基于中医临床诊疗数据的真实世界及人工智能研究思路与挑战

Research Ideas and Challenge of Real World Study and Artificial Intelligence Based On Clinical Diagnosis and Treatment Data of Traditional Chinese Medicine

随着真实世界研究方法学的进步和人工智能技术的成熟,以中医诊疗数据为基础,开展“定量”研究指导临床实践的方法正在逐步形成,但在研究总体设计、临床转化等方面仍需进一步完善。提出基于中医临床诊疗数据的真实世界及人工智能研究的总体设计思路及应用方法,包括5个步骤:建设高质量大样本的具有中医特色的研究型数据库、核心处方的挖掘及分类、队列研究评价核心处方疗效、病例对照研究明确优势人群、建立预测模型实现精准医疗。此外,研究人员还需要建立标准化的中医变量采集和数据处理体系,优化混杂因素的确定及测量方法,进一步完善及推广方法学,加强跨学科人才的培养。真实世界研究与人工智能研究的研究基础相似,临床应用互补,未来将是二者的融合。

With the continuous progress of research methodology in the real world and the growing maturity of artificial intelligence technology,a method for conducting “quantitative” research to guide clinical practice based on traditional Chinese medicine(TCM) diagnosis and treatment data was gradually developed.However,there is still a need for further improvements in the overall design of studies and the transformation of findings into clinical practice.Based on this,we put forward a comprehensive overall design concept and application approach for real-world study and artificial intelligence research based on clinical diagnosis and treatment data of TCM.This approach consists of five steps:Constructing a research-based database with a large sample size and high data quality;Mining and classification of core prescriptions;Conducting cohort studies to evaluate the effectiveness of core prescriptions;Utilizing casecontrol studies to clarify the dominant population;Establishing predictive models to achieve precision medicine.Additionally,it is imperative for researchers to establish a standardized system for collecting TCM variables and processing data,optimize the determination and measurement methods of confounding factors,further improve and promote methodologies,and strengthen the training of interdisciplinary talents.By following this research method,we anticipate that the clinical translation of research findings will be facilitated,leading to advancements in TCM precision medicine.Real-world study and artificial intelligence research share similar research foundations,and clinical applications complement each other.In the future,the two will merge together.