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Clinical decision support : distance-based, and subgroup-discovery methods in
intensive care
Nannings, B.
Publication date
2009
Link to publication
Citation for published version (APA):
Nannings, B. (2009). Clinical decision support : distance-based, and subgroup-discovery
methods in intensive care.
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Contents
CHAPTER 1. GENERAL INTRODUCTION ... 9
1.1. PROBLEM DOMAIN AND OBJECTIVES ... 10
1.1.1 Part 1: Subgroup discovery ... 10
1.1.2 Part 2: Decision Support Telemedicine Systems ... 11
1.2. PRELIMINARIES ... 12
1.2.1 Intensive Care ... 13
1.2.2 Clinical Decision Support Systems ... 15
1.2.3 Telemedicine ... 17
1.2.4 Telemedicine and decision support ... 17
1.3. REFERENCES ... 18
CHAPTER 2. APPLYING PRIM (PATIENT RULE INDUCTION METHOD) AND LOGISTIC REGRESSION FOR SELECTING HIGH-RISK SUBGROUPS IN VERY ELDERLY ICU PATIENTS. ... 19 2.1. ABSTRACT... 20 2.1.1 Purpose... 20 2.1.2 Methods ... 20 2.1.3 Results ... 20 2.1.4 Conclusions ... 20 2.2. INTRODUCTION ... 21 2.2.1 Subgroup discovery ... 22
2.2.2 Patient Rule Induction Method (PRIM) ... 22
2.2.3 Related work ... 24
2.2.4 Logistic regression models in Intensive Care ... 24
2.3. MATERIALS AND METHODS ... 25
2.3.1 Statistics... 28 2.4. RESULTS ... 28 2.5. DISCUSSION ... 31 2.6. CONCLUSION ... 32 2.7. ACKNOWLEDGEMENTS ... 32 2.8. REFERENCES ... 33
CHAPTER 3. A SUBGROUP DISCOVERY APPROACH FOR SCRUTINIZING BLOOD GLUCOSE MANAGEMENT GUIDELINES BY THE IDENTIFICATION OF HYPERGLYCEMIA DETERMINANTS IN ICU PATIENTS ... 35
3.1. ABSTRACT... 36 3.1.1 Objective ... 36 3.1.2 Methods ... 36 3.1.3 Results ... 36 3.1.4 Conclusions ... 36 3.2. INTRODUCTION ... 37 3.3. OBJECTIVES ... 37 3.4. METHODS ... 38 3.4.1 Data ... 38
3.4.2 Subgroup discovery ... 41 3.4.3 Validation ... 43 3.5. RESULTS ... 44 3.6. DISCUSSION ... 46 3.7. CONCLUSIONS ... 50 3.8. ACKNOWLEDGEMENTS ... 50 3.9. REFERENCES ... 51
CHAPTER 4. PRIM VERSUS CART IN SUBGROUP DISCOVERY: WHEN PATIENCE IS HARMFUL ... 53 4.1. ABSTRACT... 54 4.1.1 Context... 54 4.1.2 Objective ... 54 4.1.3 Methods ... 54 4.1.4 Results ... 54 4.1.5 Conclusions ... 54 4.2. INTRODUCTION ... 56
4.3. MATERIALS AND METHODS ... 57
4.3.1 PRIM and CART ... 57
4.3.2 Patient Rule Induction Method ... 57
4.3.3 Differences between PRIM and tree induction with CART ... 59
4.3.4 Case study ... 62 4.3.5 Comparison design ... 63 4.3.6 Operational aspects ... 65 4.4. RESULTS ... 68 4.5. DISCUSSION ... 74 4.6. ACKNOWLEDGEMENTS ... 78 4.7. REFERENCES ... 79
CHAPTER 5. CHARACTERIZING DECISION SUPPORT TELEMEDICINE SYSTEMS ... 81
5.1. ABSTRACT... 82 5.1.1 Objectives ... 82 5.1.2 Methods ... 82 5.1.3 Results ... 82 5.1.4 Conclusions ... 82 5.2. INTRODUCTION ... 83 5.3. METHODS ... 84 5.4. RESULTS ... 85 5.4.1 Definition ... 85
5.4.2 The Characterizing Property Set ... 85
5.5. EXAMPLES:PUTTING THE CPS INTO USE ... 87
5.6. DISCUSSION AND CONCLUSION... 89
5.6.1 Future research ... 90
5.7. ACKNOWLEDGEMENTS ... 90
CHAPTER 6. DECISION SUPPORT TELEMEDICINE SYSTEMS:A CONCEPTUAL MODEL AND
REUSABLE TEMPLATES ... 93
6.1. ABSTRACT... 94
6.1.1 Objective ... 94
6.1.2 Materials and methods ... 94
6.1.3 Results ... 94
6.1.4 Conclusion ... 94
6.2. INTRODUCTION ... 95
6.3. MATERIALS AND METHODS ... 95
6.3.1 Literature search ... 95
6.3.2 Developing a conceptual model and modeling templates ... 96
6.4. RESULTS ... 97
6.4.1 Definitions ... 97
6.4.2 General model ... 98
6.4.3 Templates ... 100
6.4.4 External validation of templates ... 103
6.5. DISCUSSION ... 104
6.6. ACKNOWLEDGEMENTS ... 105
6.7. REFERENCES ... 106
CHAPTER 7. CONCLUSION AND DISCUSSION ... 109
7.1. PRINCIPAL FINDINGS ... 110
7.2. STRENGTHS AND WEAKNESSES OF OUR APPROACH ... 112
7.3. IMPLICATIONS ... 114
7.4. RELATED RESEARCH ... 115
7.5. RECOMMENDATIONS FOR FUTURE RESEARCH ... 117
7.6. CONCLUDING REMARKS ... 117
7.7. REFERENCES ... 118
SUMMARY ... 119
