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Decision support for the management of essential hypertension

Wilson, S. L. (1997). Decision support for the management of essential hypertension. (Unpublished Doctoral thesis, City, University of London)

Abstract

The thesis presents a decision support system targeted at the needs of health care professionals in primary care. The architecture of the new decision support system is based on a model of the management of a patient with essential hypertension, that itself is based on the observation of the interactions between medical practitioner and patient and the recognition and formalisation of the steps in that process.

The need for a new decision support system is driven by two independent factors. Firstly rapid advances in medical knowledge have created enormous pressures on practitioners, who have a real need to maintain and update their medical knowledge. Secondly rapid advances in computer technology, particularly in the 1990s with the introduction of new design features into desk top computers has created opportunities for system designers to introduce a wide range of facilities into user interfaces, which in turn, provide medical practitioners with tools that are both useful and easy to use. In effect it is the combination of a medical need and user friendly technology that now enables an embedded decision support system to be demonstrated.

The work that is reported in the thesis has three main features, which have been implemented into a prototype demonstrator:
Firstly, a model of the management of a patient with essential hypertension is described which enables decision support to reflect the decision making needs of the clinician and to interface transparently with their normal working practice.

Secondly, the system architecture which enables a range of decision support components to be embedded within the normal consultation environment is described. This approach has enabled convenience, ease of access and ease of use of decision support facilities, to be demonstrated.

Thirdly, clinical guidelines have been utilised to form the foundation of the systems knowledge base. In using these guidelines it has been noted that they have been developed by several international teams of medical experts to guide doctors in their diagnosis and treatment of patients with essential hypertension.

The thesis concludes with the results of the system evaluation. The evaluations have enabled the methods and techniques that have been used to design and develop the new system to be tested, and for the advice generated by the system to be compared with current medical opinions.

Publication Type: Thesis (Doctoral)
Subjects: Q Science > QA Mathematics > QA75 Electronic computers. Computer science
R Medicine > R Medicine (General)
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
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