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Enhancing Decision Making with Deep Reinforcement Learning in a Context of Novel Coronavirus Outbreak: an Example in Emergency Department 新型冠状病毒疫情背景下深度强化学习增强决策:以急诊科为例
H. Jiang, William Yu Chung Wang, T. Goh, Jie Zhu
Physicians in hospitals are expected to improve treatment outcome and reduce health care costs. Information systems have been widely adopted in hospitals but not been properly integrated to provide information for decision support. The objective of this research is trying to validate the feasibility of enhancing hospital resource planning system in decision support by utilizing data stored in multiple systems in the hospital with a deep reinforcement learning approach to assist medical practitioner making a more accurate and efficient decision. Following the Design Science Research Method, this research is going to build an artefact to utilize data from electronic health record (EHR) and hospital resource planning (HRP) to provide medical decision support in the emergency department setting.
人们期望医院的医生改善治疗效果,降低医疗费用。信息系统已在医院广泛采用,但尚未得到适当整合,无法为决策支持提供信息。本研究的目的是通过深度强化学习的方法,利用存储在医院多个系统中的数据,来验证增强医院资源规划系统在决策支持中的可行性,以帮助医生做出更准确、更有效的决策。本研究以设计科学研究方法为基础,利用电子健康档案(EHR)和医院资源规划(HRP)的资料,建立一个人工系统,为急诊科提供医疗决策支持。
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引用次数: 0
A Low-Cost Method for Designing and Updating a DRGs Classifier Based on Machine Learning 基于机器学习的低成本DRGs分类器设计与更新方法
Chenhao Fang, Zhenzhou Shao, Chao Wu
Diagnosis-related groups(DRGs) is a payment system that can effectively solve the problem of excessive increases in health care costs. When DRGs was implemented in China, due to the complex medical environment, the design and update cost of traditional rules-based DRGs classifier became extremely high. In this paper, we proposed a low-cost method for designing and updating a DRGs classifier based on machine learning. This method first uses a rule-based classifier to classify cases roughly according to their major clinical features. With the assistance of the decision tree algorithm, this rule-based classifier can be easily designed and updated by experts. Then, an XGBoost(Extreme Gradient Boosting) classifier based on the one-vs-all(OVR) strategy is trained by a large number of cases labeled by experts or existing DRGs classifier, which will classify cases to each DRG. In the experiments, we proved that the method can utilize cases generated and labeled by China Healthcare Security Diagnosis Related Groups(CHS-DRG) classifier to design a classifier with the performance similar to the CHS-DRG classifier.Updated by low cost, the classifier performance can constantly improve after putting into use.
诊断相关组(DRGs)是一种能够有效解决医疗费用过度增长问题的支付系统。在中国实施DRGs时,由于复杂的医疗环境,传统基于规则的DRGs分类器的设计和更新成本变得非常高。本文提出了一种基于机器学习的低成本DRGs分类器设计和更新方法。该方法首先使用基于规则的分类器,根据病例的主要临床特征对其进行粗略分类。在决策树算法的辅助下,专家可以方便地设计和更新基于规则的分类器。然后,通过大量专家或现有DRG分类器标记的案例,训练基于一对一全(OVR)策略的XGBoost(Extreme Gradient Boosting)分类器,将案例分类到每个DRG。在实验中,我们证明了该方法可以利用中国医疗安全诊断相关组(CHS-DRG)分类器生成并标记的病例,设计出与CHS-DRG分类器性能相近的分类器。低成本更新,投入使用后,分类器性能不断提高。
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引用次数: 1
Exploring the Attractive Factors of Floricultural Therapy: A Case Study on Nurses 探讨花卉疗法的吸引因素:以护士为例
Wen-Hui Chen, Chun-Chin Chen, Shu-Ming Wu
Since the National Health Insurance system was implemented in Taiwan in 1995, fierce competition in the health care market has led to a shortage of front-line nurses. Such nurses are frequently tasked with an overwhelming amount of complex work, which causes them to experience constant mental stress that elicits anxiety, depression, and negative emotions. Art therapy and horticultural therapy are common stress alleviation methods. Therefore, this study explored the effectiveness of floricultural therapy on relieving the mental stress of nurses. The evaluation grid method of Miryoku engineering was employed in combination with in-depth interviews to compile the attractive factors of floricultural courses. Accordingly, this study examined the experiential cognition and preferences regarding floricultural courses and the perceived therapeutic effect of such courses in highly stressed nurses. The results can be a reference for designing future floricultural therapy courses and promotion.
自1995年台湾实施全民健康保险制度以来,医疗市场竞争激烈,导致一线护士短缺。这些护士经常被要求承担大量复杂的工作,这使他们经历持续的精神压力,从而引发焦虑、抑郁和负面情绪。艺术疗法和园艺疗法是常见的缓解压力的方法。因此,本研究探讨花卉疗法对缓解护士心理压力的效果。采用Miryoku工程评价网格法,结合深度访谈,编制花艺课程吸引因素。因此,本研究考察了高压力护士对花卉课程的经验认知和偏好,以及这些课程的感知治疗效果。研究结果可为今后花卉治疗课程的设计和推广提供参考。
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引用次数: 0
Characterization of the Impact of Sars-Cov-2 Pandemic Social Isolation on the Psychosocial Well-Being of Public University Students, Based on the Ghq-28 Scale 基于Ghq-28量表表征新型冠状病毒大流行社会隔离对公立大学学生心理社会健康的影响
M. Ferrer, V. Mancha, Melina I. Chumpitaz, Jaqueline Begazo, M. Chauca
Globally we are going through a difficult situation due to this pandemic due to COVID-19, one of the most effective measures implemented by most governments has been social isolation, which can cause psychosocial risk; The objective of this study is to evaluate the psychosocial well-being of the students of a Peruvian public university during the 90 days of social isolation; the method we have used is descriptive - cross-sectional, with a non-probability sample of 285 university students, who filled out an online survey to detect psychosocial symptoms, using the General Health Questionnaire (GHQ-28); finding that 72.6% of students exposed to a medium-high level of psychosocial risk. In conclusion, an association was found between a medium-high level of psychosocial risk and the variables: cohabiting with people at risk for COVID-19 (Xi2 = 9,661 and p <0.05); present symptoms compatible with COVID-19 19 (Xi2 = 28,957 and p <0.05) and cohabit with COVID-19 patients (Xi2 = 8,803 and p <0.05).
在全球范围内,由于COVID-19的大流行,我们正在经历一个困难的局面,大多数政府实施的最有效措施之一是社会隔离,这可能会导致社会心理风险;这项研究的目的是评估秘鲁一所公立大学学生在90天的社会隔离期间的心理健康状况;我们使用的方法是描述性的-横断面,以285名大学生为非概率样本,他们填写了一份在线调查,以检测心理社会症状,使用一般健康问卷(GHQ-28);发现72.6%的学生暴露于中高水平的社会心理风险。综上所述,中高水平的社会心理风险与以下变量之间存在关联:与COVID-19风险人群同居(Xi2 = 9661, p <0.05);出现与COVID-19相符的症状(Xi2 = 28,957, p <0.05),并与COVID-19患者同居(Xi2 = 8,803, p <0.05)。
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引用次数: 2
Applying Deep Learning for Prediction Sleep Quality from Wearable Data 应用深度学习从可穿戴数据预测睡眠质量
Dinh-Van Phan, Chien-Lung Chan, Duc-Khanh Nguyen
Sleep is not only very important for physical health but also the mental health of human, that was addressed by many previous studies. Today, with the development of technology, which opens in the application for improving quality of sleep, such as wearable devices, artificial intelligence, neural network. In this study, we applied deep learning (DL) neural networks and smart wearable devices to predict the quality of sleep. The data was collected on students (mean age = 20.79) during 106 days by Fitbit Charge HR™ device. The results showed DL models could predict sleep quality base on physical activities in awake time.
睡眠不仅对人的身体健康很重要,而且对人的心理健康也很重要,这一点在以前的很多研究中都有提到。如今,随着科技的发展,这开启了在改善睡眠质量方面的应用,如可穿戴设备、人工智能、神经网络等。在这项研究中,我们应用深度学习(DL)神经网络和智能可穿戴设备来预测睡眠质量。通过Fitbit Charge HR™设备在106天内收集学生(平均年龄= 20.79)的数据。结果表明,深度睡眠模型可以根据清醒时的身体活动来预测睡眠质量。
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引用次数: 6
Predicting Diabetes Mellitus and its Complications through a Graph-Based Risk Scoring System 通过基于图的风险评分系统预测糖尿病及其并发症
Madurapperumage A. Erandathi, W. Wang, Michael Mayo
It is vital to estimate and predict the chronological risk rate of individuals of diabetes mellitus and its complications through non-invasive or minimally invasive methods. Data mining and machine learning techniques are applied to health data repositories to achieve this goal. Although past studies have used various combinations of technologies for the assessment and prediction of diabetes and its complications, there is a lack of attention to combining temporal data with a visual representation assessment technique, which can be widely accepted. Further, prediction of risk throughout the lifetime of an individual in a chronological manner by considering their future changes with respect to the characteristics of a similar cohort is something worth contemplating for accurate risk prediction models. We aim to introduce a simple, powerful visualization technique to self-monitoring, which will be highly beneficial in enhancing the health care management sector through empowering self-care management and policymaking. The system will effectively impact the progression of diabetes and its complications by early forecasting the risk without the aid of professional physician knowledge which would help to reduce the burden of the disease while saving the expenditures of diabetes mellitus.
通过无创或微创方法估计和预测糖尿病及其并发症个体的时间危险率是至关重要的。数据挖掘和机器学习技术应用于健康数据存储库以实现这一目标。虽然过去的研究使用了各种技术组合来评估和预测糖尿病及其并发症,但缺乏将时间数据与视觉表示评估技术相结合的关注,这种技术可以被广泛接受。此外,通过考虑他们的未来变化与相似队列的特征,以时间顺序的方式预测个人一生的风险是值得考虑的准确的风险预测模型。我们的目标是引入一种简单而强大的自我监测可视化技术,通过赋予自我护理管理和决策能力,对提高医疗保健管理部门的水平非常有益。该系统在没有专业医生知识的情况下,通过早期预测风险,有效地影响糖尿病及其并发症的进展,有助于减轻疾病负担,同时节省糖尿病的费用。
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引用次数: 2
Accessibility Analysis of Hospitals Medical Services in Urban Modernization 城市现代化中医院医疗服务可达性分析
Tao Fan, Ying Sun, Xuhe Xie
The construction of medical infrastructure is a significant part of urban modernization. The accessibility of medical resources reflects the ability to respond and decentralize control in emergency management of public health emergencies. An improved gravity model is used to evaluate the accessibility of urban medical services based on the hospital and population distribution in a typical metropolis, and conducts a spatial analysis of control areas of urban public health emergency management, so as to identify risk points and propose improvements.
医疗基础设施建设是城市现代化的重要组成部分。医疗资源的可及性反映了突发公共卫生事件应急管理的响应能力和分权控制能力。基于典型大都市的医院和人口分布,采用改进重力模型对城市医疗服务可达性进行评价,并对城市突发公共卫生事件管理控制区进行空间分析,识别风险点并提出改进建议。
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引用次数: 0
Study on the Effect of Peer Education on Anxiety and Depression of Ostomy Patients 同伴教育对造口患者焦虑、抑郁的影响研究
Jiaojiao Gu, Hao Jianling
The purpose of this study is to discuss the effect of peer education on the anxiety and depression of ostomy patients, so as to help guide and improve clinical nursing work. The method was to select 30 patients who underwent enterostomy surgery and peer education at the Changhai Hospital Affiliated to Shanghai Naval Military Medical University from December 2018 to March 2019, issue questionnaires before and after the patients received peer education, and then compare the changes of patients' anxiety and depression before and after the peer education.The results are shown below. After an ostomy patient received peer education, the anxiety and depression scores were lower than those before peer education, and the difference was statistically significant (p<0.05). It can be concluded that peer education can effectively improve the anxiety and depression of ostomy patients and improve the health status of ostomy patients.
本研究旨在探讨同伴教育对造口患者焦虑抑郁的影响,以帮助指导和改进临床护理工作。方法选取2018年12月至2019年3月在上海海军军医大学附属长海医院行肠造口手术并同伴教育的患者30例,在患者接受同伴教育前后发放问卷,比较患者在接受同伴教育前后焦虑、抑郁的变化。结果如下所示。1例造口患者接受同伴教育后,焦虑、抑郁评分均低于同伴教育前,差异有统计学意义(p<0.05)。由此可见,同伴教育可以有效改善造口患者的焦虑和抑郁情绪,改善造口患者的健康状况。
{"title":"Study on the Effect of Peer Education on Anxiety and Depression of Ostomy Patients","authors":"Jiaojiao Gu, Hao Jianling","doi":"10.1145/3418094.3418147","DOIUrl":"https://doi.org/10.1145/3418094.3418147","url":null,"abstract":"The purpose of this study is to discuss the effect of peer education on the anxiety and depression of ostomy patients, so as to help guide and improve clinical nursing work. The method was to select 30 patients who underwent enterostomy surgery and peer education at the Changhai Hospital Affiliated to Shanghai Naval Military Medical University from December 2018 to March 2019, issue questionnaires before and after the patients received peer education, and then compare the changes of patients' anxiety and depression before and after the peer education.The results are shown below. After an ostomy patient received peer education, the anxiety and depression scores were lower than those before peer education, and the difference was statistically significant (p<0.05). It can be concluded that peer education can effectively improve the anxiety and depression of ostomy patients and improve the health status of ostomy patients.","PeriodicalId":192804,"journal":{"name":"Proceedings of the 4th International Conference on Medical and Health Informatics","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134487981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Efficient Signature Scheme Using Extended Chaotic Maps for Medical Imaging Records 基于扩展混沌映射的医学影像记录有效签名方案
Tian-Fu Lee, Ting-Shun Kung, I-Pin Chang
Digital security issues such as medical records, diagnostic certificates, medical images, etc. in the medical community have gradually been paid attention to. Nowadays, encrypting and signing electronic medical records including medical imaging records still have to rely on time-consuming exponential computations. Generally, medical image files are often larger and quite different from electronic medical text record file in characteristic, size and format. Recently, the chaotic map operation has been discovered to be superior to modular exponential or scalar multiplications on an elliptic curve. The extended chaotic maps also provide the characteristics of semigroup, commutative property, and the discrete logarithm problem, and thus are suitable for the development of asymmetric cryptosystems. This study develops a signature scheme based on extended chaotic maps that is suitable for medical imaging records. The proposed signature scheme not only provides the properties of digital signatures, including authentication, unforgeability and non-repudiation, but also is more efficient than the related signature mechanism used in medical institutions today.
医疗界的病历、诊断证明、医学影像等数字安全问题逐渐受到重视。目前,包括医学影像记录在内的电子医疗记录的加密和签名仍然依赖于耗时的指数计算。一般来说,医学图像文件要比电子病历文件大,在特征、大小和格式上都与电子病历文件有很大的不同。近年来,混沌映射运算被发现优于椭圆曲线上的模指数乘法或标量乘法。扩展混沌映射还提供了半群、交换性和离散对数问题的特征,因此适合于非对称密码系统的开发。本研究开发了一种适用于医学影像记录的扩展混沌映射签名方案。所提出的签名方案不仅具有数字签名的可认证性、不可伪造性和不可否认性等特性,而且比目前医疗机构使用的相关签名机制更高效。
{"title":"Efficient Signature Scheme Using Extended Chaotic Maps for Medical Imaging Records","authors":"Tian-Fu Lee, Ting-Shun Kung, I-Pin Chang","doi":"10.1145/3418094.3418144","DOIUrl":"https://doi.org/10.1145/3418094.3418144","url":null,"abstract":"Digital security issues such as medical records, diagnostic certificates, medical images, etc. in the medical community have gradually been paid attention to. Nowadays, encrypting and signing electronic medical records including medical imaging records still have to rely on time-consuming exponential computations. Generally, medical image files are often larger and quite different from electronic medical text record file in characteristic, size and format. Recently, the chaotic map operation has been discovered to be superior to modular exponential or scalar multiplications on an elliptic curve. The extended chaotic maps also provide the characteristics of semigroup, commutative property, and the discrete logarithm problem, and thus are suitable for the development of asymmetric cryptosystems. This study develops a signature scheme based on extended chaotic maps that is suitable for medical imaging records. The proposed signature scheme not only provides the properties of digital signatures, including authentication, unforgeability and non-repudiation, but also is more efficient than the related signature mechanism used in medical institutions today.","PeriodicalId":192804,"journal":{"name":"Proceedings of the 4th International Conference on Medical and Health Informatics","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114757745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Understanding Adoption of Electronic Medical Records: Application of Process Mining for Health Worker Behavior Analysis 理解电子病历的采用:过程挖掘在卫生工作者行为分析中的应用
D. Villamor, Christian E. Pulmano, M. R. Estuar
In the Philippine Health Insurance Company (PHIC) Advisory 04-2016, Primary Care Providers were given until the end of the year to adopt any of the certified electronic medical record providers for submission of patient profiling and patient consultations. With much emphasis on how electronic medical records can pave the way for better health care, this study presents finding on one year usage of a certified electronic medical record in selected areas in the Philippines. The study uses a novel approach in understanding technology adoption through process mining - technique often used in Business Process Analysis (BPA). A total of 8.8 million system-generated usage logs including: Session ID, Timestamp, URL Visited, URL Source, User ID were extracted as part of the dataset. Pre-processing techniques were performed on the data set prior to process mining. In using process mining to understand user behavior based on system-generated usage logs, one must consider: how to identify a case (i.e. how to group activities together), and how to structure your data in a way that allows the inference of real world activities and processes. Using standard adoption models shows us that adoption of early implementation of EMRs remain at basic usage with only a few users fully embracing the technology. However, use of process mining in understanding user behavior depicts actual workflow and presents adoption at a more advanced level.
在菲律宾健康保险公司2016年4月的咨询中,初级保健提供者被要求在年底前采用任何经认证的电子病历提供商提交患者概况和患者咨询。本研究着重强调电子病历如何为更好的医疗保健铺平道路,提出了在菲律宾选定地区使用经过认证的电子病历一年的发现。本研究采用了一种新颖的方法,通过流程挖掘来理解技术采用,该技术通常用于业务流程分析(BPA)。总共有880万个系统生成的使用日志,包括:会话ID,时间戳,访问过的URL, URL源,用户ID被提取作为数据集的一部分。在过程挖掘之前,对数据集进行预处理技术。在使用流程挖掘来理解基于系统生成的使用日志的用户行为时,必须考虑:如何识别一个案例(即如何将活动分组在一起),以及如何以一种允许对现实世界的活动和流程进行推断的方式构建数据。使用标准采用模型向我们表明,emr的早期实现的采用仍然处于基本使用状态,只有少数用户完全接受该技术。然而,在理解用户行为时使用过程挖掘描述了实际的工作流程,并在更高级的层面上提供了采用。
{"title":"Understanding Adoption of Electronic Medical Records: Application of Process Mining for Health Worker Behavior Analysis","authors":"D. Villamor, Christian E. Pulmano, M. R. Estuar","doi":"10.1145/3418094.3418109","DOIUrl":"https://doi.org/10.1145/3418094.3418109","url":null,"abstract":"In the Philippine Health Insurance Company (PHIC) Advisory 04-2016, Primary Care Providers were given until the end of the year to adopt any of the certified electronic medical record providers for submission of patient profiling and patient consultations. With much emphasis on how electronic medical records can pave the way for better health care, this study presents finding on one year usage of a certified electronic medical record in selected areas in the Philippines. The study uses a novel approach in understanding technology adoption through process mining - technique often used in Business Process Analysis (BPA). A total of 8.8 million system-generated usage logs including: Session ID, Timestamp, URL Visited, URL Source, User ID were extracted as part of the dataset. Pre-processing techniques were performed on the data set prior to process mining. In using process mining to understand user behavior based on system-generated usage logs, one must consider: how to identify a case (i.e. how to group activities together), and how to structure your data in a way that allows the inference of real world activities and processes. Using standard adoption models shows us that adoption of early implementation of EMRs remain at basic usage with only a few users fully embracing the technology. However, use of process mining in understanding user behavior depicts actual workflow and presents adoption at a more advanced level.","PeriodicalId":192804,"journal":{"name":"Proceedings of the 4th International Conference on Medical and Health Informatics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125287187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
Proceedings of the 4th International Conference on Medical and Health Informatics
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