Decision Support Systems in Critical Care

Modern critical care is characterized by the collection of large volumes of data and the making of urgent patient care decisions. The two do not necessarily go together easily. For many years the hope has been that ICU data management systems could play a meaningful role in ICU decision support. These hopes now have a basis in fact, and this book details the history, methodology, current status, and future prospects for critical care decision support systems. By focusing on real and operational systems, the book demonstrates the importance of integrating data from diverse clinical data sources; the keys to implementing clinically usable systems; the pitfalls to avoid in implementation; and the development of effective evaluation methods.

Modern critical care is characterized by the collection of large volumes of data and the making of urgent patient care decisions. By focusing on real and operational systems, the book demonstrates the importance of integrating data from diverse clinical data sources;

I. Fundamentals.- 1. Medical Informatics and Desicion Support Systems in the Intensive Care Unit: State of the Art.- 2. Computers in Critical Care: A Historical Perspective.- 3. Physician Decision-Making: Evaluation of Data Used in a Computerized Intensive Care Unit.- 4. Development of Decision Support Systems.- 5. Decision Analysis: A Framework for Critical Care Decision Assistance.- II. Decision Support Data Links.- 6. Standardized Acquisition of Bedside Data: The IEEE P1073 Medical Information Bus.- 7. Real-Time Data Acquisition: Recommendations for the Medical Information Bus.- 8. A Common Reference Model for Healthcare Data Exchange: P1157 MEDIX System Architecture.- III. Clinical Alerting Tools.- 9. Development of a Computerized Laboratory Alerting System.- 10. Inferencing Strategies for Automated Alerts on Critically Abnormal Laboratory and Blood Gas Data.- 11. Decision Support Alerts for Clinical Laboratory and Blood Gas Data.- 12. Assessing the Effectiveness of a ComputerizedPharmacy System.- IV. Clinical Systems and Decision-Making.- 13. Clinical Decisions and Computers.- 14. Computerized Data Management and Decision Making in Critical Care.- 15. Performance of Computerized Protocols for the Management of Arterial Oxygenation in an Intersive Care Unit.- 16. Acuity of Illness and Risk Prediction in Critically I11 Adults: The APACHE III Intensive Care Unit Management System.- 17. Automatic Extraction of Intensity-Intervention Scores From a Computerized Surgical Intensive Care Unit Flowsheet.- 18. Quality Assurance and Utilization Assessment: The Major By-Products of an Intensive Care Unit Clinical Information System.- 19. Nursing Decision Support: The Challenges Facing Nursing in Regard to Computerization.- 20. Anesthesia Support Systems.- 21. The Role of Smart Medical Systems in the Space Station.- V. Conclusions.- 22. The Why, What, and So What of Computers in the Intensive Care Unit.- 23. A Strategy for Development of Computerized Critical Care DecisionSupport Systems.- 24. The Role for Artificial Intelligence in Critical Care.- 25. The Future of Computerized Decision Support in Critical Care.