利用医疗大数据促进合理用药。

IF 3.2 Q1 HEALTH CARE SCIENCES & SERVICES
Frontiers in digital health Pub Date : 2024-11-07 eCollection Date: 2024-01-01 DOI:10.3389/fdgth.2024.1198904
Linghong Hong, Shiwang Huang, Xiaohai Cai, Zhiming Lin, Yunting Shao, Longbiao Chen, Min Zhao, Chenhui Yang
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引用次数: 0

摘要

据世界卫生组织统计,不合理用药已成为影响合理用药安全的重要因素。在定点药店、医疗机构等医保监管的灰色地带,"小病开大处方 "的不当用药现象比比皆是。传统的临床决策支持系统大多基于既定的规则来监管不当处方,不适合临床环境,需要智能审核。在本研究中,我们基于医疗大数据,对患者、疾病和药物之间的复杂关系进行建模,以促进合理用药。具体来说,我们首先基于三级医院的历史处方大数据和医疗文本数据构建用药知识图谱。其次,在用药知识图谱的基础上,我们采用高斯混合模型将患者人群表征作为生理特征进行分组。对于诊断特征,我们采用了来自变换器的预训练词向量双向编码器表示,以增强诊断之间的语义表示。此外,为了减少药物组合引起的不良药物相互作用,我们采用图卷积网络将药物相互作用信息转化为药物相互作用特征。最后,我们采用序列生成模型来学习患者、疾病和药物之间的复杂关系,并从药物清单和用药疗程两个方面为小型医院的医生处方提供合适的用药评价。在本研究中,我们利用 MIMIC III 数据集和福建省一家三甲医院的数据来验证我们的模型。结果表明,在合理用药的用药方案预测准确性方面,我们的方法比其他基线方法更有效。此外,它在小型医院处方的合理用药检测方面也达到了较高的准确率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Promoting appropriate medication use by leveraging medical big data.

According to World Health Organization statistics, inappropriate medication has become an important factor affecting the safety of rational medication. In the gray area of medical insurance supervision, such as designated drugstores and medical institutions, there are lots of inappropriate medication phenomena regarding "big prescription for minor ailments." A traditional clinical decision support system is mostly based on established rules to regulate inappropriate prescriptions, which are not suitable for clinical environments and require intelligent review. In this study, we model the complex relationships between patients, diseases, and drugs based on medical big data to promote appropriate medication use. More specifically, we first construct the medication knowledge graph based on the historical prescription big data of tertiary hospitals and medical text data. Second, based on the medication knowledge graph, we employ a Gaussian mixture model to group patient population representation as physiological features. For diagnostic features, we employ pre-training word vector Bidirectional Encoder Representations from Transformers to enhance the semantic representation between diagnoses. In addition, to reduce adverse drug interactions caused by drug combinations, we employ a graph convolution network to transform drug interaction information into drug interaction features. Finally, we employ the sequence generation model to learn the complex relationships between patients, diseases, and drugs and provide an appropriate medication evaluation for doctor prescriptions in small hospitals from two aspects: drug list and medication course of treatment. In this study, we utilize the MIMIC III dataset alongside data from a tertiary hospital in Fujian Province to validate our model. The results show that our method is more effective than other baseline methods in the accuracy of the medication regimen prediction of rational medication. In addition, it achieved high accuracy in the appropriate medication detection of prescription in small hospitals.

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CiteScore
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