Clinical Decision Support System using Real-Time Data Analysis for a Neonatal Intensive Care Unit

Abstract

There are two main contributions to knowledge presented in this thesis: (1) an efficient Clinical Data Repository (CDR) with a novel data storage format, and (2) ne neonatal mortality risk estimation models that use data analysed in real-time fro the CDR.The CDR collects, stores, and retrieves clinical data in real-time. It uses a nov hybrid Entity-Attribute-Value (EAV) storage format that is faster, uses less comp queries, and allows the data to remain in its original data type while using the Thank you to my supervisor Dr. Monique Prize who inspired me to pursue a PhD after learning of her research work. I knew that I could make a difference if we wor together, and we did! Thank you to my co-supervisor Dr. Colleen M. Ennett who provided an invaluable industry perspective on our research work and who had many interesting ideas and improvements for the research we conducted together.A heartfelt thank you to Dr. Erika Bariciak at the Children's Hospital of Eastern Ontario (CHEO) who always made herself available to answer any questions that I had. Your help and support of my research project was instrumental in my success.I would like to thank and acknowledge the extra work that the NICU team at CHEO provided to help collect data for the patients in the unit including nursing manager Patricia O'Flaherty for all of her support, the patient service clerks, the nurses, the biomedical engineering team, especially Kim Greenwood, and the IS dept.Thank you to my defence committee for all of the useful feedback on my research

Integration of Neonatal Mortality Prediction Models into a Clinical Decision Support System

“…Jeff Gilchrist developed a clinical data repository (CDR) with real-time data acquisition, storage, and retrieval in the NICU at CHEO, and created real-time risk prediction models using Decision Trees (DTs) , (Gilchrist, 2012).…”

“…There are not many decision aids available for the NICU, and there are even less computerized ones. BabyCare link, a commercially available Internet-based telemedicine system, designed by researchers from Harvard Medical School and the Beth Israel Deaconess Medical Center, is the only computerized decision-aid for parents described in the literature (Gray et al, 2000).…”

“…The BabyCare link system focuses on VLBW infants in the NICU and is said to be designed to provide enhanced medical, informational, and emotional support to families as well as reduce the costs of care (Gray et al, 2000). Using BabyCare link, parents can monitor their infant from home, schedule visits, and find medical information about their infant's condition.…”

“…After a randomized study, Gray et al (2000) concluded that users of the tool report a higher quality of care and an enhanced interaction between families, staff, and community providers. However, the tool does not provide outcome predictions or any means of helping parents clarify their preferences or make decisions.…”

“…It was designed to accommodate a fast-changing medical environment and supports the addition of new attributes automatically. To protect patients' private information, confidential data is split from raw research data before it is stored, which enables researchers and physicians to access real-time data without violating patient privacy; a study ID is used to associate the patient with the research data in an anonymous way (Gilchrist et al, 2011b), (Gilchrist, 2012).…”