Deveolping clinical pathways of acute appendicitis patients in emergency room

응급실 급성 충수염 환자의 임상경로 개발

  • Park, Cheol-Yong (Department of Statistics, Keimyung University) ;
  • Kim, Yoon-Nyun (Department of Internal Medicine, School of Medicine, Keimyung University) ;
  • Choi, Hyun-Seok (Department of Statistics, Keimyung University) ;
  • Shin, A-Mi (Department of Medical Informatics, School of Medicine, Keimyung University)
  • Received : 2010.03.25
  • Accepted : 2010.05.17
  • Published : 2010.05.31

Abstract

In this study, we develop clinical pathways for test and medical treatment items of acute appendicitis patients in emergency room. In order to develop the clinical pathways, we first employ the order selection method by Park et al. (2010), and then display the selected orders in such a way that associated orders are tied together. More specifically the order selection method that we employ is based on lift and, starting from the orders with higher frequencies, sequentially removes the negatively associated orders with lift values less than 0.9. The way associated orders are selected and tied together is similar to that of the order selection method. More specifically, starting from the selected orders with higher frequencies, the orders with lift values greater than 1.1 are considered associated and displayed to the right of the corresponding order. Therefore, in the diagram of clinical pathways, the orders at the left hand side, in principle, are not associated with each other and upper orders have higher frequencies, and associated orders are located to the right of corresponding order at the left hand side and more left orders, in principle, have higher frequencies.

이 논문에서는 응급실 급성 충수염 환자의 치료와 검사 항목에 대한 임상경로를 개발하였다. 임상경로 개발을 위해 먼저 Park과 Kim (2010)에 의해 제시된 처방 선택 방법을 이용하였으며, 그 다음에 이렇게 선택된 처방들을 연관성이 있는 처방끼리 묶어서 그림으로 표시하였다. 구체적으로 사용된 처방 선택 방법은 향상도에 근거하고 있으며 빈도가 높은 처방부터 출발하여 이것과의 향상도가 0.9에 못 미치는 음의 연관성 처방들을 순차적으로 제거하였다. 이렇게 선택된 처방들에 대해 연관성이 있는 처방들을 묶는 방법도 처방 선택 방법과 비슷하다. 구체적으로 선택된 처방 중 빈도가 높은 처방부터 출발하여 순차적으로 이것과의 향상도가 1.1을 넘는 처방들을 연관성 있는 처방으로 고려하여 해당 처방 오른쪽에 표시하였다. 따라서 임상경로 그림에는 제일 왼쪽에는 연관성이 낮은 처방들을 빈도순으로 위에서 아래로 배치하고, 제일 왼쪽에 있는 각 처방의 오른쪽에는 이것과 연관성이 높은 처방들을 왼쪽에서 오른쪽으로 역시 빈도순으로 배치하는 것을 원칙으로 하였다.

Keywords

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