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Journal of Translational Medicine
Published in: Journal of Translational Medicine 2/2014

Open Access 01-12-2014 | Research

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

Authors: Filip Velickovski, Luigi Ceccaroni, Josep Roca, Felip Burgos, Juan B Galdiz, Nuria Marina, Magí Lluch-Ariet

Published in: Journal of Translational Medicine | Special Issue 2/2014

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Abstract

Background

The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway.

Objectives

The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow.

Methods

The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team.

Results

A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms.

Conclusions

Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.
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Metadata
Title
Clinical Decision Support Systems (CDSS) for preventive management of COPD patients
Authors
Filip Velickovski
Luigi Ceccaroni
Josep Roca
Felip Burgos
Juan B Galdiz
Nuria Marina
Magí Lluch-Ariet
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue Special Issue 2/2014
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/1479-5876-12-S2-S9

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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