以精準醫療為導向的臨床決策支援系統

Abstract

精準醫療為一資料導向的新興醫學領域，主要利用個人基因型或是基因表現及蒐集臨床資料資訊，選擇最適合個人使用之藥物、治療方法或預防的方式，以期達到藥品最大療效與最小的副作用，為醫療領域開啟新的機會，然而精準醫療最終目的是希望能夠實踐在臨床流程中，臨床決策支援系統則是協助醫療人員提供醫療決策支援的系統 因此，本研究以精準醫療為導向，設計符合其精神的臨床流程，並提出一套臨床支援系統的架構，後續以質性訪談為研究方法，在研究分析後，研究發現醫務人員對於精準醫療認為目前還在前期階段，必需蒐集更多病患、完成基因定序及分析以醫療資料整合，臨床流程上必須依科別制定並且考量醫師立場，而系統架構上必須強調完整清楚呈現病患數據、推理和預測機制則是能夠和傳統醫學概念互相討論，進一步提升醫師使用意願及信賴程度。目前學術及醫療產業界相關研究甚少，期許本系統架構能夠讓未來讓醫療院所或是相關單位在設計臨床決策支援系統時，能夠有符合精準醫療的流程和架構依循。

Precision Medicine is an emerging data-oriented medical field that uses personal genotypes or gene expression and collects clinical information to choose the most suitable drug treatment or prevention method for patients, in order to achieve maximum efficacy with minimum toxicity for our patients. It opens up new opportunities in the healthcare field. The ultimate goal of precision medicine is to be realized in the clinical process. The clinical decision support system is a system to provide medical decision support to medical personnel. Therefore, we start our research with the objective of achieving precision medicine, design the clinical process in line with its spirit, and proposes a framework of clinical support system. We use the interview method as our main research method. After research and analysis, our research found what doctors think about precision medicine. At present, it is still in the early stage and it is necessary to collect more patient data, do whole genome sequencing and integrate all kinds of different medical data. Clinical procedures must be formulated according to each department and we should design in doctors’ place. The proposed system architecture should emphasize the presentation of patient data to be clear. The reasoning and predictive mechanism should be able to conform with traditional medical concepts to further enhance the willingness and trust of physicians. Currently, there is little research on precision medicine in the academic and medical industry. We hope our system architecture will enable medical organizations to have a reference of process and architecture that conforms to precision medicine when designing clinical decision support systems.