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2 2004

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An expert system supporting risk stratification in acute coronary syndromes

Grabowski M., Filipiak K. J., Rudowski R., Opolski G.

TASK Quarterly : scientific bulletin of Academic Computer Centre in Gdansk

2004

Vol. 8, No 2

281-286

The aim of the project was to create a computer program, an expert system (ES), which would support physicians when a management for patients with acute coronary syndrome needs to be chosen. A knowledge database was created with the support of clinical experts, based on the current management standards. Data from new patients are added to the case database. The inference engine integrates two types of reasoning rule-based and case-based. The ES gives unambiguous and objective answers, its recommendation are reliable. At present, the ES is tested in clinical practice. Strategies recommended by the ES are compared with the management applied in a clinic.

Electronic patient record, expert system and mobile monitoring in Cardio.net project

Rudowski R., Grabowski M., Sierdziński J., Guć M.

Biocybernetics and Biomedical Engineering

2004

Vol. 24, no. 1

61-71

Cardio.net project is aimed at the implementation of the prototype system of telecardiology in Mazovia and Pomerania Regions of Poland. It is planned as a tool to reduce the time from the onset of symptoms to the cardiological intervention, which can significantly reduce the mortality of patients with the acute coronary syndromes (ACS). The system will enable teleconsultations, from the reference centers to the regional hospitals, regarding the need for invasive cardiological intervention. If there is such a need then the patient will be transported to the reference center. The Cardio.net tasks include the design of telecommunication infrastructure, incorporating data transmission standards HL7, DICOM, work on the security and safety of the system, the design of Electronic Patient Record (EPR), uniform archive of EPR's and also the expert system. The EPR consist of two types of forms: a) personal data forms, b) forms supporting the physician work (case history, diagnosis, physical examination, the clinical course of hospitalization, additional tests and drugs). The tools used for creating EPR and archive of EPR's were PHP, Java Script, XML and MySQL. The risk stratification and therapeutic decision making in ACS are the main tasks of the expert system. There are two main therapeutic strategies: early invasive versus conservative. The chosen strategy depends on several factors. The expert system has been verified on the archival data of 147 patients with ACS. In 127 (86%) the expert system suggested the same strategy as applied by the cardiologist. In conclusion: uniform EPR and archive of EPR's give a chance of improving the quality of the cardiological care due to teleconsultations performed directly by specialists or indirectly by the expert system. Mobile monitoring and alerting can decrease the time from the onset of symptoms to the therapeutic intervention thus improving the patients safety,