F Eckelt1, J Remmler1, T Kister1, M Wernsdorfer1, H Richter2, M Federbusch1, M Adler3, A Kehrer3, M Voigt4, C Cundius4, J Telle3, J Thiery1, T Kaiser5. 1. Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik, Universitätsmedizin Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Deutschland. 2. Krankenhäuser Grimma und Wurzen, Muldentalkliniken GmbH Gemeinnützige Gesellschaft, Grimma/Wurzen, Deutschland. 3. Xantas AG, Leipzig, Deutschland. 4. Informationsmanagement, Universitätsklinikum Leipzig, Leipzig, Deutschland. 5. Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik, Universitätsmedizin Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Deutschland. thorsten.kaiser@medizin.uni-leipzig.de.
Abstract
BACKGROUND: Laboratory diagnostics are essential for diagnosis, initiation of therapy, and monitoring of patients. Laboratory results that are overlooked or incorrectly interpreted lead to adverse events and endanger patient safety. Clinical decision support systems (CDSSs) may facilitate appropriate interpretation of results and subsequent medical response. OBJECTIVES: The research project on digital laboratory medicine (AMPEL) aims at developing a CDSS based on laboratory diagnostics, which supports practitioners in ensuring the necessary medical consequences. MATERIALS AND METHODS: A literature review of CDSSs describes the current state of research. The research project AMPEL is presented with its objectives, challenges, and first results. Furthermore, the development of a framework and reporting system is illustrated through the clinical example of severe hypokalemia. RESULTS AND CONCLUSION: Through interdisciplinary development and constant optimization, a specific CDSS with high acceptance among clinicians was developed. Initial results in the case of severe hypokalemia show a positive effect on patient care. Thereby, more complex frameworks such as sepsis diagnostics or acute coronary syndrome are implemented. The limited availability of standardized and digital clinical data is challenging. In addition to the application of classic decision trees in CDSS, the use of machine learning offers a promising perspective for future developments.
BACKGROUND: Laboratory diagnostics are essential for diagnosis, initiation of therapy, and monitoring of patients. Laboratory results that are overlooked or incorrectly interpreted lead to adverse events and endanger patient safety. Clinical decision support systems (CDSSs) may facilitate appropriate interpretation of results and subsequent medical response. OBJECTIVES: The research project on digital laboratory medicine (AMPEL) aims at developing a CDSS based on laboratory diagnostics, which supports practitioners in ensuring the necessary medical consequences. MATERIALS AND METHODS: A literature review of CDSSs describes the current state of research. The research project AMPEL is presented with its objectives, challenges, and first results. Furthermore, the development of a framework and reporting system is illustrated through the clinical example of severe hypokalemia. RESULTS AND CONCLUSION: Through interdisciplinary development and constant optimization, a specific CDSS with high acceptance among clinicians was developed. Initial results in the case of severe hypokalemia show a positive effect on patient care. Thereby, more complex frameworks such as sepsis diagnostics or acute coronary syndrome are implemented. The limited availability of standardized and digital clinical data is challenging. In addition to the application of classic decision trees in CDSS, the use of machine learning offers a promising perspective for future developments.
Entities:
Keywords:
Clinical decision support; Machine learning; Medical errors; Reporting systems; Severe hypokalemia
Authors: Christina Pempe; Robert Werdehausen; Philip Pieroh; Martin Federbusch; Sirak Petros; Reinhard Henschler; Andreas Roth; Christian Pfrepper Journal: Sci Rep Date: 2021-02-23 Impact factor: 4.379