decision_support_health_informatics

							                                                Center
                                                   for
                                                Health
                                           Informatics




DECISION SUPPORT FOR
 HEALTH INFORMATICS

               Robert Neches
   Distributed Scalable Systems Division
    USC Information Sciences Institute
            4676 Admiralty Way
         Marina del Rey, CA 90292
             RNeches@isi.edu
    Comprehensive, Effective Decision                                            Center
                                                                                    for
               Support                                                           Health
                                                                            Informatics



• Useful Decision Support tools do not make decisions –
  they help people make decisions
• Specifically, they assist with four key functions:
   1.   Identifying/assembling promising alternative courses of action
        (e.g., treatment protocols) germane to patients’ and/or
        physicians’ specific situation and needs

   2.   Determining detailed case-specific requirements and
        implications of competing alternatives

   3.   Assessing relative tradeoffs (e.g., costs, benefits, risks...) of
        alternatives from personalized perspectives

   4.   Formulating personalized metrics and triggers for future
        “continue vs. revise” decisions regarding adopted choices
         Key Technical Elements                                                               Center
                                                    Constraint/dependency
                                                                                                 for
                                                     management system                        Health
                                                                                         Informatics
                                   Identifying/as                                     Data
                                   sembling
                                   promising
                                                                                    monitoring
                                   alternative
                                   courses of
                                   action

                                                          Assessing relative
 Data                                                     tradeoffs of
mining                                                    alternatives from
                        Determining                       personalized
                        requirements &                    perspectives
                        implications of
                        competing
                        alternatives




                                             Plan &
                                            Schedule
                                            Manager

   User tools for exploration of choices               Integrated provenance/trust solution
                            ISI Decision Support Approach                                                 Center
                                                                                                             for
                                                                                                          Health
                                                                                                     Informatics

Sample Health Decision Support                                       Significant features
Issues Potentially Addressable1
                                                                     • Facilitate investigating large
1.       Which of 173 open studies on Non-Hodgkins
         Lymphoma for adults in stage 4 from                           numbers of alternatives
         ClinicalTrials.gov might help me? Of the 282 open           • See how to keep options open
         studies for adults in Phase 4 in PDQ®?
                                                                     • Help refine criteria by
2.       What’s involved in treating my renal insufficiency in
         order to be eligible for the University of Bologna
                                                                       understanding impacts of choices
         study? What’s involved in a HLA-haploidentical              • Track status, change plans
         familial donor bone marrow transplantation, and can
         I get Natural Killer Cells from my donor for the Asan
         Medical Center Study?                                       Applications in other areas
3.       Am I willing to accept a 50% chance of experiencing
                                                                     • Helping adult hospitals plan for
         grade III toxicities to get the potential benefits of the     pediatric needs in disasters
         Asan study? Does that risk make me want to do it
         before I get too weak, or wait until other options are      • Balancing health maintenance,
         exhausted?                                                    safety, and research assignments
4.       What health signs must be monitored to make sure I            of International Space Station crew
         commit to the Asan study before I’m too sick to travel      • Improving safety while accelerating
         to Korea?
     1   Taken from a patient’s perspective
                                                                       training in military flight operations