基于决策树的某区县级三甲医院急性冠状动脉综合征诊疗模型研究

A decision tree model is used to show diagnosis and treatment process of acute coronary syndrome in a county-level 3A hospital

目的将决策树技术分析得到的急性冠状动脉综合征诊治关键流程与患者实际诊疗流程图进行对比并做差异分析,进而探索信息化技术在实际医疗诊断工作中的运用方法,同时对其优劣势展开探讨,寻找提升区县级医院信息化辅助医疗诊断效率的方法。方法收集某区县级三甲医院2021年11月至2022年10月出院的涉及急性冠状动脉综合征的患者住院信息(包含药品、治疗方式、生化检验和辅助检查等),通过Mann-Whitney统计检验和决策树进行分析,进而得到一套急性冠状动脉综合征诊断治疗的数据流程,然后将此结果与患者的实际诊疗流程图进行对比分析。结果从分析中得到心电图检查、患者当前症状、急诊PCI手术是决策分型的关键特征,并围绕这3个关键特征建立决策树图和分组流程。结论本项目得到了关键性的分组特征,对急性冠状动脉综合征治疗流程做出了宏观的解释,这同时也说明将理论的深入和实践的反馈相结合,才能实现真正意义上的信息化辅助医疗诊断。

Objective To compare and analyze the key data flow of acute coronary syndrome diagnosis and treatment ob⁃tained from decision tree technology with the actual diagnosis and treatment flowchart of patients,and to explore the ap⁃plication methods of information technology in actual medical diagnosis work.At the same time,to explore its advantages and disadvantages,with the aim of exploring methods to improve the efficiency of information assisted medical diagnosis in district and county-level hospitals.Methods Collected hospitalization information(including drugs,treatment methods,biochemical tests,and auxiliary examinations)of patients with acute coronary syndrome discharged from a county-level tertiary hospital in a certain district from November 2021 to October 2022,analyzed through statistical techniques and decision trees,and obtain a set of data flow for ACS diagnosis and treatment.Then compare and analyze this result with the actual diagnosis and treatment flow chart of ACS patients.Results From the analysis,it is obtained that electrocardiogram examination,patient's current symptoms,and emergency PCI surgery are key features for classifi⁃cation,and a decision tree diagram and grouping process are established around these three key features.Conclusion This project has obtained key grouping features and provided a macro explanation of the ACS treatment process,which also demonstrates that combining theoretical depth with practical feedback can truly achieve information-based assisted medical diagnosis.