A study on analysis and improvement methods of clinical processes in lung cancer diagnosis and treatment with network planning methods.

网络规划方法对肺癌诊疗临床流程的分析与改进方法研究

基本信息

批准号：
07672436
负责人：
TAKADA Akira
金额：
$ 1.41万
依托单位：
University of Tsukuba
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1996
项目状态：
已结题

项目摘要

Based on the medical records of patients who were admitted between April 1991 and March 1992 to treat and examine lung cancer, events, including examinations and medical interventions are identified. Regarding the logical relations of them, time intervals and distribution between them are calculated. With that result, the events that actually affected clinical process of the lung cancer diagnosis and treatment was identified. Then the PERT model was build by these events and is assessed the utility for alternative planing.First, we evaluated application of PERT on diagnosis process. With this evaluation we revealed that the network planning method can be applied into the diagnostic process using the logical and chronological relations between each events in the clinical process.To evaluate the effect of the unexpected event in the application of the PERT (Program Evaluation and Review Technique) for evaluations of clinical process, we examined the therapeutic process of the lung cancer treatment. In therapeutic process, following difficulties are revealed to compromise the application of PERT to such process.1) Therapeutic process are not standardized.2) The time records of medical intervention are subject to be omitted in the medical record.3) The time when the unexpected (or harmful) events are resolved was not explicitly assessed.With these difficulties, logical and chronological relations could hardly be reconstructed from medical history currently used in Japan.In conclusion, this study established the effectiveness of the PERT in the clinical process where standardized to plan and evaluate allocation of medical resources. This study also revealed that its limitation in the process not standardized. To evaluated and enhance the effectiveness of the clinical practice, standardization of the clinical process and appropriated medical records that describes medical interventions and its reasons and assessments are considered essential.

根据1991年4月至1992年3月在治疗和检查肺癌的患者的病历，确定了包括检查和医疗干预的事件。关于它们的逻辑关系，计算时间间隔和分布。结果，确定了实际影响肺癌诊断和治疗的临床过程的事件。然后通过这些事件构建了PERT模型，并评估了替代策划的实用性。首先，我们评估了PERT在诊断过程中的应用。通过此评估，我们透露，可以使用临床过程中每个事件之间的逻辑和时间顺序关系将网络计划方法应用于诊断过程。评估意外事件在应用PERT中的效果（程序评估和审查）技术）为评估临床过程，我们检查了肺癌治疗的治疗过程。在治疗过程中，揭示了以下困难以损害PERT在此过程中的应用。1）治疗过程未标准化。2）医疗干预的时间记录在医疗记录中被省略。3）未能明确评估意外（或有害的）事件。由于这些困难，逻辑和按时间顺序的关系几乎不可能从日本目前使用的病史中重建。总而言，这项研究确定了PERT在临床过程中的有效性，在该过程中，标准化的有效性计划和评估医疗资源的分配。这项研究还表明，其在过程中的限制未标准化。为了评估和提高临床实践的有效性，临床过程的标准化以及描述医疗干预措施及其原因和评估的医疗记录被认为是必不可少的。