3401 KB564 KB0 KB2014Kamišalić Latifić, AidaRiano, DavidWelzer-Družovec, TatjanaXXVI, 305 str., 30 cmCOBISSID:17625110URN:URN:NBN:SI:doc-6GAREHJIenA. Kamišalić Latifićvisokošolska delačasovna dimenzijadecision-makingDisertacijeknowledge aquisitionknowledge representationmedical processesMedicinamedicinski procesiModeliranje procedularnega znanjamodeliranje proceduralnega znanjapredstavitev znanjapridobivanje znanjaprocedural knowledge modelingtemporal knowledgeAcquiring temporal knowledge for making decisions in medical processes| doctor of philosophy thesis|A medical process is a set of medical actions performed by healthcare professionals while making observations about signs and symptoms, ordering interventions, prescriptions, tests, and any other actions in order to solve a health problem that is affecting a particular patient. The objective is to offer a curative, chronic, palliative and/or symptomatic treatments. The capability of a physician to propose an appropriate treatment depends on his/her knowledge of similar clinical cases and by following advances in the treatment of particular diseases. Time is an important concept of the real world that has to be considered in regard to medical processes. Clinical Practice Guidelines (CPGs) are a narrative set of recommendations for treating patients suffering from a particular disease. By constantly referring to CPGs physicians can stay up to date with the best evidence-based medical care and with the recommendations of experts. The time dimension is, however, often omitted or only partially covered in CPGs. Some CPGs do contain certain recommendations considering time but often there are huge gaps that are supposed to be overcome by physicians own knowledge and experience. At the same time, healthcare centres hold healthcare records and information systems that register medical processes and patients data, including information about the times of any encounters, prescriptions, and other medical actions. Therefore healthcare records and information systems data can be a source for detecting temporal medical knowledge and sound evidence regarding healthcare.This thesis is centred on temporal knowledge acquisition and representation for the purposes of decision-making during medical processes. CPGs were analysed to obtain procedural knowledge models and Extended Timed Transition Diagrams defined for representations of the obtained knowledge. The data about the treatments of patients were analysed in order to detect temporal medical knowledge models that represented those medical procedures that were carried out while the data was being generated. These models thus provided an explicit representation of the time dimensions of past medical procedures. They could be used for complementing the knowledge provided by CPGs, for studying adherences to the CPGs and for representing a basic framework for medical procedural decision support systems developmentMedicinski proces je sestavljen iz niza medicinskih ukrepov, ki jih opravijo zdravstveni delavci med opazovanjem znakov in simptomov, predpisovanjem ukrepov, receptov, analiz, in podobnega, z namenom reševanja bolnikovih zdravstvenih težav. Cilj medicinskega procesa je zdravljenje bolnika (kurativno zdravljenje), omejitev razvoja bolezni (kronično zdravljenje), zmanjšanje bolnikovega trpljenja (blažilno zdravljenje) in skrb za bolnikove znake in simptome (simptomatsko zdravljenje). Sposobnost zdravnika, da predlaga ustrezno zdravljenje, je odvisna od poznavanja podobnih kliničnih primerov in spremljanja napredka pri zdravljenju določene bolezni. Čas je pomemben koncept realnega sveta, ki ga je potrebno upoštevati v okviru medicinskih procesov. Smernice klinične prakse so tekstualna priporočila za zdravljenje bolnikov, ki imajo določeno bolezen. Z uporabo smernic klinične prakse lahko zdravniki ostanejo v stiku z najnovejšimi dognanji in sledijo priporočilom strokovnjakov glede zdravstvene oskrbe, vezane na posamezno bolezen. Časovna dimenzija je pogosto izpuščena ali le delno zajeta v smernicah klinične prakse. Nekatere smernice klinične prakse vsebujejo določena priporočila glede časovne dimenzije, vendar pogosto obstajajo velike vrzeli, ki naj bi jih zdravniki premagali z uporabo lastnega znanja in izkušenj. Istočasno pa bolnišnice in zdravstveni domovi vodijo evidenco o bolnikih in o opravljenih medicinskih procesih, vključno z informacijami o terminih obiskov pri zdravniku, izdajanju receptov in drugih zdravstvenih dejavnostih. Zato so shranjeni podatki lahko vir za odkrivanje medicinskega znanja o časovnem poteku bolezni in dokazov dobre medicinske prakse.Problem, ki je obravnavan v doktorski disertaciji, je soočanje z in iskanje rešitve za pomankanje eksplicitne predstavitve časovne dimenzije medicinskih postopkov. Naš cilj je, ob uporabi kliničnih podatkov o bolnikih, pridobiti znanje o časovnem poteku za medicinske postopke različnih kroničnih bolezni. Analizirali smo smernice klinične prakse in pripravili modele proceduralnega znanja. Definirali smo razširjene časovne diagrame prehajanja stanj in jih uporabili za predstavitev pridobljenega znanja. Podatke o bolnikih smo analizirali za pridobitev časovnih modelov medicinskega znanja, ki predstavljajo medicinske postopke, izvedene v času zajemanja podatkov. Ti modeli ponujajo eksplicitno predstavitev časovne dimenzije izvedenih medicinskih postopkov. Lahko jih uporabljamo za dopolnitev znanja podanega v smernicah klinične prakse, za študijo prileganja smernicam klinične prakse, ali pa kot ogrodje za razvoj sistemov za podporo odločanju v medicinskih postopkihTEXTvisokošolska delatheses and dissertationsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverza v Mariboru, Fakulteta za elektrotehniko računalništvo in informatiko