基于国际头痛诊断标准的原发性头痛辅助决策系统
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摘要
针对原发性头痛在我国发病率较高但诊断准确率较低的问题,提出了一种将文本化的国际头痛诊断标准转换为计算机可执行推理的临床知识建模和知识库构建方法。该方法首先将基于诊断标准绘制的诊断思维流程图转换为规范化的临床知识表达模型,再将临床知识表达模型通过规则映射技术转换为计算机推理诊断所用的规则,形成知识库,并以此为基础开发了覆盖完整头痛诊断流程的原发性头痛辅助决策系统。临床评估显示,该系统可正确地识别出91. 3%的偏头痛、87. 2%的紧张型头痛和90. 0%的丛集性头痛病人,对常见的原发性头痛具有较高的诊断准确率。
In order to overcome the problem of high morbidity and low diagnostic accuracy of primary headaches in China,this paper proposed a clinical knowledge modeling and knowledge base constrcuting method that translating text-based diagnostic criteria to computer execuable knowledge. This method first translated diagnostic criteria based flow chart of diagnostic thoughts to clinical knowledge representation model,then translated clinical knowledge representation model to reasoning rules by rules-mapping technique. On the basis of the above method,it developed an assistant decision-making system for primary headaches. Clinical evaluation shows that this system can recognize 91. 3% of migraine,87. 2% of tension-type headache,90. 0% of cluster headache,and therefore achieve a relatively high success rate for common primary headaches.
In order to overcome the problem of high morbidity and low diagnostic accuracy of primary headaches in China,this paper proposed a clinical knowledge modeling and knowledge base constrcuting method that translating text-based diagnostic criteria to computer execuable knowledge. This method first translated diagnostic criteria based flow chart of diagnostic thoughts to clinical knowledge representation model,then translated clinical knowledge representation model to reasoning rules by rules-mapping technique. On the basis of the above method,it developed an assistant decision-making system for primary headaches. Clinical evaluation shows that this system can recognize 91. 3% of migraine,87. 2% of tension-type headache,90. 0% of cluster headache,and therefore achieve a relatively high success rate for common primary headaches.
引文
[1]董钊,于生元.神经病理性疼痛与头面痛[J].中国现代神经疾病杂志,2013,13(9):752-754.(Dong Zhao,Yu Shengyuan. Neuropathic pain and headache[J]. Chinese Journal of Contemporary Neurology and Neurosurgery,2013,13(9):752-754.)
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[3]于生元.头痛诊治要点概览[J].中国实用内科杂志,2010,30(6):493-494.(Yu Shengyuan. Overview of main points of headache diagnosis and treatment[J]. Chinese Journal of Practical Internal Medicine,2010,30(6):493-494.)
[4] Liu Ruozhuo,Yu Shengyuan,He Mianwang,et al. Health-care utilization for primary headache disorders in China:a population-based door-to-door survey[J]. Journal of Headache and Pain,2013,14(1):1-8.
[5]乌欣蔚,杨晓苏.慢性每日头痛的研究进展[J].中国全科医学,2014,17(34):4133-4136.(Wu Xinwei,Yang Xiaosu. Research progress on chronic daily headache[J]. Chinese General Practise,2014,17(34):4133-4136.)
[6] Headache Classification Committee of the International Headache Society. The international classification of headache disorders,3rd edition(beta version)[J]. Cephalalgia,2013,33(9):629-808.
[7] Khayamnia M,Yazdchi M,Vahidiankamyad A,et al. The recognition of migraine headache by designation of fuzzy expert system and usage of LFE learning algorithm[C]//Proc of the 5th Iranian Joint Congress on Fuzzy and Intelligent Systems. Piscataway,NJ:IEEE Press,2017:50-53.
[8] Hasan M R,Hasan M S,Siraj F. An expert system based headache solution[C]//Proc of IEEE Symposium on Computer Applications and Industrial Electronics. Piscataway,NJ:IEEE Press,2013:287-292.
[9] Krawczyk B,Simi c'D,Simi c'S,et al. Automatic diagnosis of primary headaches by machine learning methods[J]. Central European Journal of Medicine,2013,8(2):157-165.
[10]田宸宇,唐聃,赵武. CT对比剂智能应用专家系统的研究与开发[J].计算机应用研究,2017,34(7):2088-2089,2117.(Tian Chenyu,Tang Dan,Zhao Wu. Research and development of CT contrast agent intelligent application expert system[J]. Application Research of Computers,2017,34(7):2088-2089,2117.)
[11]Tu S W,Campbell J R,Glasgow J,et al. The SAGE guideline model:achievements and overview[J]. Journal of the American Medical Informatics Association,2007,14(5):589-598.
[12]Kaniecki R G. Migraine and tension-type headache:an assessment of challenges in diagnosis[J]. Neurology,2002,58(6):15-20.
[2] GuerreroL,Rojo E,Herrero S,et al. Characteristics of the first1000 headaches in an outpatient headache clinic registry[J]. Headache:the Journal of Head and Face Pain,2011,51(2):226-231.
[3]于生元.头痛诊治要点概览[J].中国实用内科杂志,2010,30(6):493-494.(Yu Shengyuan. Overview of main points of headache diagnosis and treatment[J]. Chinese Journal of Practical Internal Medicine,2010,30(6):493-494.)
[4] Liu Ruozhuo,Yu Shengyuan,He Mianwang,et al. Health-care utilization for primary headache disorders in China:a population-based door-to-door survey[J]. Journal of Headache and Pain,2013,14(1):1-8.
[5]乌欣蔚,杨晓苏.慢性每日头痛的研究进展[J].中国全科医学,2014,17(34):4133-4136.(Wu Xinwei,Yang Xiaosu. Research progress on chronic daily headache[J]. Chinese General Practise,2014,17(34):4133-4136.)
[6] Headache Classification Committee of the International Headache Society. The international classification of headache disorders,3rd edition(beta version)[J]. Cephalalgia,2013,33(9):629-808.
[7] Khayamnia M,Yazdchi M,Vahidiankamyad A,et al. The recognition of migraine headache by designation of fuzzy expert system and usage of LFE learning algorithm[C]//Proc of the 5th Iranian Joint Congress on Fuzzy and Intelligent Systems. Piscataway,NJ:IEEE Press,2017:50-53.
[8] Hasan M R,Hasan M S,Siraj F. An expert system based headache solution[C]//Proc of IEEE Symposium on Computer Applications and Industrial Electronics. Piscataway,NJ:IEEE Press,2013:287-292.
[9] Krawczyk B,Simi c'D,Simi c'S,et al. Automatic diagnosis of primary headaches by machine learning methods[J]. Central European Journal of Medicine,2013,8(2):157-165.
[10]田宸宇,唐聃,赵武. CT对比剂智能应用专家系统的研究与开发[J].计算机应用研究,2017,34(7):2088-2089,2117.(Tian Chenyu,Tang Dan,Zhao Wu. Research and development of CT contrast agent intelligent application expert system[J]. Application Research of Computers,2017,34(7):2088-2089,2117.)
[11]Tu S W,Campbell J R,Glasgow J,et al. The SAGE guideline model:achievements and overview[J]. Journal of the American Medical Informatics Association,2007,14(5):589-598.
[12]Kaniecki R G. Migraine and tension-type headache:an assessment of challenges in diagnosis[J]. Neurology,2002,58(6):15-20.