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Clinical decision support system as a risk assessment tool to aid in earlier diagnosis of pancreatic cancer

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Title
Clinical decision support system as a risk assessment tool to aid in earlier diagnosis of pancreatic cancer
Name (type = personal)
NamePart (type = family)
Adams
NamePart (type = given)
Emmase
NamePart (type = date)
1975-
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Emmase Adams
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
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DINESH P
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DINESH P MITAL
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Advisory Committee
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chair
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Haque
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Syed
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Syed Haque
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Advisory Committee
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internal member
Name (type = personal)
NamePart (type = family)
Srinivisan
NamePart (type = given)
Shankar
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Shankar Srinivisan
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Coffman
NamePart (type = given)
Frederick
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Frederick Coffman
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Health Related Professions
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2015
DateOther (qualifier = exact); (type = degree)
2015-05
CopyrightDate (encoding = w3cdtf); (qualifier = exact)
2015
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Background: Pancreatic cancer is the most aggressive and the most deadly type of cancer. It is the fourth leading cause of cancer-related death with a dismal prognosis because most diagnoses are made during the advanced stage of the disease. Although, several studies have researched methods for early diagnosis and treatment of pancreatic cancer, the use of clinical decision support systems as a precursor for early diagnosis has not been extensively studied. Clinical decision support systems are computer programs that could be used to aid clinicians or others in their decision-making at the point-of-care of their patients. It can also be designed to aid the general population in evaluating their risk of developing a particular illness or other facets of health care related issues. Objectives: To develop a clinical decision support system that can identify pancreatic cancer risk levels in individuals, and also provide recommendations and alerts tailored towards each individual’s situation in order that pancreatic cancer diagnoses are made earlier than later. Design: A multi-method approach using quasi-experimental and quantitative study. Methods: This study posed three hypotheses that will be tested using the developed clinical decision support system. First, extensive review of literature and existing data were conducted in addition to data analysis of the Nationwide Inpatient sample to gather clinical evidence and facts about pancreatic cancer risk factors. The knowledge gathered and probabilistic basis were used to define the variables and parameters and their respective weighted scores. Five weight groups of 100, 60, 30, 15, and 5 were created with “100” as maximum risk and “5’ as minimum risk. Fourteen common risk factors were used and within these risk factors, 87 parameters were defined and categorized into one of the five weight groups. The variables used include; demographic information, smoking history, history of cancer, family history of cancer, and other risk factors of pancreatic cancer. Using IF/THEN rules, logical order of steps were created. With the inference engine of the clinical decision support system, the system is able to compute the sum of the weighted scores and provide immediate feedback in the form of total risk factor score at the end of the test. The system also displays the scoring chart for the three risk levels; high-risk, moderate-risk and low-risk at the end of the test for users to identify which one of the three levels they belong. Results: Twelve case scenarios were used to test the validity and reliability of the system. Among the 12 cases, nine were diagnosed with pancreatic cancer, one was a healthy individual with no diagnosis of any sort and two were diagnosed with other health conditions. The results were as follows; two low risk patients, three moderate risk patients and seven high risk patients. The healthy individual turned out to be high risk. In some cases, recommendations and alerts were generated for patients to seek immediate medical attention, screen for pancreatic cancer or get a scan of the pancreas. Conclusion: The results show that it is possible to develop a system that can identify high risk individuals for pancreatic cancer. The impact the system will have on patient care and whether the system can reduce the number of misdiagnoses, delayed diagnoses, or lead to earlier diagnoses of pancreatic cancer is uncertain. Further studies will need to be conducted to expand the knowledge in using clinical decision support system for pancreatic cancer risk assessment, and also to identify the precise parameters of the three risk level-scores.
Subject (authority = RUETD)
Topic
Biomedical Informatics
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_6480
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
1 online resource (xiv, 123 p. : ill.)
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Subject (authority = ETD-LCSH)
Topic
Pancreas--Cancer--Diagnosis
Subject (authority = ETD-LCSH)
Topic
Cancer--Risk factors
Note (type = statement of responsibility)
by Emmase Adams
RelatedItem (type = host)
TitleInfo
Title
School of Health Related Professions ETD Collection
Identifier (type = local)
rucore10007400001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/T3CJ8G9W
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Adams
GivenName
Emmase
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2015-04-29 16:14:33
AssociatedEntity
Name
Emmase Adams
Role
Copyright holder
Affiliation
Rutgers University. School of Health Related Professions
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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ETD
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windows xp
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