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Erschienen in: Journal of Medical Systems 1/2012

01.02.2012 | Original Paper

Implementing an Integrative Multi-agent Clinical Decision Support System with Open Source Software

verfasst von: Jelber Sayyad Shirabad, Szymon Wilk, Wojtek Michalowski, Ken Farion

Erschienen in: Journal of Medical Systems | Ausgabe 1/2012

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Abstract

Clinical decision making is a complex multi-stage process. Decision support can play an important role at each stage of this process. At present, the majority of clinical decision support systems have been focused on supporting only certain stages. In this paper we present the design and implementation of MET3—a prototype multi-agent system providing an integrative decision support that spans over the entire decision making process. The system helps physicians with data collection, diagnosis formulation, treatment planning and finding supporting evidence. MET3 integrates with external hospital information systems via HL7 messages and runs on various computing platforms available at the point of care (e.g., tablet computers, mobile phones). Building MET3 required sophisticated and reliable software technologies. In the past decade the open source software movement has produced mature, stable, industrial strength software systems with a large user base. Therefore, one of the decisions that should be considered before developing or acquiring a decision support system is whether or not one could use open source technologies instead of proprietary ones. We believe MET3 shows that the answer to this question is positive.
Fußnoten
Literatur
1.
Zurück zum Zitat Patel, V. L., Kushniruk, A. W., Yang, S., and Yale, J. F., Impact of a computer-based patient record system on data collection, knowledge organization, and reasoning. J. Am. Med. Inform. Assoc. 7(6):569–85, 2000.CrossRef Patel, V. L., Kushniruk, A. W., Yang, S., and Yale, J. F., Impact of a computer-based patient record system on data collection, knowledge organization, and reasoning. J. Am. Med. Inform. Assoc. 7(6):569–85, 2000.CrossRef
2.
Zurück zum Zitat Patel, V., Arocha, J. F., and Zhang, J., Thinking and reasoning in medicine. In: Holyoak, K., and Morrison, R. (Eds.), The Cambridge Handbook of Thinking and Reasoning. Cambridge University Press, Cambridge, pp. 727–50, 2005. Patel, V., Arocha, J. F., and Zhang, J., Thinking and reasoning in medicine. In: Holyoak, K., and Morrison, R. (Eds.), The Cambridge Handbook of Thinking and Reasoning. Cambridge University Press, Cambridge, pp. 727–50, 2005.
3.
Zurück zum Zitat Field, M. J., and Lohr, K. N. (Eds.), Guidelines for Clinical Practice: From Development to Use. National Academy Press, Washington, D.C., 1992. Field, M. J., and Lohr, K. N. (Eds.), Guidelines for Clinical Practice: From Development to Use. National Academy Press, Washington, D.C., 1992.
5.
Zurück zum Zitat Sackett, D. L., Rosenberg, W., Gray, J. M., Haynes, R., and Richardson, W., Evidence based medicine: What it is and what it isn’t. Br. Med. J. 312:71–72, 1996.CrossRef Sackett, D. L., Rosenberg, W., Gray, J. M., Haynes, R., and Richardson, W., Evidence based medicine: What it is and what it isn’t. Br. Med. J. 312:71–72, 1996.CrossRef
6.
Zurück zum Zitat Berlin, A., Sorani, M., and Sim, I., A taxonomic description of computer-based clinical decision support systems. J. Biomed. Inform. 39(6):656–67, 2006.CrossRef Berlin, A., Sorani, M., and Sim, I., A taxonomic description of computer-based clinical decision support systems. J. Biomed. Inform. 39(6):656–67, 2006.CrossRef
7.
Zurück zum Zitat Sittig, D. F., Wright, A., Osheroff, J. A., Middleton, B., Teich, J. M., Ash, J. S., et al., Grand challenges in clinical decision support. J. Biomed. Inform. 41(2):387–92, 2008.CrossRef Sittig, D. F., Wright, A., Osheroff, J. A., Middleton, B., Teich, J. M., Ash, J. S., et al., Grand challenges in clinical decision support. J. Biomed. Inform. 41(2):387–92, 2008.CrossRef
8.
Zurück zum Zitat Wilk, S., Michalowski, W., O’Sullivan, D., Farion, K., and Matwin, S., Engineering of a clinical decision support framework for the point of care use. AMIA Annu. Symp. Proc. 6:814–818, 2008. Wilk, S., Michalowski, W., O’Sullivan, D., Farion, K., and Matwin, S., Engineering of a clinical decision support framework for the point of care use. AMIA Annu. Symp. Proc. 6:814–818, 2008.
9.
Zurück zum Zitat Farion, K., Michalowski, W., Wilk, S., O’Sullivan, D., Rubin, S., and Weiss, D., Clinical decision support system for point of care use: Ontology driven design and software implementation. Methods Inf. Med. 48(4):381–390, 2009.CrossRef Farion, K., Michalowski, W., Wilk, S., O’Sullivan, D., Rubin, S., and Weiss, D., Clinical decision support system for point of care use: Ontology driven design and software implementation. Methods Inf. Med. 48(4):381–390, 2009.CrossRef
10.
Zurück zum Zitat Michalowski, W., Slowinski, R., Wilk, S., Farion, K., Pike, J., and Rubin, S., Design and development of a mobile system for supporting emergency triage. Methods Inf. Med. 44(1):14–24, 2005. Michalowski, W., Slowinski, R., Wilk, S., Farion, K., Pike, J., and Rubin, S., Design and development of a mobile system for supporting emergency triage. Methods Inf. Med. 44(1):14–24, 2005.
11.
Zurück zum Zitat Moreno, A., Valls, A., Riaño, and D. PalliaSys: Agent-based proactive monitoring of palliative patients. In proceedings of IWPAAMS, Oct 20–21, León, Spain, 2005. Moreno, A., Valls, A., Riaño, and D. PalliaSys: Agent-based proactive monitoring of palliative patients. In proceedings of IWPAAMS, Oct 20–21, León, Spain, 2005.
12.
Zurück zum Zitat Su, C., and Wua, C., JADE implemented mobile multi-agent based, distributed information platform for pervasive health care monitoring. Applied Soft Computing (In press). Su, C., and Wua, C., JADE implemented mobile multi-agent based, distributed information platform for pervasive health care monitoring. Applied Soft Computing (In press).
13.
Zurück zum Zitat Moreno, A., Isern, D., and Sanchez, D., Provision of agent-based health care services. AI Commun. 16(3):167–178, 2003.MathSciNetMATH Moreno, A., Isern, D., and Sanchez, D., Provision of agent-based health care services. AI Commun. 16(3):167–178, 2003.MathSciNetMATH
14.
Zurück zum Zitat Hudson, D. L., and Cohen, M. E., Use of intelligent agents in the diagnosis of cardiac disorders. Comput. Cardiol. 633–636, 2002. Hudson, D. L., and Cohen, M. E., Use of intelligent agents in the diagnosis of cardiac disorders. Comput. Cardiol. 633–636, 2002.
15.
Zurück zum Zitat Godo, L., Puyol-Gruart, J., Sabater, J., Torra, V., Barrufet, P., and Fàbregas, X., A multi-agent system approach for monitoring the prescription of restricted use antibiotics. Artif. Intell. Med. 27(3):259–282, 2003.CrossRef Godo, L., Puyol-Gruart, J., Sabater, J., Torra, V., Barrufet, P., and Fàbregas, X., A multi-agent system approach for monitoring the prescription of restricted use antibiotics. Artif. Intell. Med. 27(3):259–282, 2003.CrossRef
16.
Zurück zum Zitat Hashmi, Z. I., Abidi, S. S. R., and Cheah, Y., An intelligent agent-based knowledge broker for enterprise-wide healthcare knowledge procurement. In Proceedings of 15th IEEE Symposium on Computer-Based Medical Systems. Maribor, Slovenia, 173, 2002. Hashmi, Z. I., Abidi, S. S. R., and Cheah, Y., An intelligent agent-based knowledge broker for enterprise-wide healthcare knowledge procurement. In Proceedings of 15th IEEE Symposium on Computer-Based Medical Systems. Maribor, Slovenia, 173, 2002.
17.
Zurück zum Zitat Bloodsworth, P., and Greenwood, S., COSMOA an ontology-centric multi-agent system for co-ordinating medical responses to large-scale disasters. AI Commun. 18(3):229–240, 2005.MathSciNet Bloodsworth, P., and Greenwood, S., COSMOA an ontology-centric multi-agent system for co-ordinating medical responses to large-scale disasters. AI Commun. 18(3):229–240, 2005.MathSciNet
18.
Zurück zum Zitat Cruz-Correia, R., Vieira-Marques, P., Costa, P., Ferreira, A., Oliveira-Palhares, E., Araújo, F., and Costa-Pereira, A., Integration of hospital data using agent technologies—A case study. AI Commun. 18(3):191–200, 2005.MathSciNet Cruz-Correia, R., Vieira-Marques, P., Costa, P., Ferreira, A., Oliveira-Palhares, E., Araújo, F., and Costa-Pereira, A., Integration of hospital data using agent technologies—A case study. AI Commun. 18(3):191–200, 2005.MathSciNet
19.
Zurück zum Zitat Hogarth, M. A., and Turner, S., A study of clinically related open source software projects. Proceedings of AMIA Symposium, 330–334, 2005. Hogarth, M. A., and Turner, S., A study of clinically related open source software projects. Proceedings of AMIA Symposium, 330–334, 2005.
20.
Zurück zum Zitat Wright, A., and Sittig, D. F., A four-phase model of the evolution of clinical decision support architectures. Int. J. Med. Inform. 77(10):641–9, 2008.CrossRef Wright, A., and Sittig, D. F., A four-phase model of the evolution of clinical decision support architectures. Int. J. Med. Inform. 77(10):641–9, 2008.CrossRef
21.
Zurück zum Zitat Chu, S. C., From component-based to service oriented software architecture for healthcare. In Proceedings of 7th International Workshop on Enterprise Networking and Computing in Healthcare Industry. HEALTHCOM 96–100, 2005. Chu, S. C., From component-based to service oriented software architecture for healthcare. In Proceedings of 7th International Workshop on Enterprise Networking and Computing in Healthcare Industry. HEALTHCOM 96–100, 2005.
22.
Zurück zum Zitat Weiss G., A modern approach to distributed artificial intelligence. MIT, 1999. Weiss G., A modern approach to distributed artificial intelligence. MIT, 1999.
23.
Zurück zum Zitat Payne, T. R., Web services from an agent perspective. IEEE Intell. Syst. 23(2):12–4, 2008.CrossRef Payne, T. R., Web services from an agent perspective. IEEE Intell. Syst. 23(2):12–4, 2008.CrossRef
24.
Zurück zum Zitat Garcia-Ojeda, J. C., DeLoach, S. A., Robby, Oyenan, W. H., and Valenzuela, J., O-MaSE: a customizable approach to developing multi-agent development processes. In: Luck, M. (Ed.), Agent-oriented software engineering VIII: the 8th International Workshop on Agent Oriented Software Engineering (AOSE). Springer-Verlag, Berlin, pp. 1–15, 2008. Garcia-Ojeda, J. C., DeLoach, S. A., Robby, Oyenan, W. H., and Valenzuela, J., O-MaSE: a customizable approach to developing multi-agent development processes. In: Luck, M. (Ed.), Agent-oriented software engineering VIII: the 8th International Workshop on Agent Oriented Software Engineering (AOSE). Springer-Verlag, Berlin, pp. 1–15, 2008.
25.
Zurück zum Zitat Woodridge, M., Jennings, N. R., and Kinny, D., The Gaia methodology for agent-oriented analysis and design. Autonomous Agents and Multi-Agent Systems (AAMAS) 3(3):285–312, 2000.CrossRef Woodridge, M., Jennings, N. R., and Kinny, D., The Gaia methodology for agent-oriented analysis and design. Autonomous Agents and Multi-Agent Systems (AAMAS) 3(3):285–312, 2000.CrossRef
26.
Zurück zum Zitat Bresciani, P., Perini, A., Giorgini, P., Giunchiglia, F., and Mylopoulos, J., TROPOS: An agent-oriented software development methodology. In Journal of Autonomous Agents and Multi-Agent Systems. Kluwer Academic Publishers, May 2004. Bresciani, P., Perini, A., Giorgini, P., Giunchiglia, F., and Mylopoulos, J., TROPOS: An agent-oriented software development methodology. In Journal of Autonomous Agents and Multi-Agent Systems. Kluwer Academic Publishers, May 2004.
27.
Zurück zum Zitat Iglesias, C. A., Garijo, M., Centeno-González, J., and Velasco, J. R., Analysis and design of multiagent systems using MAS-Common KADS, Proceedings of the 4th International Workshop on Intelligent Agents IV, Agent Theories, Architectures, and Languages, Lecture Notes In Computer Science, vol. 1365. Springer-Verlag London, UK, pp. 313–327, 1997. Iglesias, C. A., Garijo, M., Centeno-González, J., and Velasco, J. R., Analysis and design of multiagent systems using MAS-Common KADS, Proceedings of the 4th International Workshop on Intelligent Agents IV, Agent Theories, Architectures, and Languages, Lecture Notes In Computer Science, vol. 1365. Springer-Verlag London, UK, pp. 313–327, 1997.
28.
Zurück zum Zitat Foster, I., Jennings, N. R., and Kesselman C., Brain meets brawn: why Grid and agents need each other. In Proceedings 3rd International Conference on Autonomous Agents and Multi-Agent Systems, New York, US, 2004. Foster, I., Jennings, N. R., and Kesselman C., Brain meets brawn: why Grid and agents need each other. In Proceedings 3rd International Conference on Autonomous Agents and Multi-Agent Systems, New York, US, 2004.
29.
Zurück zum Zitat Kawamoto, K., and Lobach, D. F., Proposal for fulfilling strategic objectives of the U.S. roadmap for national action on decision support through a service-oriented architecture leveraging HL7 services. J. Am. Med. Inform. Assoc. 14(2):146–155, 2007.CrossRef Kawamoto, K., and Lobach, D. F., Proposal for fulfilling strategic objectives of the U.S. roadmap for national action on decision support through a service-oriented architecture leveraging HL7 services. J. Am. Med. Inform. Assoc. 14(2):146–155, 2007.CrossRef
30.
Zurück zum Zitat Wilk, S., Slowinski, R., Michalowski, W., and Greco, S., Supporting triage of children with abdominal pain in the emergency room. Eur. J. Oper. Res. 160(3):696–709, 2005.MATHCrossRef Wilk, S., Slowinski, R., Michalowski, W., and Greco, S., Supporting triage of children with abdominal pain in the emergency room. Eur. J. Oper. Res. 160(3):696–709, 2005.MATHCrossRef
31.
Zurück zum Zitat Michalowski, W., Wilk, S., Farion, K., Pike, J., Rubin, S., and Slowinski, R., Development of a decision algorithm to support emergency triage of scrotal pain and its implementation in the MET system. INFOR 43(4):287–301, 2005. Michalowski, W., Wilk, S., Farion, K., Pike, J., Rubin, S., and Slowinski, R., Development of a decision algorithm to support emergency triage of scrotal pain and its implementation in the MET system. INFOR 43(4):287–301, 2005.
32.
Zurück zum Zitat Farion, K., Michalowski, W., Wilk, S., O’Sullivan, D., and Matwin, S., A tree-based decision model to support prediction of the severity of asthma exacerbations in children. J Med Syst, 2009 (in press). Farion, K., Michalowski, W., Wilk, S., O’Sullivan, D., and Matwin, S., A tree-based decision model to support prediction of the severity of asthma exacerbations in children. J Med Syst, 2009 (in press).
33.
Zurück zum Zitat Farion, K., Michalowski, W., Rubin, S., Wilk, S., Corell, R., and Gaboury, I., Prospective evaluation of the MET-AP system providing triage plans for acute pediatric abdominal pain. Int. J. Med. Inform. 77(3):208–218, 2008.CrossRef Farion, K., Michalowski, W., Rubin, S., Wilk, S., Corell, R., and Gaboury, I., Prospective evaluation of the MET-AP system providing triage plans for acute pediatric abdominal pain. Int. J. Med. Inform. 77(3):208–218, 2008.CrossRef
35.
Zurück zum Zitat Bellifemine, F. L., Caire, G, and Greenwood, D., Developing multi-agent systems with JADE. Wiley, 2004. Bellifemine, F. L., Caire, G, and Greenwood, D., Developing multi-agent systems with JADE. Wiley, 2004.
36.
Zurück zum Zitat Krishnamurthy, S., A managerial overview of open source software. Bus. Hor. 46(5):47–56, 2003.CrossRef Krishnamurthy, S., A managerial overview of open source software. Bus. Hor. 46(5):47–56, 2003.CrossRef
Metadaten
Titel
Implementing an Integrative Multi-agent Clinical Decision Support System with Open Source Software
verfasst von
Jelber Sayyad Shirabad
Szymon Wilk
Wojtek Michalowski
Ken Farion
Publikationsdatum
01.02.2012
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 1/2012
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-010-9452-9

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