Proposal for Development of EBM-CDSS (Evidence-Based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients
Abstract
The goal of this project is to develop an Evidence-based Clinical Decision Support (CDSS-EBM) System available at the point of care to improve prognostication of the life expectancy of terminally ill patients. The system is designed to improve referral of patients to hospice. We have completed the research and development (R&D) committee review process at the James A. Haley veteran's hospital, and have obtained the University of South Florida's and Tampa General Hospital's institutional review board (IRB) authorization. We are now in the process of obtaining final approvals from the James A. Haley veteran's hospital and the USAMRMC Office of Research Protections Human Research Protections Office (HRPO). So far, our key research accomplishments are as follows: (1) developed a case report for data extraction from Tampa Bay Lifepath Hospice Center's data; (2) developed decision curves for the SUPPORT prognostication model; (3) developed the first version of the Rough Set Theory prognostication model; (4) created a novel methodology that combines Decision Curve Analysis and Regret Theory to compare multiple decision strategies based on the decision maker's personal attitudes toward each strategy; (5) developed a new method for elicitation of patient preferences regarding continuation of life-sustaining vs. palliative care; (6) developed a pilot, web-based version of the CDSS-EBM to compute life expectancy for terminally ill patients based on the DEALE and SUPPORT prognostication models; (7) created evidence tables for lung cancer; and (8) expanded CDSS-EBM with a pain management module to assist physicians in managing terminally ill patients or patients with chronic pain.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2010
- Accession Number
- ADA547488
Entities
People
- Benjamin Djulbegovic
Organizations
- University of South Florida