TABLE OF
CONTENTS
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF STUDY
1.2
STATEMENT OF THE PROBLEM
1.3
OBJECTIVES OF THE STUDY
1.4
SIGNIFICANCE OF STUDY
1.5
SCOPE OF THE STUDY
1.6
LIMITATIONS OF THE STUDY
1.7
DEFINITION OF RELATED TERMS
CHAPTER
TWO
REVIEW
OF RELATED LITERATURE
2.0 CLINICAL DIAGNOSTIC SUPPORT SYSTEMS
2.1
SUCCESS FACTORS OF CDS SYSTEMS
2.2
EXAMPLES OF CDSS IN PRACTICE
2.3 SELECTED
CONTEMPORARY EXAMPLES OF CDSS ATHENA
CHAPTER
THREE
METHODOLOGY
AND SYSTEM ANALYSIS
3.1 PREAMBLE
3.2 METHODS OF DATA COLLECTION
3.3 ANALYSIS OF EXISTING SYSTEM
3.4 BLOCK DIAGRAM OF EXISTING SYSTEM
3.5 LIMITATIONS OF EXISTING SYSTEM
3.6 INPUT, PROCESS
AND OUTPUT ANALYSIS
OF PROPOSED SOLUTION
3.7 JUSTIFICATION FOR THE NEW SYSTEM
CHAPTER FOUR
DESIGN, TESTING AND IMPLEMENTATION
OF THE NEW SYSTEM
4.1 DESIGN STANDARD
4.2 OUTPUT DESIGN
4.3 INPUT DESIGN
4.4 DATABASE DESIGN
4.5 THE MAIN MENU
4.6 THE SUB MENU
4.7 SYSTEM FLOWCHART
4.8 CHOICE OF PROGRAMMING LANGUAGE
4.9 SYSTEM REQUIREMENTS
4.10
Program Flowchart
4.11
CHANGE OVER PROCESS
4.12
SOFTWARE TESTING
CHAPTER
FIVE
SUMMARY,
CONCLUSION AND RECOMMENDATIONS
5.1 SUMMARY
5.2 CONCLUSION
5.3 RECOMMENDATIONS
REFERENCES
CHAPTER ONE
INTRODUCTION
1.0 BACKGROUND OF STUDY
Medical diagnosis, (often
simply termed diagnosis) refers both to the process of attempting to determine
or identifying a possible disease or disorder to the opinion reached by this
process. A diagnosis in the sense of diagnostic procedure can be regarded as an
attempt at classifying an individual’s health condition into separate and
distinct categories that allow medical decisions about treatment and prognosis
to be made. Subsequently, a diagnostic opinion is often described in terms of a
disease or other conditions.
In the medical diagnostic
system procedures, elucidation of the etiology of the disease or conditions of
interest, that is, what caused the disease or condition and its origin is not
entirely necessary. Such elucidation can be useful to optimize treatment,
further specify the prognosis or prevent recurrence of the disease or condition
in the future.
Clinical decision support
systems (CDSS) are interactive computer programs designed to assist healthcare
professionals such as physicians, physical therapists, optometrists, healthcare
scientists, dentists, pediatrists, nurse practitioners or physical assistants
with decision making skills. The clinician interacts with the software
utilizing both the clinician’s knowledge and the software to make a better
analysis of the patient’s data than neither humans nor software could make on
their own.
Typically, the system makes
suggestions for the clinician to look through and the he picks useful
information and removes erroneous suggestions.
To diagnose a disease, a
physician is usually based on the clinical history and physical examination of
the patient, visual inspection of medical images, as well as the results of laboratory tests. In some cases,
confirmation of the diagnosis is particularly difficult because it requires
specialization and experience, or even the application of interventional
methodologies (e.g., biopsy). Interpretation of medical images (e.g., Computed
Tomography, Magnetic Resonance Imaging, Ultrasound, etc.) usually performed by
radiologists, is often limited due to the non-systematic search patterns of
humans, the presence of structure noise (camouflaging normal anatomical
background) in the image, and the presentation of complex disease states
requiring the integration of vast amounts of image data and clinical
information. Computer-Aided Diagnosis (CAD), defined as a diagnosis made by a
physician who uses the output from a computerized analysis of medical data as a
―second opinion‖ in detecting lesions, assessing disease severity, and making
diagnostic decisions, is expected to enhance the diagnostic capabilities of
physicians and reduce the time required for accurate diagnosis. With CAD, the
final diagnosis is made by the physician.
The first CAD systems were
developed in the early 1950s and were based on production rules (Shortliffe,
1976) and decision frames (Engelmore & Morgan, 1988). More complex systems
were later developed, including blackboard systems (Engelmore & Morgan,
1988) to extract a decision, Bayes models (Spiegelhalter, Myles, Jones, &
Abrams, 1999) and artificial neural networks (ANNs) (Haykin, 1999). Recently, a
number of CAD systems have been implemented to address a number of diagnostic
problems. CAD systems are usually based on biosignals, including the
electrocardiogram (ECG), electroencephalogram (EEG), and so on or medical
images from a number of modalities, including radiography, computed tomography,
magnetic resonance imaging, ultrasound imaging, and so on.
In therapy, the selection of
the optimal therapeutic scheme for a specific patient is a complex procedure
that requires sound judgement based on clinical expertise, and knowledge of
patient values and preferences, in addition to evidence from research. Usually,
the procedure for the selection of the therapeutic scheme is enhanced by the
use of simple statistical tools applied to empirical data. In general, decision
making about therapy is typically based on recent and older information about
the patient and the disease, whereas information or prediction about the
potential evolution of the specific patient disease or response to therapy is
not available. Recent advances in hardware and software allow the development
of modern Therapeutic Decision Support (TDS) systems, which make use of
advanced simulation techniques and available patient data to optimize and
individualize patient treatment, including diet, drug treatment, or
radiotherapy treatment.
In addition to this, CDS
systems may be used to generate warning messages in unsafe situations, provide
information about abnormal values of laboratory tests, present complex research
results, and predict morbidity and mortality based on epidemiological data.
1.3
STATEMENT OF THE PROBLEM
Disease diagnosis and treatment
constitute the major work of physicians. Some of the time, diagnosis is wrongly
done leading to error in drug prescription and further complications in the
patient’s health. It has also been noticed that much time is spent in physical
examination and interview of patients before treatment commences. The clinical
decision support system (CDSS) shall address these problems by effectively
providing quality diagnosis in real-time.
1.4
OBJECTIVES OF THE STUDY
To develop modern interactive diagnostic
software that will aid clinicians in diagnostic procedures.
To offer prescription of medication.
To enable flexibility in access to information
through the World Wide Web or comprehensive knowledge bases.
To offer information on effective disease
prevention.
To provide for real-time overall effective,
efficient and accurate service delivery by clinicians in line with global
medical health standards.
1.5
SIGNIFICANCE OF STUDY
Advances in the areas of
computer science and artificial intelligence have allowed for development of
computer systems that support clinical diagnostic or therapeutic decisions
based on individualized patient data. Clinical decision support (CDS) systems
aim to codify and strategically manage biomedical knowledge to handle
challenges in clinical practice using mathematical modeling tools, medical data
processing techniques and artificial intelligence (A.I.) methods.
Its
significance is also seen in its ability to:
Provide diagnostic support and model the
possibility of occurrence of various diseases or the efficiency of alternative
therapeutic schemes.
Reduce the potential for harmful drug
interactions, prescription errors and adverse drug reactions.
Enable clinicians report adverse drug
reactions to the relevant authorities.
Promote better patient care by enhancing
collaboration between physicians and pharmacists.
1.6
SCOPE OF THE STUDY
Due to the fact that it is
difficult to develop an expert system for diagnosing all diseases at a time,
financial and time constraints, this research is limited to medical diagnosis
and treatment for malaria, typhoid fever and pneumonia.
The therapy covers severe and
uncomplicated cases of the treatment of extreme or severe associated cases in
patients such as cerebral malaria which causes insanity, blondness, asthma,
tuberculosis and so on.
The study will also involve
method(s) of diagnosis especially the patient history, physical examination and
request for clinical laboratory test but will not go into how these tests are
carried out.
Rather,
it will only make use of the laboratory and treatment.
1.7
LIMITATIONS OF THE STUDY
In the course of this study, a
major constraint experienced was that of time factor and insufficient finance.
Others include the inevitability of human error and bias as some information
were obtained via interpersonal interactions, interviews and research, making
some inconsistent with existing realities or outrightly incorrect.
Great pains were however taken
to ensure that these limitations are at their very minimum and less impactful
on the outcome of the work.
1.8
DEFINITION OF RELATED TERMS
Here,
the researcher shall try as much as possible to explain certain technical terms
used during the course of his study.
Prognosis:
This is a medical opinion as to the likely outcome of a disease
Etiology:
This is the branch of medicine that investigates the causes and origin of
diseases.
Diagnostic Criteria:
This term designates the specific combination of signs, symptoms, and
test results that the clinician uses to attempt to determine the correct
diagnosis.
Therapy critiquing and
consulting: This function of a clinician implies
assessing of the therapy looking for inconsistencies, errors,
cross-references for drug interactions and prevents prescribing of allergenic
drugs.
Allergen: A substance that causes an allergy.
Epidemiology:
The scientific and medical study of the causes and transmission of
disease within a population.
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