gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

17.09. - 21.09.2017, Oldenburg

Towards an evidence-informed and patient centered decision support system for intersectoral care

Meeting Abstract

  • Christian Haux - Universität Heidelberg, Heidelberg, Deutschland
  • Stefan Listl - Universitätsklinikum Heidelberg, Heidelberg, Deutschland
  • Matthias Ganzinger - Universität Heidelberg, Heidelberg, Deutschland
  • Ingrid Schubert - PMV Forschungsgruppe, Köln, Deutschland
  • Petra Knaup - Universität Heidelberg, Heidelberg, Deutschland

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS). Oldenburg, 17.-21.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocAbstr. 233

doi: 10.3205/17gmds115, urn:nbn:de:0183-17gmds1151

Published: August 29, 2017

© 2017 Haux et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: The evidence on interrelationships between oral and general health has increased during the last years [1]. Ryden et al. [2] showed that the risk of a first myocardial infarction was increased in patients with periodontitis. It is also debated, that the treatment of periodontal diseases may have positive effects on some chronic systemic conditions [3]. Nevertheless, the intersectoral collaboration between general practitioners (GPs) and dentists is still limited. Increased intersectoral care might improve the quality in general and oral health care.

Aim of the study: The Dent@Prevent project aims to improve intersectoral care by developing an electronic decision support system (DSS). It will draw dentists’ and GP’s attention on the interrelationship between oral and chronic diseases and provide relevant knowledge from guidelines for treatment of such patients. Furthermore, patient reported outcome measures (PROMs), to get information about the health status and treatment preferences of the patients will be defined and collecting such information with a mobile application will be evaluated.

Proposed methods: Claims data from spectrumK GmbH that contain about seven million policyholders from 80 company health insurance funds in Germany from 2010 to 2015 have been acquired so far. [4]. Data from both dentists and GPs contain diagnoses as well as performed dental, inpatient, and outpatient services and patient master data [5], [6].

A systematic literature review has been performed to capture the current state of knowledge regarding the association of periodontitis with chronic systemic diseases, especially type 2 diabetes [7], coronary heart diseases [8] and stroke [9]. Within the project, methods for the identification of causal links between these diseases will be developed. Furthermore, the literature review aims to find guidelines for the treatment of respective patients and to determine potential relevant PROMs, which will be later refined in an expert survey, using the Delphi technique [10]. The final PROMs will be implemented in a mobile application a will be tested with patients in several practices.

For the DSS, an ontology will be developed. Decision rules to draw conclusions on a possible relation between periodontics and the chronic disease of an individual patient will be defined by several focus group sessions with dentists, GPs, patients and computer scientists [11], [12], [13]. The DSS will be implemented as a rule-based system and will finally be evaluated by simulating case vignettes and using System Usability Scale technique [14].

Points for discussion: The development of a DSS could facilitate the collaboration between dentists and GPs and has the potential to improve intersectoral care. However, an appropriate way to establish such a system in medical and dental practices must be found to increase the acceptance and to avoid additional workload for dentists and GPs. Integrating the DSS in the information system of the practices may be an option and would offer the potential to access additional information, which can be used to improve the quality of care further. However, prerequisites have to be carefully analyzed and processes regarding data transfer and privacy have to be elaborated.



Die Autoren geben an, dass kein Interessenkonflikt besteht.

Die Autoren geben an, dass kein Ethikvotum erforderlich ist.


References

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