基于参考模型的临床路径挖掘
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摘要
鉴于临床诊疗过程的高度动态性和复杂性,目前通过计算机辅助临床路径制定的效果不佳提出一种基于参考模型的临床路径挖掘算法。该算法以时序数据为输入,以国家标准临床路径为参考模型进行临床路径挖掘,生成本地化的临床路径模型。通过同义医嘱数据消解降低医嘱数据维度,通过关键医嘱序列挖掘实现医嘱数据与参考模型的时序对齐,通过多分类的医嘱主题聚类实现医嘱到标准临床路径活动的映射。实验结果表明,所提算法充分考虑了我国临床路径管理模式推广过程中的实际情况,能够有效辅助我国医疗机构进行本地化临床路径的制定。
Most of the computer aided clinical pathway design could not apply in general cases due to complexity and high level of diversity during the clinical process.Aiming at the situation in China,a clinical pathway mining method named CPMRM algorithm was proposed.Based on time series data,the algorithm took the national standard clinical path as a reference model to achieve local clinical pathway mining.It used synonymous order reduction to reduce the size of order set,key order pattern mining to align the time of order set and the reference model and multi-classification based topic-model clustering to map the orders to clinical pathway activities.Experiments showed that CPMRM algorithm fully considered the actual situation in the process of popularization of clinical pathway management model in China,and could effectively assist the development of local clinical pathways in Chinese medical service provider.
Most of the computer aided clinical pathway design could not apply in general cases due to complexity and high level of diversity during the clinical process.Aiming at the situation in China,a clinical pathway mining method named CPMRM algorithm was proposed.Based on time series data,the algorithm took the national standard clinical path as a reference model to achieve local clinical pathway mining.It used synonymous order reduction to reduce the size of order set,key order pattern mining to align the time of order set and the reference model and multi-classification based topic-model clustering to map the orders to clinical pathway activities.Experiments showed that CPMRM algorithm fully considered the actual situation in the process of popularization of clinical pathway management model in China,and could effectively assist the development of local clinical pathways in Chinese medical service provider.
引文
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[21]JIN Tao.Clinical pathway mining based on ontology and LDA[D].Beijing:Tsinghua University,2016(in Chinese).[金涛.基于本体和主题模型的临床路径挖掘[D].北京:清华大学,2016.]
[22]FOURNIER V P,GOMARIZ A,CAMPOS M,et al.Fast vertical mining of sequential patterns using co-occurrence information[C]//Proceedings of the International Conference on Pacific-Asia Conference on Knowledge Discovery and Data Mining.Berlin,Germany:Springer-Verlag,2014:40-52.
[2]SPOONER S H,YOCKEY P S.Assessing clinical path effectiveness:a model for evaluation[J].Nursing Case Management:Managing the Process of Patient Care,1995,1(4):188-198.
[3]WANG Huangqiong.Study on semantic-based personalized clinical pathways[D].Hangzhou:Zhejiang University,2015(in Chinese).[王华琼.基于语义技术的个性化临床路径研究[D].杭州:浙江大学,2015.]
[4]MANS R,SCHONENBERG H,LEONARDI G,et al.Process mining techniques:an application to stroke care[J].Studies in Health Technology and Informatics,2008,136(6):573-578.
[5]VAN DONGEN B F,DE MEDEIROS A K A,VERBEEK H M W,et al.The ProM framework:a new era in process mining tool support[C]//Proceedings of the International Conference on Application and Theory of Petri Nets.Berlin,Germany:Springer-Verlag,2005:444-454.
[6]WEIJTERS A,VAN DER AALST W M P,DE MEDEIROS A K A.Process mining with the heuristics miner-algorithm[J].Cirp Annals—Manufacturing Technology,2006,166:1-34.
[7]MANS R S,SCHONENBERG M H,SONG M,et al.Application of process mining in healthcare-a case study in a dutch hospital[M].Berlin,Germany:Springer-Verlag,2009.
[8]GNTHER C W,VAN DER AALST W M P.Fuzzy miningadaptive process simplification based on multi-perspective metrics[C]//Proceedings of the International Conference on Business Process Management.Berlin,Germany:Springer-Verlag,2007:328-343.
[9]DE WEERDT J,CARON F,VANTHIENEN J,et al.Getting agrasp on clinical pathway data:an approach based on process mining[C]∥Proceedings of the Pacific-Asia Conference on Knowledge Discovery and Data Mining.Berlin,Germany:Springer-Verlag,2012:22-35.
[10]LAKSHMANAN G T,ROZSNYAI S,WANG F.Investigating clinical care pathways correlated with outcomes.[C]∥Proceedings of the 11th International Conference on Business Process Management.Berlin,Germany:Springer-Verlag,2013:323-338.
[11]FERNANDEZ L C,SACCHI L,BENEDI J M,et al.Temporal abstractions to enrich activity-based process mining corpus with clinical time series[C]∥Proceedings of the International Conference on Biomedical and Health Informatics.Washington,D.C.,USA:IEEE,2014:785-788.
[12]YANG W,SU Q.Process mining for clinical pathway:Literature review and future directions[C]∥Proceedings of the11th International Conference on Service Systems and Service Management.Washington,D.C.,USA:IEEE,2014:1-5.
[13]ANTONACCI G,CALABRESE A,DAMBROGIO A,et al.A BPMN-based automated approach for the analysis of healthcare processes[C]∥Proceedings of the IEEE 25th International Conference on Enabling Technologies:Infrastructure for Collaborative Enterprises.Washington,D.C.,USA:IEEE,2016:124-129.
[14]LIN F R,HSIEH L S,PAN S M.Learning clinical pathway patterns by hidden Markov model[C]∥Proceedings of the38th Annual Hawaii International Conference on System Sciences.Washington,D.C.,USA:IEEE,2005:142.
[15]FERNANDEZ L C,MENEU T,BENEDI J M,et al.Activity-based process mining for clinical pathways computer aided design.[C]//Proceedings of the Annual International Conference on the Engineering in Medicine and Biology Society.Washington,D.C.,USA:IEEE,2010:6178-6181.
[16]DAGLIATI A,SACCHI L,CERRA C,et al.Temporal data mining and process mining techniques to identify cardiovascular risk-associated clinical pathways in type 2 diabetes patients.[C]//Proceedings of the IEEE-EMBS International Conference on Biomedical and Health Informatics.Washington,D.C.,USA:IEEE,2014:240-243.
[17]HELBIG K,ROMER M,MELLOULI T.A clinical pathway mining approach to enable scheduling of hospital relocations and treatment services[C]//Proceedings of the International Conference on Business Process Management.Berlin,Germany:Springer-Verlag,2016:242-250.
[18]BETTENCOURT-SILVA J H,CLARK J,COOPER C S,et al.Building data-driven pathways from routinely collected hospital data:a case study on prostate cancer[J].JMIR Medical Informatics,2015,3(3):e26.
[19]WANG Y,WU P,LIU Y,et al.Learning optimal individualized treatment rules from electronic health record data[C]//Proceedings of the International Conference on Healthcare Informatics.Washington,D.C.,USA:IEEE,2016:65-71.
[20]LEVENSHTEIN V I.Binary codes capable of correcting deletions,insertions,and reversals[J].Soviet Physics Doklady,1966(10):707-710.
[21]JIN Tao.Clinical pathway mining based on ontology and LDA[D].Beijing:Tsinghua University,2016(in Chinese).[金涛.基于本体和主题模型的临床路径挖掘[D].北京:清华大学,2016.]
[22]FOURNIER V P,GOMARIZ A,CAMPOS M,et al.Fast vertical mining of sequential patterns using co-occurrence information[C]//Proceedings of the International Conference on Pacific-Asia Conference on Knowledge Discovery and Data Mining.Berlin,Germany:Springer-Verlag,2014:40-52.