基于案例推理的牙科病历智能生成技术研究
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摘要
随着信息技术的飞速发展，医院信息化建设逐步深入，病历生成的研究成为医院信息化向智能化方向发展的热点问题。病历的生成较大程度上依赖于医务人员先前的经验和知识，继承与重用这些经验和知识、借鉴已有的典型病历模型和病历案例，可在较大程度上提高病历生成的效率和规范化。本文将案例推理(Case-Based Reasoning，简称CBR)技术应用于牙科病历的生成过程中，提出了一种基于案例推理的牙科病历生成方法。
文章首先分析了病历管理的现状和存在问题，重点研究了牙科病历模式及其特征，在此基础上引入了案例推理技术，对牙科病历案例进行了规划，构建了牙科病历智能生成系统的总体框架。其次，给出了牙科病历知识库的结构，重点构建了牙科病历案例库，提出了融合模糊数学、改进的欧拉距离相似度算法的牙科病历案例混合检索策略，同时给出了特征权重的优化方法，并根据牙科病历案例的特征，提出了基于规则的案例修正方法。最后研制了牙科病历智能生成系统的原型，组织初始案例对案例表示、检索方法的有效性及其效率以及修正幅度和修正效率比较等进行了实验。
结果表明：基于CBR的牙科病历智能生成方法具有较好的有效性，可有效地辅助医生诊断，较大程度上缩短病历书写时间，同时也为病历的电子化管理和利用提供了一种新方法。
The generation of medical records is of great importance in medical activities. With the rapid development of information technology and the management of modern medical institutions, the generation of medical records tends to be increasingly intelligent. To a great extent, the generation of medical records depends on the previous experience and knowledge of medical staff .Thus its efficiency and quality can be greatly improved by inheriting and reusing these experience and knowledge and by referring to the typical modes of medical records and medical cases. In this paper, CBR is applied in the process of generating record of dental cases, and a new method which is based on case inference is proposed.
First, the present management of medical records and relevant problems are analyzed, and the pattern of dental records and its characteristics are studied. Then, the frame of intelligent generation technique of dental medical is constructed after introducing CBR and programming dental cases. Based on the analysis of the features of dental records, the method of case inference is proposed and the case base is constructed. Thus mixed case retrieval is proposed for dental records by adopting fuzzy mathematics and by improving similarity algorithm based on Eulerian-Lagrangian distance, and an optimal method is presented. At the same time, according to the features of dental records, Ruler-based adaptation is suggested. Finally, the CBR-DCH system is constructed and the effectiveness of the system, the efficiency of retrieval method, the extent of adaptation and adaptation efficiency are tested by using original case base.
It is demonstrated that the method proposed is greatly effective because it can reduce the time of writing medical record, improve its efficiency and it is an effective aid for diagnoses. Moreover a new method is provided for the electronic management of medical records and its application.
文章首先分析了病历管理的现状和存在问题，重点研究了牙科病历模式及其特征，在此基础上引入了案例推理技术，对牙科病历案例进行了规划，构建了牙科病历智能生成系统的总体框架。其次，给出了牙科病历知识库的结构，重点构建了牙科病历案例库，提出了融合模糊数学、改进的欧拉距离相似度算法的牙科病历案例混合检索策略，同时给出了特征权重的优化方法，并根据牙科病历案例的特征，提出了基于规则的案例修正方法。最后研制了牙科病历智能生成系统的原型，组织初始案例对案例表示、检索方法的有效性及其效率以及修正幅度和修正效率比较等进行了实验。
结果表明：基于CBR的牙科病历智能生成方法具有较好的有效性，可有效地辅助医生诊断，较大程度上缩短病历书写时间，同时也为病历的电子化管理和利用提供了一种新方法。
The generation of medical records is of great importance in medical activities. With the rapid development of information technology and the management of modern medical institutions, the generation of medical records tends to be increasingly intelligent. To a great extent, the generation of medical records depends on the previous experience and knowledge of medical staff .Thus its efficiency and quality can be greatly improved by inheriting and reusing these experience and knowledge and by referring to the typical modes of medical records and medical cases. In this paper, CBR is applied in the process of generating record of dental cases, and a new method which is based on case inference is proposed.
First, the present management of medical records and relevant problems are analyzed, and the pattern of dental records and its characteristics are studied. Then, the frame of intelligent generation technique of dental medical is constructed after introducing CBR and programming dental cases. Based on the analysis of the features of dental records, the method of case inference is proposed and the case base is constructed. Thus mixed case retrieval is proposed for dental records by adopting fuzzy mathematics and by improving similarity algorithm based on Eulerian-Lagrangian distance, and an optimal method is presented. At the same time, according to the features of dental records, Ruler-based adaptation is suggested. Finally, the CBR-DCH system is constructed and the effectiveness of the system, the efficiency of retrieval method, the extent of adaptation and adaptation efficiency are tested by using original case base.
It is demonstrated that the method proposed is greatly effective because it can reduce the time of writing medical record, improve its efficiency and it is an effective aid for diagnoses. Moreover a new method is provided for the electronic management of medical records and its application.
引文
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[8]赵卫东，杜雪寒等．基于神经网络的案例推理医疗诊断[J]．东南大学学报，2000，30(3)：46-50
[9]倪志伟，李学俊，胡彩平，李锋刚．基于范例和规则相结合的推理技术[J]．小型微型计算机系统，2004，25(7)：1156-1159
[10]路云，吴应宇，达庆利．基于案例推理技术的企业经营决策支持模型设计术[J]．中国管理科学，2005，13(2)：81-87
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[13]Leake D B. CBR in context:the present and future[A].Case-Based Reasoning, Experiences, Lessons&Future Directions[C].Menlo Park CA,USA:AAAI Press/the MIT Press, 1996.1-30.
[14]Watson I. Appling case-based reasoning: techniques for enterprise system[M]. [s. 1.]:Morgan Kauf-mann Publishers,Inc, 1997.
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