Clinical Decision Support System (DSS)

What is a clinical DSS?

Medical knowledge is an ever-growing field and it becomes more and more difficult to have an overview of all medical expertise that exists. Clinical decision support systems (DSS) help physicians by automatically mapping medical knowledge to a given patient case. There are at least two ways how this can happen. First, model-based decision support includes clinical rules, e.g. given by guidelines, and displays the recommended therapy measures for a patient following these rules. Second, AI-based decision support provides the recommendations computed by a data-based AI-algorithm to the physician.

Why is a Clinical Decision Support System needed in COMFORTage?

The goal of the COMFORTage project is to establish a pan European framework for Community-based, Integrated and People-Centric prevention, monitoring and progression managing solutions for dementia and frailty. To document data of patients with dementia or frailty, to monitor their progress and to choose and monitor sufficient treatments, a clinical DSS is necessary. It has to contain all relevant decision parameters and treatment options as well as a rule-based mapping between them. In addition, it must be able to incorporate AI-based treatment recommendations and to give a clear overview to medical experts of rule-based and AI-based recommendations such that they can make good decisions.

How could the clinical DSS in COMFORTage look like?

The COMFORTage clinical DSS will combine knowledge-based recommendations and AI-based recommendations. For each specific patient case, the medical experts will obtain recommendations according to clinical guidelines and from AI models that will be trained during the project. An example for a patient documentation is shown in Figure 1.  Here, it is documented the patient Joe Doe lives alone and is diagnosed with dementia. Such information will then be used to give treatment recommendations for the patient.

Which steps next?

The COMFORTagge clinical DSS developed mainly by Fraunhofer ITWM shall allow for a utilization of artificial intelligence (AI) methods for case-specific treatment planning in the technological environment of the larger COMFORTage software platform. This interaction of decision-making methods and AI methods as well as the integration of the cDSS into the COMFORTage framework requires smart functional and data interfaces. ITWM is working in collaboration with technological consortium partners on the conception and implementation of these interfaces. Furthermore, the clinical DSS is to be filled with relevant clinical parameters and decision rules.