건강검진을 위한 지능형 임상병리 자동화 시스템의 개발

Abstract

[한글]

1995년부터 정부에서 건강 증진법을 시행함에 따라 보건소에서의 지역사회주민 건강검진 역할이 강조되었다. 그러나, 대부분의 보건소에는 급증하고 있는 임상데이터를 신속하고 정확하게 해석할 수 있는 전문의들이 부족한 실정이므로 검사결과를 해석하고, 처방을 제공하는데 있어서 의사를 보조할 수 있는 효과적인 임상정보시스템이 더욱 요구되고 있다. 이에, 건강검진을 위한 지능형 임상병리 자동화 시스템을 개발하였다.

임상병리 전문의와 가정의학 전문의로부터 지식을 습득하고 객체지향 기법을 이용하여 지식간의 연관성을 규명하고, 이를 규칙으로 표현하였다. 실제 건강검진 데이터를 이용하여 구축된 규칙베이스의 타당성 검증을 실시하였다. 개발된 지능형 임상병리 자동화 시스템과 도메인 전문가와의 검진 결과를 비교하여 78.0%의 진단 예측력을 나타내었다.

검사결과 해석의 자동화를 위한 지능형 임상병리 시스템을 개발하므로써 전문의가 부족한 지역사회 보건소에 전문지식을 제공하고, 보건소 관리의사를 보조하여 건강검진에 있어서 효율적인 진단이 이루어지도록 하였다. 본 시스템을통하여 보건소 관리의사가 검진대상자의 모든 검진 자료를 검토한 후에 종합판정을 내리는데 소요되는 시간의 감축과 국민의 보건건강 증진을 위한 건강검진의 질적 향상의 계기가 될 것으로 기대된다.

[영문]

The Korean government has been actively taking the initiative in introducing a health promotion movement by enacting the Health Promotion Law in 1995. The focal point of such activities is to strengthen the capability of the health center in delivering health promotion services, such as mass screening programs and health education. Bracht(1990) suggested that the most effective and proper center of gravity for health promotion is the community.

While this program had a positive impact on improving the health status of community residents, it also significantly increased the workloads of the heath center staff. Since laboratory tests are indispensable to the screening program,

this significantly increased the amount of paperwork generated by laboratory tests performed as part of the mass screening program. In addition, this also increased the workload of physicians who have to interpret laboratory data and make diagnoses

based on the test results and other patient information. This became even more problematic because there is no clinical pathologist who can interpret laboratory data in most of health centers. As the number of clinical tests and clinical request has increased, an efficient laboratory information system has become more and more necessary in proportion to this increase in the volume of test results. Especially, there is a great need for an information system to support physicians in interpreting test results and providing therapy advice.

This study aimed to develop an Intelligent Laboratory Information System(ILIS) for the community health center to help process an increasing number of laboratory test data in an efficient manner and to support the clinical decision-making of

public health doctors. An ILIS consists of two modules: result interpretation and therapy advisor. An object-oriented rule editor, the Intelligent Rules Element (IRE). The cases were put through the system to determine whether they were in

agreement with the physician's judgement. Overall, the system correctly predicted 78.0% of the cases. The integration of and ILIS with the health promotion information system will automate the entire laboratory test process from order entry to diagnosis and therapy advice, improving efficiency of the process and

reducing workloads of health workers. Implications for future improvement and the role of an ILIS were also discussed.