Parker ER, Ohene-Frempong J, Davis KM, Krist AH, Woolf SH, Schwartz MD, Fishman MB, Cole C, Taylor KL: The development of a web- and a print-based decision aid for prostate cancer screening. BMC Medical Informatics and Decision Making. 2010, 10: 12-10.1186/1472-6947-10-12.CrossRefPubMedPubMedCentral Dorfman CS, Williams RM, Kassan EC, Red SN, Dawson DL, Tuong W, Parker ER, Ohene-Frempong J, Davis KM, Krist AH, Woolf SH, Schwartz MD, Fishman MB, Cole C, Taylor KL: The development of a web- and a print-based decision aid for prostate cancer screening. BMC Medical Informatics and Decision Making. 2010, 10: 12-10.1186/1472-6947-10-12.CrossRefPubMedPubMedCentral
15.
go back to reference Gamma E, Helm R, Johnson R, Vlissides J: Design Patterns: Elements of Reusable Object-Oriented Software. 1994, Addison-Wesley Gamma E, Helm R, Johnson R, Vlissides J: Design Patterns: Elements of Reusable Object-Oriented Software. 1994, Addison-Wesley
16.
go back to reference Chaudhuri S, Dayal U: An Overview of Data Warehousing and OLAP Technology. ACM SIGMOD Record. 1997, 26: 65-74. 10.1145/248603.248616.CrossRef Chaudhuri S, Dayal U: An Overview of Data Warehousing and OLAP Technology. ACM SIGMOD Record. 1997, 26: 65-74. 10.1145/248603.248616.CrossRef
17.
go back to reference Carter HB, Allae ME, Partin AW: Diagnosis and Staging of Prostate Cancer. Campbell-Walsh Urology. Edited by: Wein AJ. 2007, Philadelphia: W.B. Saunders, 3: Sec.XVI, Ch.94, 9 Carter HB, Allae ME, Partin AW: Diagnosis and Staging of Prostate Cancer. Campbell-Walsh Urology. Edited by: Wein AJ. 2007, Philadelphia: W.B. Saunders, 3: Sec.XVI, Ch.94, 9
18.
go back to reference Sensabaugh GF: Isolation and characterization of a semen-specific protein from human seminal plasma: A potential new marker for semen identification. J Forensic Sci. 1978, 23: 106-115.CrossRefPubMed Sensabaugh GF: Isolation and characterization of a semen-specific protein from human seminal plasma: A potential new marker for semen identification. J Forensic Sci. 1978, 23: 106-115.CrossRefPubMed
19.
go back to reference Epstein J, Chan D, Sokoll L, Walsh P, Cox J, Rittenhouse H, Wolfert R, Carter H: Radical prostatectomy as treatment for prostate-specific antigen-detected stage T1c prostate cancer. J Urology. 1997, 15: 373-377. Epstein J, Chan D, Sokoll L, Walsh P, Cox J, Rittenhouse H, Wolfert R, Carter H: Radical prostatectomy as treatment for prostate-specific antigen-detected stage T1c prostate cancer. J Urology. 1997, 15: 373-377.
20.
go back to reference Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC: Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999, 281: 1591-1597. 10.1001/jama.281.17.1591.CrossRefPubMed Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC: Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999, 281: 1591-1597. 10.1001/jama.281.17.1591.CrossRefPubMed
21.
go back to reference Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KJ, Oesterling JE, Scardino PT, Pearson JD: Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA. 1997, 277: 1445-1451. 10.1001/jama.277.18.1445.CrossRefPubMed Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KJ, Oesterling JE, Scardino PT, Pearson JD: Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA. 1997, 277: 1445-1451. 10.1001/jama.277.18.1445.CrossRefPubMed
22.
go back to reference Wang MC, Papsidero LD, Kuriyama M, Valenzuela LA, Murphy GP, Chu TM: Prostate antigen: A new potential marker for prostatic cancer. The Prostate. 1981, 2 (1): 89-96. 10.1002/pros.2990020109.CrossRefPubMed Wang MC, Papsidero LD, Kuriyama M, Valenzuela LA, Murphy GP, Chu TM: Prostate antigen: A new potential marker for prostatic cancer. The Prostate. 1981, 2 (1): 89-96. 10.1002/pros.2990020109.CrossRefPubMed
23.
go back to reference Ercole CJ, Lange PH, Mathisen M, Chiou RK, Reddy PK, Vessella RL: Prostatic specific antigen and prostatic acid phosphatase in the monitoring and staging of patients with prostatic cancer. J Urology. 1987, 138: 1181-1184. Ercole CJ, Lange PH, Mathisen M, Chiou RK, Reddy PK, Vessella RL: Prostatic specific antigen and prostatic acid phosphatase in the monitoring and staging of patients with prostatic cancer. J Urology. 1987, 138: 1181-1184.
24.
go back to reference Myrtle J, Ivor L: Measurement of PSA in serum by two immunometric methods (Hybritech Tandem-R/Tandem-E PSA). Clinical aspects of prostate cancer. Edited by: Catalona WJ. 1989, New York: Elsevier, 161-71. Myrtle J, Ivor L: Measurement of PSA in serum by two immunometric methods (Hybritech Tandem-R/Tandem-E PSA). Clinical aspects of prostate cancer. Edited by: Catalona WJ. 1989, New York: Elsevier, 161-71.
25.
go back to reference Gann PH, Hennekens CH, Stampfer MJ: A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. JAMA. 1995, 273: 289-294. 10.1001/jama.273.4.289.CrossRefPubMed Gann PH, Hennekens CH, Stampfer MJ: A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. JAMA. 1995, 273: 289-294. 10.1001/jama.273.4.289.CrossRefPubMed
26.
go back to reference Catalona WJ, Smith DS, Ornstein DK: Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/mL and benign prostate examination. Enhancement of specificity with free PSA measurements. JAMA. 1997, 277: 1452-1455. 10.1001/jama.277.18.1452.CrossRefPubMed Catalona WJ, Smith DS, Ornstein DK: Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/mL and benign prostate examination. Enhancement of specificity with free PSA measurements. JAMA. 1997, 277: 1452-1455. 10.1001/jama.277.18.1452.CrossRefPubMed
27.
go back to reference Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA: Prevalence of prostate cancer among men with a prostate-specific antigen level > or = 4.0 ng per milliliter. N Engl J Med. 2004, 350: 2239-2246. 10.1056/NEJMoa031918.CrossRefPubMed Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA: Prevalence of prostate cancer among men with a prostate-specific antigen level > or = 4.0 ng per milliliter. N Engl J Med. 2004, 350: 2239-2246. 10.1056/NEJMoa031918.CrossRefPubMed
28.
go back to reference Bazinet M, Meshref AW, Trudel C, Aronson S, Péloquin F, Nachabe M, Bégin LR, Elhilali MM: Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology. 1994, 43: 44-51. 10.1016/S0090-4295(94)80260-2.CrossRefPubMed Bazinet M, Meshref AW, Trudel C, Aronson S, Péloquin F, Nachabe M, Bégin LR, Elhilali MM: Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology. 1994, 43: 44-51. 10.1016/S0090-4295(94)80260-2.CrossRefPubMed
29.
go back to reference Uzzo RG, Wei JT, Waldbaum RS, Perlmutter AP, Byrne JC, Vaughan ED: The influence of prostate size on cancer detection. J Urology. 1995, 46: 831-836. 10.1016/S0090-4295(99)80353-7.CrossRef Uzzo RG, Wei JT, Waldbaum RS, Perlmutter AP, Byrne JC, Vaughan ED: The influence of prostate size on cancer detection. J Urology. 1995, 46: 831-836. 10.1016/S0090-4295(99)80353-7.CrossRef
30.
go back to reference Carter HB, Pearson JD, Metter EJ, Brant LJ, Chan DW, Andres R, Fozard JL, Walsh PC: Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA. 1992, 267: 2215-2220. 10.1001/jama.267.16.2215.CrossRefPubMedPubMedCentral Carter HB, Pearson JD, Metter EJ, Brant LJ, Chan DW, Andres R, Fozard JL, Walsh PC: Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA. 1992, 267: 2215-2220. 10.1001/jama.267.16.2215.CrossRefPubMedPubMedCentral
31.
go back to reference D'Amico AV, Renshaw AA, Sussman B, Chen MH: Pretreatment PSA velocity and risk of death from prostate cancer following external beam radiation therapy. JAMA. 2005, 294: 440-447.CrossRefPubMed D'Amico AV, Renshaw AA, Sussman B, Chen MH: Pretreatment PSA velocity and risk of death from prostate cancer following external beam radiation therapy. JAMA. 2005, 294: 440-447.CrossRefPubMed
32.
go back to reference Fowler JE, Prabhakar P, Braswell NT, Seaver L, Carpenter R, Moul JW, Thomae KR: Prostate specific antigen progression rates after radical prostatectomy or radiation therapy for localized prostate cancer. Surgery. 1994, 116: 302-306.PubMed Fowler JE, Prabhakar P, Braswell NT, Seaver L, Carpenter R, Moul JW, Thomae KR: Prostate specific antigen progression rates after radical prostatectomy or radiation therapy for localized prostate cancer. Surgery. 1994, 116: 302-306.PubMed
33.
go back to reference Gleason D: Classification of prostatic carcinoma. Cancer Chemother Rep. 1966, 50 (3): 125-128.PubMed Gleason D: Classification of prostatic carcinoma. Cancer Chemother Rep. 1966, 50 (3): 125-128.PubMed
34.
go back to reference Partin AW, Yoo J, Carter HB, Pearson JD, Chan DW, Epstein JI, Walsh PC: The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. J Urol. 1993, 150: 110-114.PubMed Partin AW, Yoo J, Carter HB, Pearson JD, Chan DW, Epstein JI, Walsh PC: The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. J Urol. 1993, 150: 110-114.PubMed
35.
go back to reference Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD: Contemporary update of prostate cancer staging nomograms (Partin tables) for the new millennium. J Urology. 2001, 58: 843-848. 10.1016/S0090-4295(01)01441-8.CrossRef Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD: Contemporary update of prostate cancer staging nomograms (Partin tables) for the new millennium. J Urology. 2001, 58: 843-848. 10.1016/S0090-4295(01)01441-8.CrossRef
36.
go back to reference Kleer E, Oesterling JE: PSA and staging of localized prostate cancer. J Urol Clin North Am. 1993, 20: 695-704. Kleer E, Oesterling JE: PSA and staging of localized prostate cancer. J Urol Clin North Am. 1993, 20: 695-704.
37.
go back to reference D'Amico AV, Whittington R, Malkowicz S, Weinstein M, Tomaszewski J, Schultz D, Rhude M, Rocha S, Wein A, Richie J: Predicting prostate specific antigen outcome preoperatively in the prostate specific antigen era. J Urol. 2001, 166: 2185-2188.CrossRefPubMed D'Amico AV, Whittington R, Malkowicz S, Weinstein M, Tomaszewski J, Schultz D, Rhude M, Rocha S, Wein A, Richie J: Predicting prostate specific antigen outcome preoperatively in the prostate specific antigen era. J Urol. 2001, 166: 2185-2188.CrossRefPubMed
38.
go back to reference Detmar SB, Muller MJ, Schornagel JH, Wever LDV, Aaronson NK: Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA. 2002, 288 (23): 3027-3034. 10.1001/jama.288.23.3027.CrossRefPubMed Detmar SB, Muller MJ, Schornagel JH, Wever LDV, Aaronson NK: Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA. 2002, 288 (23): 3027-3034. 10.1001/jama.288.23.3027.CrossRefPubMed
39.
go back to reference Stephenson AJ, Scardino PT, Eastham JA, Bianco FJ, Dotan ZA, DiBlasio CJ, Reuther A, Klein EA, Kattan MW: Postoperative Nomogram Predicting the 10-Year Probability of Prostate Cancer Recurrence After Radical Prostatectomy. J Clinical Oncology. 2005, 23 (28): 7005-7012. 10.1200/JCO.2005.01.867.CrossRef Stephenson AJ, Scardino PT, Eastham JA, Bianco FJ, Dotan ZA, DiBlasio CJ, Reuther A, Klein EA, Kattan MW: Postoperative Nomogram Predicting the 10-Year Probability of Prostate Cancer Recurrence After Radical Prostatectomy. J Clinical Oncology. 2005, 23 (28): 7005-7012. 10.1200/JCO.2005.01.867.CrossRef
Metadata
Title
Development of a real-time clinical decision support system upon the web mvc-based architecture for prostate cancer treatment
Authors
Hsueh-Chun Lin
Hsi-Chin Wu
Chih-Hung Chang
Tsai-Chung Li
Wen-Miin Liang
Jong-Yi Wang Wang
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2011
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/1472-6947-11-16

Other articles of this Issue 1/2011

BMC Medical Informatics and Decision Making 1/2011 Go to the issue