基于EMR数据挖掘的临床路径构建中EMR数据预处理

高质量决策取决于高质量数据。与其他领域的数据挖掘一样,在基于电子病历数据挖掘构建临床路径中,也需要对拟挖掘的电子病历数据进行预处理,为最终的数据挖掘提供干净、准确、更有针对性的数据,从而提高挖掘的效率和准确度,但对于基于EMR数据挖掘的临床数据构建中的电子病历预处理又有其自身的特点。文章对此进行了分析与探索。     

EMR适于数据挖掘构建临床路径的数据特征分析

通过深入剖析卫生部下发的相关临床路径及《电子病历基本架构与数据标准》相关内容,文章从数据特征视角入手,探讨了电子病历适于数据挖掘方法构建临床路径的数据特征,从电子病历数据内容及数据结构两方面分析了基于电子病历的数据挖掘方法构建临床路径的可行性。     

电子病历系统对临床路径管理的影响研究

目的 探讨电子病历系统对临床路径管理的影响。方法 入选河北北方学院附属第一医院2014年1月—2014年6月进入临床路径管理的512例患者（包括胆囊结石腹腔镜胆囊切除术、慢性鼻-鼻窦炎、2型糖尿病3个病种）作为观察对象,其中258例患者采用电子病历系统进行临床路径管理,254例患者采用纸质病历系统进行临床路径管理,比较两组病历质量、路径变异率、病种治疗费用及患者满意度。结果 观察组甲级率明显高于对照组、乙级率明显低于对照组,差异均具有统计学意义（均P<0.05）;观察组路径变异率为7.8%（20/258）,显著低于对照组15.0%（38/254）,差异具有统计学意义（P＜0.05）;观察组3个病种的治疗费用均显著低于对照组,差异均具有统计学意义（均P＜0.05）;观察组患者满意度为95.3%（246/258）,显著高于对照组的77.2%（196/254）,差异具有统计学意义（P＜0.05）。结论 电子病历系统与临床路径管理结合有助于降低路径变异率,提高医护人员工作效率,降低医疗费用,提高患者满意度。     

电子化临床路径管理系统对病历内涵质量的影响

在电子病历提供各种模板的便利条件下,病历的内涵质量已逐渐成为质控的难点和重点。在总结电子病历质控缺陷的基础上,介绍了电子化临床路径管理系统的特点和作用,根据医院实施效果,指出电子化临床路径管理系统能够提高病历内涵质量。     

基于临床路径的医师防御性医疗行为测量与分析

目的 提出具有较高可行性、效度和信度的防御性医疗行为测量工具和方法,了解医师防御性医疗行为的类型、数量和分布。方法 以河北省某医院的110例脑出血住院患者为例,以临床路径为基础,应用病历回顾性评判法对医师的防御性医疗行为进行测量和分析。结果 医师采取了多种类型的防御性医疗行为,内科治疗和外科手术治疗患者的防御性医疗分别占全部检查化验费的24.6%和21.1%。结论 研究提出的防御性医疗行为测量方法具有较高的科学性,但仍需进一步完善;医疗纠纷和诉讼压力导致医师产生了各种类型的防御性医疗行为,而且较为程度较为严重。     

临床路径评价指标体系的设计与构建

通过对评价因子的研究,力图探索并建立一套对临床路径的使用和管理进行比较全面完整评价的指标体系和标准,并对评价方法进行了深入探讨,对临床路径的运用及改进提供了有效可行的、评价工具,推动临床路径工作的持续进展。     

临床路径变异指标管理评价体系构建

通过对3家样本医院2013年实施临床路径病种产生变异的260例病例的变异原因进行分析,掌握导致变异的所有指标,运用主成分分析的方法,筛选出产生变异的主要指标,从而规范临床路径管理的工作流程,以便提高医院的管理效益,加强医疗质量,最终目的是减轻患者负担,切实解决看病难、看病贵的问题,促进医患关系的和谐。     

肺癌数字化临床路径管理平台的构建和初步应用

目的:构建肺癌数字化临床路径并研究其在临床中应用优势。方法:收集2013年8月-2016月3月于哈医大四院胸外二科入院的肺癌手术患者,150名患者通过肺癌数字化临床路径管理系诊治(临床路径组),150人通过常规方式诊疗(对照组),比较两组最终的住院天数和住院总费用。结果:临床路径组的住院总天数、住院总费用均小于对照组(P0.05或0.01)。结论:数字化肺癌路径管理平台在临床病人管理中具有一定的优势。     

医院临床数据中心建设与应用

为解决医疗记录报告单的管理混乱问题,文章提出了医院临床数据中心体系架构,主要从系统整体架构、层次结构以及关键技术实现等方面进行了阐述,实现了基于Ensemble集成平台的医疗记录报告单数字化集中归档,生成PDF格式的报告单,为医护人员及病人提供各类应用服务。医生借助电子病历里调阅PDF格式的医疗记录报告单,解决了电子病历与各临床信息系统之间的信息集成,提高了医院的服务质量。     

支持复杂疾病的临床路径知识库平台的构建及应用

目的 为了提高医疗服务质量、降低医疗成本,建立临床路径知识库平台,为临床提供决策服务。方法 围绕临床路径知识库的构建,主要解决三个问题：临床规则库的建立、临床路径自适应及修复模型和HIS数据整合框架。结果 构建支持复杂疾病的临床路径知识库,并实现共享平台。结论 通过建立支持复杂疾病的临床知识库平台,为患者提供准确的医疗服务,为医院提供临床路径决策支持,具有良好的应用效果。     

基于粗糙集的数据挖掘技术及其在临床医学诊断中的应用

数据挖掘是一个利用各种分析工具在海量数据中发现模型和数据间关系的过程。临床医学上大量的数据中蕴含着丰富的信息,利用数据挖掘技术,特别是基于粗糙集理论的数据挖掘技术,通过数据训练集所训练得到的算法模型能够有效应用于疾病诊断。并获得很高的准确率,本文简单介绍了数据挖掘技术的基本原理和主要方法,以及粗糙集理论的基本原理,并给出了一个利用数据挖掘技术对肺部肿瘤进行诊断评价的应用实例。     

基于DNA序列数据挖掘算法研究

引入数据挖掘技术,研究DNA序列数据内在规律性,并给出DNA序列分类问题的算法．综合考虑碱基组的出现概率以及相邻氨基酸之间的关系,从DNA序列片段的个案中密码子分布密度角度出发,提取出已知类别的DNA序列片段的特征;应用分类的逐步判别分析方法,剔除判别能力不显著的变量,给出DNA序列分类的判别函数．仿真结果表明,该算法具有分类计算公式简单且分类结果精度的优点．     

基于数据挖掘的门诊信息资源分析

目的：随着各级医院信息化建设的不断加强,医院的信息化水平也日益提高。目前各医院都有自己完善的信息化系统,在日常的门诊中,信息化系统积累了大量的门诊就诊数据,但长久以来这部分数据只是处于低层次的应用。对数据的深层次分析、加工以及对医院管理层的决策支持能力较弱。面对着这些宝贵的数据,医院迫切需要数据挖掘和分析工具从积累的就诊数据中分析出更深层次的、高价值的信息,从而为医院的管理决策提供高价值的决策信息。方法：以聚类算法进行数据挖掘建模,对某院门诊信息资源中有用字段进行挖掘分析。结果：根据数据挖掘模型进行挖掘分析,对有价值字段进行聚类分析,得到相关字段数据挖掘结果。结论：将得到相关字段数据挖掘结果进行分析,并将所分析的结果在医院管理决策和医疗质量管理等方面的应用进行探讨。     

基于USB数据采集器的膜片钳系统软件设计

为了控制新的基于USB总线的数据采集器进行膜片钳实验,设计和实现了能应用于Windows 2000／XP操作系统的膜片钳系统软件。软件运用面向对象程序设计方法和统一建模语言,实现了封接测试．电压门控和配体门控等实验模式。实验结果表明,该系统软件能够精确控制数据采集器进行高速数据采集,满足细胞生理实验的要求。     

Drug Repositioning for Diabetes Based on 'Omics' Data Mining

Drug repositioning has shorter developmental time, lower cost and less safety risk than traditional drug development process. The current study aims to repurpose marketed drugs and clinical candidates for new indications in diabetes treatment by mining clinical ‘omics’ data. We analyzed data from genome wide association studies (GWAS), proteomics and metabolomics studies and revealed a total of 992 proteins as potential anti-diabetic targets in human. Information on the drugs that target these 992 proteins was retrieved from the Therapeutic Target Database (TTD) and 108 of these proteins are drug targets with drug projects information. Research and preclinical drug targets were excluded and 35 of the 108 proteins were selected as druggable proteins. Among them, five proteins were known targets for treating diabetes. Based on the pathogenesis knowledge gathered from the OMIM and PubMed databases, 12 protein targets of 58 drugs were found to have a new indication for treating diabetes. CMap (connectivity map) was used to compare the gene expression patterns of cells treated by these 58 drugs and that of cells treated by known anti-diabetic drugs or diabetes risk causing compounds. As a result, 9 drugs were found to have the potential to treat diabetes. Among the 9 drugs, 4 drugs (diflunisal, nabumetone, niflumic acid and valdecoxib) targeting COX2 (prostaglandin G/H synthase 2) were repurposed for treating type 1 diabetes, and 2 drugs (phenoxybenzamine and idazoxan) targeting ADRA2A (Alpha-2A adrenergic receptor) had a new indication for treating type 2 diabetes. These findings indicated that ‘omics’ data mining based drug repositioning is a potentially powerful tool to discover novel anti-diabetic indications from marketed drugs and clinical candidates. Furthermore, the results of our study could be related to other disorders, such as Alzheimer’s disease.     

基于决策树的红色籽用西瓜数据挖掘

利用Clementine软件提供的决策树C5．0算法,探索红色籽用西瓜自交系多个数量性状之间的相互制约关系。初步建立了单瓜种子重决策树模型,预测精度达到68％。可据此模型对红籽瓜自交系的各经济性状进行定量分析,为育种生产者进行优良自交系和亲本选配提供决策。     

Study on the Absorbed Fingerprint-Efficacy of Yuanhu Zhitong Tablet Based on Chemical Analysis,Vasorelaxation Evaluation and Data Mining

Yuanhu Zhitong Tablet (YZT) is an example of a typical and relatively simple clinical herb formula that is widely used in clinics. It is generally believed that YZT play a therapeutical effect in vivo by the synergism of multiple constituents. Thus, it is necessary to build the relationship between the absorbed fingerprints and bioactivity so as to ensure the quality, safety and efficacy. In this study, a new combinative method, an intestinal absorption test coupled with a vasorelaxation bioactivity experiment in vitro, was a simple, sensitive, and feasible technique to study on the absorbed fingerprint-efficacy of YZT based on chemical analysis, vasorelaxation evaluation and data mining. As part of this method, an everted intestinal sac method was performed to determine the intestinal absorption of YZT solutions. YZT were dissolved in solution (n = 12), and the portion of the solution that was absorbed into intestinal sacs was analyzed using rapid-resolution liquid chromatography coupled with quadruple time-of-flight mass spectrometry (RRLC-Q-TOF/MS). Semi-quantitative analysis indicated the presence of 34 compounds. The effect of the intestinally absorbed solution on vasorelaxation of rat aortic rings with endothelium attached was then evaluated in vitro. The results showed that samples grouped by HCA from chemical profiles have similar bioactivity while samples in different groups displayed very different. Moreover, it established a relationship between the absorbed fingerprints and their bioactivity to identify important components by grey relational analysis, which could predict bioactive values based on chemical profiles and provide an evidence for the quantification of multi-constituents.     

Ultrafast Charge Generation Pathways in Photovoltaic Blends Based on Novel Star‐Shaped Conjugated Molecules

The quest for new materials is one of the main factors propelling recent advances in organic photovoltaics. Star‐shaped small molecules (SSMs) have been proven promising candidates as perspective donor material due to the increase in numbers of excitation pathways caused by the degeneracy of the lowest unoccupied molecular orbital (LUMO) level. In order to unravel the pathways of the initial photon‐to‐charge conversion, the photovoltaic blends based on three different SSMs with a generic structure of N(phenylene‐nthiophene‐dicyanovinyl‐alkyl)₃ (n = 1–3), and [6,6]‐phenyl‐C₇₁‐butyric acid methyl ester (PC₇₁BM) acceptor are investigated by ultrafast photoinduced absorption spectroscopy assisted by density functional theory calculations. It is shown that both electron transfer from SSMs to PC₇₁BM and hole transfer from PC₇₁BM to SSMs are equally significant for generation of long‐lived charges. In contrast, intramolecular (intra‐SSM) charge separation results in geminate recombination and therefore constitutes a loss channel. Overall, up to 60% of long‐lived separated charges are generated at the optimal PC₇₁BM concentrations. The obtained results suggest that further improvement of the SSM‐based solar cells is feasible via optimization of blend morphology and by suppressing the intra‐SSM recombination channel.