Decision Support Systems for MAG3 Renography

MAG3 肾造影决策支持系统

• 批准号: 6513989
• 负责人: ANDREW Thompson TAYLOR
• 金额: $ 27.97万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6513989
• 关键词: bioimaging /biomedical imaging; clinical research; computer assisted diagnosis; computer assisted medical decision making; computer system design /evaluation; human data; informatics; interactive multimedia; kidney imaging /visualization; patient oriented research

DESCRIPTION (provided by applicant): The current health care system requires physicians to master an ever-expanding knowledge base while the hours available to master this knowledge base and apply it to specific tasks (e.g., image interpretation, seeing a new patient) are steadily shrinking. The convergence of an expanding knowledge base and escalating time constraints poses a serious problem that will inevitably lead to physician errors. Solutions to this problem require the development of new tools and processes to save physician time and facilitate the application of a broad and sophisticated knowledge base to speci5c clinical problems. Our long-term objective is to improve the care of nephrourology patients and we propose to meet this objective by developing new tools (Decision Support Systems) to (1) assist and educate physicians and trainees to appropriately perform and interpret Tc-99m mercaptoacetyltriglycine (MAG3) renography and (2) to process, check quality control and actually interpret MAG3 renograms. Specijkally, we hypothesize that we can develop Decision Support Systems to interpret adult MAG3 scans as well as a panel of experts. We have chosen to develop Decision Support Systems for MAG3 renography because (1) the vast majority of the estimated 400,000 radionuclide renal scans performed annually in the United States are interpreted by radiologists who lack the time to develop the needed expertise and (2) MAG3 is used in over 70% of studies. We propose to develop two separate Decision Support Systems using totally different approaches, a heuristic model (knowledge based expert system) and a predictive statistical system. These Systems will be developed from a database of 3500-4000 MAG3 studies and will be designed to acquire the study, generate images and curves from a dynamic radionuclide renogram, check for errors, extract the relevant quantitative data and then use these data to interpret the study. Moreover, the user will be able to query the Systems to obtain the supporting data and rules justifying a specific interpretation. The heuristic and predictive statistical approaches will clarify the relative merits of each approach and will provide a template for the development and application of similar diagnostic and educational aids in the future. Finally, the Decision Support Systems will allow us to calculate the incremental contribution each parameter makes to the diagnostic accuracy, delete superfluous measurements, minimize the time and effort required to acquire, process and interpret renal scans, provide an objective analysis of renogram data, facilitate wide dissemination of interpretative criteria, foster standardized interpretation, teach physicians and trainees to perform and interpret renal scans as competently as experts, encourage more appropriate utilization and, most of all, improve the accuracy of MAG3 scan interpretation and thereby enhance the care of nephro-urology patients.

描述（由申请人提供）：当前的医疗保健系统要求医生掌握不断扩展的知识库，而可用于掌握此知识基础的时间并将其应用于特定任务（例如，图像解释，看到新患者）正在稳步缩小。不断扩展的知识库和不断升级的时间约束的融合带来了一个严重的问题，这将不可避免地导致医师错误。 解决此问题的解决方案需要开发新的工具和流程，以节省医生时间，并促进广泛而复杂的知识库应用到Speci5C临床问题上。我们的长期目标是改善对肾上腺学患者的护理，我们建议通过开发新工具（决策支持系统）来实现这一目标，以（1）协助和教育医生和受训者，以适当地执行和解释TC-99M默西乙酰基三甘氨酸（MAG3）肾脏术（MAG3）肾脏术（MAG3）肾脏术（MAG3）以及（2）检查质量控制和MAG3肾上图。特别是我们假设我们可以开发决策支持系统来解释成人MAG3扫描以及专家小组。我们选择为MAG3肾脏摄影开发决策支持系统，因为（1）在美国，每年进行的40万核素核素肾脏扫描中的绝大多数是由缺乏时间开发所需专业知识的时间来解释的，并且（2）MAG3用于70％以上的研究。我们建议使用完全不同的方法开发两个独立的决策支持系统，即启发式模型（基于知识的专家系统）和预测统计系统。这些系统将从3500-4000 MAG3研究的数据库开发，并将设计为从动态放射性核素肾上腺素肾上腺素肾上腺素肾上图，检查错误，提取相关的定量数据，然后使用这些数据来解释研究来获取研究，生成图像和曲线。此外，用户将能够查询系统以获取支持数据和规则，以证明特定的解释是合理的。启发式和预测性的统计方法将阐明每种方法的相对优点，并将为未来开发和应用类似的诊断和教育辅助工具提供模板。 Finally, the Decision Support Systems will allow us to calculate the incremental contribution each parameter makes to the diagnostic accuracy, delete superfluous measurements, minimize the time and effort required to acquire, process and interpret renal scans, provide an objective analysis of renogram data, facilitate wide dissemination of interpretative criteria, foster standardized interpretation, teach physicians and trainees to perform and interpret renal scans as competently as experts, encourage more appropriate utilization而且，最重要的是，提高了MAG3扫描解释的准确性，从而提高了肾脏 - 动物学患者的护理。