[PP.30.08] CLINICAL DECISION SUPPORT SYSTEMS CONTROLLER AND DNA DATABASES

Objective: Software design for cardiovascular genetics laboratories.Design and method: Software design and development for adaptive accompaniment of CDS, being based on standardized protocols and benchmarks for the diagnosis and treatment of essential hypertension EH. Results: We have developed GeneSecure software package supporting CDS technologies within the EMR, supply module status CardioHalth and access to a local DNA database. We have developed two independent solutions for the CDS -Modeling of the EH risk assessment - risks, events, actions and their consequences over time, 2) Drawing up recommendations based on mutations in twenty one genes of cardiovascular continuum. During the CDS testing, we were obtained epidemiological data of clinical development EH in the Uzbek population. For example, 91.2% of participants with EH were structural changes in the heart with a disease duration of 5.4 ± 4.41 years (LVMI 159.8 ± 35.55). The highest blood pressure was recorded on a level of 220/130 mm Hg (0.5% of the sample). Registration of the genotyping results has identified an association ENDOTHEL system genes (B2BKR/+9/−9; eNOS /4a/4b) with the risk of endothelial dysfunction. However, in some cases, the CDS are not always able to clearly determine the synergistic and intergenomic effect of analyzed genes. These issues occur when the volume of new data exceeds the amount of filer memory, leading to the appearance of these areas, which are very difficult to manage. The polygenic nature of EH and incomplete update patient records significantly reduce diagnostic effect of the CDS (Figure). Conclusions: As a result of CDS system testing revealed significant deficiencies. First of all it concerned the lack of coordination between the EMR, the DNA database and CDS controller due to the autonomy of some clinical modules architecture. Another problem has been related with the understanding and use of the tool. Is not uncommon the CDS conclusion does not coincide with the findings of the clinician. Perhaps the reason for this controversy is the effect of syntropy and differences between the standards of norms of laboratory parameters, or forms of treatment standards in the care process.

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