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  本文關(guān)鍵詞：序列模式挖掘在臨床路徑發(fā)現(xiàn)問題中的研究與應(yīng)用　出處：《中國科學(xué)技術(shù)大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 臨床路徑 頻繁序列模式 醫(yī)療大數(shù)據(jù) 醫(yī)療應(yīng)用 數(shù)據(jù)挖掘

【摘要】：提高醫(yī)院管理的效率和增加患者就醫(yī)的透明度,規(guī)范醫(yī)護(hù)人員的臨床行為和減少醫(yī)療資源的浪費(fèi)關(guān)乎每個人的切身利益,這是當(dāng)前全社會關(guān)注的熱點(diǎn)問題。臨床路徑作為一種臨床醫(yī)療行為管理的手段,已經(jīng)被世界上很多國家用于醫(yī)院管理,并取得了很好的效果。我國從2009年開始進(jìn)行臨床路徑的試點(diǎn)和推廣工作,力爭2020年底實(shí)現(xiàn)全部二級以上醫(yī)院納入臨床路徑管理。目前臨床路徑的制定是由相關(guān)領(lǐng)域醫(yī)學(xué)專家根據(jù)經(jīng)驗和專業(yè)知識制定,費(fèi)時費(fèi)力。醫(yī)療信息技術(shù)的發(fā)展使得醫(yī)院積累了海量的臨床數(shù)據(jù),促進(jìn)了大數(shù)據(jù)技術(shù)在臨床醫(yī)學(xué)上的研究和應(yīng)用,這為臨床路徑的發(fā)現(xiàn)和制定提供了新思路。數(shù)據(jù)挖掘技術(shù)能充分利用已有數(shù)據(jù)的信息,為臨床路徑的制定提供參考和指導(dǎo),使臨床路徑的制定更具科學(xué)性和合理性。本文基于頻繁序列模式挖掘?qū)εR床路徑發(fā)現(xiàn)問題進(jìn)行了研究。主要工作內(nèi)容如下:(1)提出了有前綴約束的頻繁序列模式挖掘算法CPM-PC(Clinical Pathways Mining with Prefix Constraints)。臨床路徑是針對某個病種的一套標(biāo)準(zhǔn)化的治療方案,實(shí)際上是一系列檢查、治療以及護(hù)理行為按照時間先后順序組成的一個序列,因此臨床路徑的挖掘問題被轉(zhuǎn)化為頻繁序列模式挖掘問題。另外,患者一個完整的治療療程總是由一些特定的醫(yī)療行為開始,像手術(shù)過程一般是從麻醉開始,據(jù)此在論文中提出臨床路徑"前綴集"的概念,即可以作為某種疾病治療開端的臨床項目的集合。在此基礎(chǔ)上,提出了一個適用于臨床路徑發(fā)現(xiàn)的序列模式挖掘算法CPM-PC,該算法充分考慮臨床路徑"前綴集"的作用,能夠較高效的挖掘出有意義的序列模式。(2)提出了臨床路徑基于屬性的評估模型。由于臨床路徑的挖掘會產(chǎn)生大量的候選序列模式,對這些模式如何選擇,目前還沒有相關(guān)研究。對臨床路徑評估的研究大都集中于對已經(jīng)試點(diǎn)的臨床路徑進(jìn)行結(jié)果分析式的評估,這種方法不能適用于臨床路徑的選擇過程。因此,在總結(jié)國內(nèi)外臨床路徑評估方法的基礎(chǔ)上,對各評價指標(biāo)進(jìn)行分析,選擇住院時長LOS,醫(yī)療總費(fèi)用C,藥占比P三個基本屬性提出了基于屬性的臨床路徑評估模型,更加側(cè)重于臨床路徑本身的屬性,通過計算臨床路徑基于屬性的加權(quán)評估值A(chǔ)BWE評價臨床路徑的優(yōu)劣。最后,在阜陽市某醫(yī)院的真實(shí)臨床數(shù)據(jù)集上進(jìn)行了實(shí)驗,對實(shí)驗結(jié)果的分析顯示CPM-PC算法在挖掘臨床路徑過程中相比于傳統(tǒng)的序列模式挖掘算法有更好的性能。
[Abstract]:To improve the efficiency of hospital management and increase patient transparency, standardize medical staff of the clinical behavior and to reduce the waste of medical resources related to the vital interests of each person, this is the current hot issues of concern to the whole society. Clinical pathway as a clinical medical behavior management means, has been in many countries in the world for hospital management, and good results have been achieved. China began to carry out the clinical pathway from 2009 pilot and promotion work, and strive to achieve by the end of 2020 all two hospitals in clinical pathway management. At present the development of clinical pathways is the domain of medical experts according to experience and expertise to develop, time-consuming and laborious. The development of medical information technology allows the accumulation of hospital the clinical data, promote the research and application of big data technology in clinical medicine, the clinical path discovery and formulation for New ideas. Data mining technology can make full use of the existing data information, to provide reference and guidance for the development of clinical pathway, make clinical pathway is more scientific and reasonable. The frequent sequential pattern mining based on the clinical path finding problem is studied. The main work contents are as follows: (1) proposed CPM-PC frequent sequence pattern mining (Clinical prefix constraint Pathways Mining with Prefix Constraints). Clinical pathway is a treatment for a disease of a standard, is actually a series of examinations, treatment and nursing behavior according to a sequence of time sequence composition, so the problem of clinical pathway mining mining was transformed into frequent sequence pattern. In addition, patients with a complete course of treatment is started by some specific medical behavior, as the operation process is generally from the beginning of anesthesia, The concept of clinical pathway "prefix set" in the paper, which is a collection of items can be used as a clinical disease treatment beginning. Based on the algorithm of CPM-PC sequence model proposed a suitable found in clinical pathway mining, the algorithm takes into account the clinical path "prefix set", can be more efficient the mining sequence patterns meaningful. (2) proposed the clinical pathway based on attribute evaluation model. Due to mining of clinical path will produce a large number of candidate sequence patterns, how to choose the mode, there is no relevant research. The study of clinical pathway evaluation mostly focuses on clinical pathway for the pilot has the analysis of the evaluation of the selection process, this approach cannot be applied to the clinical pathway. Therefore, based on summarizing the clinical pathway evaluation methods, the evaluation indexes were analyzed and selected Choose the length of stay in LOS, the total medical costs of C, the ratio of drug P three basic properties of proposed evaluation model of clinical pathway based on attribute, attribute more focused on the clinical pathway itself, by calculating the value of the advantages and disadvantages of ABWE clinical pathway evaluation of clinical pathway based on weighted assessment attributes. Finally, experiments are carried out in a hospital Fuyang City, the real clinical data sets, the analysis of the experimental results show that CPM-PC algorithm in mining sequential patterns of clinical pathway process compared to the traditional mining algorithm has a better performance.

【學(xué)位授予單位】：中國科學(xué)技術(shù)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：TP311.13

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