Seminar on “Intelligent data analysis and data mining – Application in medicine”
description
Transcript of Seminar on “Intelligent data analysis and data mining – Application in medicine”
![Page 1: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/1.jpg)
12 June 2004 Clinical algorithms in public health 1
Seminar on “Intelligent data analysis and data mining – Application in medicine”
Research on poisonings Research on poisonings in children: public in children: public
health perspective for health perspective for the development of the development of clinical algorithmsclinical algorithms
byDr Sergio Pièche
![Page 2: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/2.jpg)
12 June 2004 Clinical algorithms in public health 2
Developing clinical algorithms in public health
The problem
The target
Principles
Research
![Page 3: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/3.jpg)
12 June 2004 Clinical algorithms in public health 3
Developing clinical algorithms in public health: The The
problemproblem
InjuriesInjuries
• Mortality: causing deaths• Morbidity: burden of the
condition• Age group at risk• Costs: hospital and primary
health care• Likely impact of interventions
![Page 4: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/4.jpg)
12 June 2004 Clinical algorithms in public health 4
Developing clinical algorithms in public health: The targetThe target
Health providers at primary health care level:
– Health background: doctors, medical assistants, nurses, other health workers
– Type of facility: equipment, supply, access to referral facility
![Page 5: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/5.jpg)
12 June 2004 Clinical algorithms in public health 5
Developing clinical algorithms in public health: PrinciplesPrinciples
• Safe and effective guidelines: Sensitive and specific clinical signs
Minimum number of clinical signs
Requiring simple skills to be used
Standard and simple assess-classify-treat system
Possible to teach and learn
Minimum number of essential drugs
Best care possible for severe cases
• Safe and effective guidelines: Sensitive and specific clinical signs
Minimum number of clinical signs
Requiring simple skills to be used
Standard and simple assess-classify-treat system
Possible to teach and learn
Minimum number of essential drugs
Best care possible for severe cases
![Page 6: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/6.jpg)
12 June 2004 Clinical algorithms in public health 6
Clinical algorithm
ASSESSMENT:signs
CLASSIFICATION:for action
TREATMENT:the action
Danger signs SEVEREReferral:
pre-referral treatment
Other signs MODERATETreatment (follow-up
needed)
Other signs or no signs
MILD Home care
![Page 7: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/7.jpg)
12 June 2004 Clinical algorithms in public health 7
Developing clinical algorithms in public health: ResearchResearch
•Hydrocarbon poisoning
•Organophosphate poisoning
![Page 8: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/8.jpg)
12 June 2004 Clinical algorithms in public health 8
Developing clinical algorithms in public health: Research Research
on poisoning: prospective on poisoning: prospective studystudy
Clinical predictors of severity of accidental poisoning from hydrocarbons and organophosphates in children below 5 years old
![Page 9: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/9.jpg)
12 June 2004 Clinical algorithms in public health 9
Developing clinical algorithms in public health: Research on Research on
poisoning: aimpoisoning: aim
…to develop an algorithm for the
outpatient management of
children with hydrocarbon and
organophosphate poisonings at
primary health care facilities in
developing countries.
![Page 10: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/10.jpg)
12 June 2004 Clinical algorithms in public health 10
Developing clinical algorithms in public health: Research Research
stepssteps
• Derivation of clinical decision
rule (factors with predictive power)
• Prospective validation of the algorithm in different settings
• Provider performance analysis
• Impact
![Page 11: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/11.jpg)
12 June 2004 Clinical algorithms in public health 11
Developing clinical algorithms in public health: Research Research
approachapproach• Identification and standard
definition of signs and symptoms
• Gold standards for diagnoses
• Definition of outcomes
• Observer variability and bias
• Procedures (protocol and instruments; training, supervision)
![Page 12: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/12.jpg)
12 June 2004 Clinical algorithms in public health 12
Developing clinical algorithms in public health: Research Research
methodology - 1methodology - 1
EnrolmentEnrolment• Children 2 to 59 months old
• History: unintentional exposure to hydrocarbons or organophosphates
• Acute exposure
• Seen within 48 hours of exposure to poison
• New cases
![Page 13: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/13.jpg)
12 June 2004 Clinical algorithms in public health 13
Developing clinical algorithms in public health: Research Research
methodology - 2methodology - 2ProceduresProcedures
• All children admitted for at least 48 hours post-exposure irrespective of severity (written consent and free admission)
• Examined by study physician + investigations upon admission
• Followed up at 6, 12, 24, 48 hours post-exposure
• No delay or interference with quality care
![Page 14: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/14.jpg)
12 June 2004 Clinical algorithms in public health 14
Follow-up
Post-exposure
OPD/ER6 hours
Follow-up
12 hours
Follow-up
24 hours
Follow-up
48 hours
Follow-upDischarge
/ death
Cl. exam.(Lab tests;
X-ray)
Intermediate outcomesFinal
outcome
![Page 15: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/15.jpg)
12 June 2004 Clinical algorithms in public health 15
E.g. Hydrocarbon poisoning
•Respiratory signs:cough, fast breathing,etc•Vomiting•…
Chemicalpneumonitis
OutcomeBacterial
pneumonia
Severity
![Page 16: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/16.jpg)
12 June 2004 Clinical algorithms in public health 16
Developing clinical algorithms in public health: Research Research
methodology - 3methodology - 3
Sample sizeSample size• To detect the overall association and prediction
of common symptoms and signs with poisoning severity and outcome
• To account in the analysis for stratification of cases in sub-groups based on time of exposure to poison
![Page 17: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/17.jpg)
12 June 2004 Clinical algorithms in public health 17
Key questions
• Which common clinical signs and symptoms best predict poisoning severity and outcome?
• How long is the safe clinical observation period before sending home a child who has been exposed to hydrocarbons or organophosphates?
![Page 18: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/18.jpg)
12 June 2004 Clinical algorithms in public health 18
Developing clinical algorithms in public health: Research: Research:
AnalysisAnalysis
• Chi-square statistics or Fisher exact test, risk differences, risk ratios, odds ratios
• Multivariate logistics regression - incl. stepwise techniques
• Data mining techniques to be considered• Sensitivity, specificity, predictive accuracy
![Page 19: Seminar on “Intelligent data analysis and data mining – Application in medicine”](https://reader035.fdocuments.in/reader035/viewer/2022062305/56814e28550346895dbb9020/html5/thumbnails/19.jpg)
12 June 2004 Clinical algorithms in public health 19
Data analysis:
The challenge!
The challenge!