基于可穿戴医疗传感器和机器学习集成的疾病诊断健康决策支持系统

Hongxu Yin;Niraj K. Jha
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引用次数: 85

摘要

即使每年的支出超过3万亿美元,美国的医疗体系也远非最佳。例如,在美国,第三大死亡原因是可预防的医疗错误,仅次于心脏病和癌症。基于计算机的临床决策支持系统(CDSS)已被提出来解决这些缺陷,并在过去十年中显著改善了临床实践。然而,它们仍然局限于诊所和医院,并且没有利用每天使用能够弥合这一信息差距的可穿戴医疗传感器(WMS)获得的患者数据。WMS可以随时随地收集任何人的生理信号。因此,他们有可能开创一个普及医疗保健的时代。然而,大多数先前关于WMS的工作只关注硬件和协议设计,而不关注能够充分利用收集的信号进行有效疾病诊断的信息系统。在本文中,我们首次介绍了一个用于疾病诊断的分层健康决策支持系统,该系统将来自WMS的健康数据集成到CDSS中。所提出的系统具有多层结构,从WMS层开始,由强大的机器学习支持,使疾病诊断模块能够单独跟踪疾病。我们通过针对四种ICD-10-CM疾病类别的六个疾病诊断模块来证明这种系统的可行性。我们表明,该系统可以使用另外五种疾病类别进行扩展。仅WMS级别就对各种疾病提供了令人印象深刻的诊断准确率:心律失常(86%)、2型糖尿病(78%)、膀胱疾病(99%)、肾盂肾炎(94%)和甲状腺功能减退(95%)。我们估计,所有已知69000种人类疾病的疾病诊断模块在WMS层中只需要62GB的存储空间。即使在当今面向云或基站的WMS系统中,这也是实用的。
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A Health Decision Support System for Disease Diagnosis Based on Wearable Medical Sensors and Machine Learning Ensembles
Even with an annual expenditure of more than $3 trillion, the U.S. healthcare system is far from optimal. For example, the third leading cause of death in the U.S. is preventable medical error, immediately after heart disease and cancer. Computer-based clinical decision support systems (CDSSs) have been proposed to address such deficiencies and have significantly improved clinical practice over the past decade. However, they remain limited to clinics and hospitals, and do not take advantage of patient data that are obtained on a daily basis using wearable medical sensors (WMSs) that have the ability to bridge this information gap. WMSs can collect physiological signals from anyone anywhere anytime. Thus, they have the potential to usher in an era of pervasive healthcare. However, most prior work on WMSs only focuses on hardware and protocol design, and not on an information system that can fully utilize the collected signals for efficient disease diagnosis. In this paper, for the first time, we introduce a hierarchical health decision support system for disease diagnosis that integrates health data from WMSs into CDSSs. The proposed system has a multi-tier structure, starting with a WMS tier, backed by robust machine learning, that enables diseases to be tracked individually by a disease diagnosis module. We demonstrate the feasibility of such a system through six disease diagnosis modules aimed at four ICD-10-CM disease categories. We show that the system is scalable using five more disease categories. Just the WMS tier offers impressive diagnostic accuracies for various diseases: arrhythmia (86 percent), type-2 diabetes (78 percent), urinary bladder disorder (99 percent), renal pelvis nephritis (94 percent), and hypothyroid (95 percent). We estimate that the disease diagnosis modules of all known 69,000 human diseases would require just 62 GB of storage space in the WMS tier. This is practical even in today's cloud or base station oriented WMS systems.
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