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Conception et évaluation d'un système décisionnel informatisé basé sur le raisonnement des experts élaborant les guides de bonnes pratiques en antibiothérapie empirique

Abstract : Context: CDSS (Clinical Decision Support System) for the empiric prescription of antibiotics present many limits: (i) recommendations are only given for clinical situations that are described in CPGs (Clinical Practice Guidelines); (ii) updating is infrequent; (iii) poor ergonomics is an impediment to clinical adoption. To overcome these limits, we propose an approach leading to a CDSS that is able to generate ecommendations as in CPGs, and to display recommendations in an interface supporting knowledge. Methods: Our approach consists in (i) extracting from CPGs the deep medical reasoning used by experts to establish recommendations, (ii) using the decision process in empiric antibiotherapy and the usability principles to design a pleasant interface. Results: The implementation of the medical reasoning of the experts as an algorithm using 12 properties of antibiotics, allows to retrieve automatically the recommended antibiotics for all clinical situations, without the intervention of the experts. These properties could be updated automatically thanks to others resources like drugs data bases. The design of an interface supporting knowledge according to the decision process in empiric antibiotherapy and the usability principles, improve significantly the perceived usability and the confidence in the system. Conclusion: The extrapolation of our approach to the chronic diseases should be assessed.
Keywords : Medical reasoning
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Rosy Tsopra Tahiraly. Conception et évaluation d'un système décisionnel informatisé basé sur le raisonnement des experts élaborant les guides de bonnes pratiques en antibiothérapie empirique. Génie logiciel [cs.SE]. Université Paris-Nord - Paris XIII, 2014. Français. ⟨NNT : 2014PA132034⟩. ⟨tel-01241279⟩

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