SYSTEM AND METHOD FOR REAL TIME CLINICAL QUESTIONS PRESENTATION AND MANAGEMENT

• US 20140379379A1
• Filed: 06/24/2014
• Published: 12/25/2014
• Est. Priority Date: 06/24/2013
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: DIMITROVA, NEVENKA, JANEVSKI, ANGEL, KAMALAKARAN, SITHARTHAN, BANERJEE, NILANJANA, VARADAN, VINAY, DANISMAN TASAR, MINE
• Granted Patent: US 11,309,060 B2
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G16B 20/00 ICT specially adapted for functional genomics or proteomics, e.g. genotype-phenotype associations
• CPC Class Codes: G16B 20/10 Ploidy or copy number detection
• CPC Class Codes: G16B 20/20 Allele or variant detection, e.g. single nucleotide polymorphism [SNP] detection
• CPC Class Codes: G16B 30/00 ICT specially adapted for sequence analysis involving nucleotides or amino acids
• CPC Class Codes: G16B 30/10 Sequence alignment; Homology search
• CPC Class Codes: G16B 50/00 ICT programming tools or database systems specially adapted for bioinformatics
• CPC Class Codes: G16B 50/30 Data warehousing; Computing architectures
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

In a clinical decision support method, outputs of computer-implemented analytical modules are computed for a patient. Information is displayed for the patient pertaining to a clinical question comprising outputs computed for the patient of analytical modules associated with the clinical question. The analytical modules may include modules configured to perform in silico genetic/genomic tests using genetic/genome sequencing (whole genome, whole exome, whole transcriptome, targeted gene panels, etc) or microarray data. A clinical question-module matrix (CQ-M matrix) may be generated for the patient associating clinical questions with analytical modules, and the method may further include populating the clinical questions with outputs computed for the patient of the analytical modules associated with the clinical questions by the CQ-M matrix. Such populating advantageously re-uses outputs computed for the patient when an analytical module is associated with two or more different clinical questions by the CQ-M matrix. This system empowers the clinician to focus on the clinical aspects of patient management while allowing the data complexities of patient genomic data interpretation to be handled by the clinical decision support system.

Claims

1. A non-transitory storage medium storing instructions executable by an electronic data processing device (10, 12) to perform a clinical decision support method including:

associating computer-implemented analytical modules with clinical questions;

computing outputs of computer-implemented analytical modules for a patient; and

displaying information for the patient pertaining to a clinical question comprising outputs computed for the patient of the computer-implemented analytical modules associated with the clinical question.

2. The non-transitory storage medium of claim 1, wherein the clinical questions include at least one prognosis or diagnosis clinical question, at least one treatment clinical question, at least one therapy response clinical question, and at least one clinical trial selection clinical question.

3. The non-transitory storage medium of any one of claims 1-2, wherein the computer-implemented analytical modules include at least one module configured to perform an in silico test classifying a cancer sub-type, at least one module configured to perform an in silico test for detecting status of a hormone receptor, at least one module configured to perform an in silico test for detecting fusion genes, and at least one module configured to perform an in silico test predicting a therapy response based on a genetic signature.

4. The non-transitory storage medium of claim 1, wherein the computer-implemented analytical modules include a plurality of computer-implemented analytical modules configured to perform in silico genetic tests using genetic sequencing or microarray or proteomic data.

5. The non-transitory storage medium of any one of claims 1-4, wherein the associating comprises:

generating a clinical question-module (CQ-M) association data structure for the patient associating clinical questions and computer-implemented analytical modules.

6. The non-transitory storage medium of claim 5, wherein:

the associating further comprises generating a module-module (M-M) association data structure associating modules, and

the clinical decision support method further comprises, during the computing, identifying missing input data for a computer-implemented analytical module to be computed and computing outputs of computer-implemented analytical modules for the patient indicated by the M-M association data structure as providing the missing input data.

7. The non-transitory storage medium of claim 5, further comprising:

receiving a user request to compute output of a computer-implemented analytical module for a patient other than the computer-implemented modules computed by the associating and computing operations; and

additionally computing the output of the user-requested computer-implemented analytical module.

8. The non-transitory storage medium of any one of claims 5-7, wherein the clinical decision support method further comprises:

populating the clinical questions with outputs computed for the patient of the computer-implemented analytical modules,

wherein the populating re-uses outputs computed for the patient when a computer-implemented analytical module is associated with two or more different clinical questions by the CQ-M association data structure for the patient.

9. The non-transitory storage medium of claim 8, wherein the clinical decision support method further comprises:

receiving new or updated information affecting the output computed for the patient of a computer-implemented analytical module affected by the new or updated information;

re-computing the output of the affected computer-implemented analytical module for the patient based on the new or updated information; and

re-populating each clinical question associated with the affected computer-implemented analytical module by the CQ-M association data structure for the patient.

10. The non-transitory storage medium of claim 8, wherein the clinical decision support method further comprises:

receiving new or updated information that updates a clinical question; and

modifying the CQ-M association data structure to modify the analytical modules associated with the updated clinical question based on the new or updated information.

11. The non-transitory storage medium of claim 10, wherein:

the receiving of new or updated information comprises generating an answer for the updated clinical question; and

the modifying of the CQ-M association data structure comprises removing analytical modules not related to the answer to the updated clinical question.

12. The non-transitory storage medium of any one of claims 5-11, wherein the generating comprises:

copying a template CQ-M association data structure to generate the CQ-M association data structure for the patient.

13. The non-transitory storage medium of claim 12, wherein the clinical decision support method further comprises:

providing a user interface via which a user modifies the CQ-M association data structure for the patient, and

updating the populating based on the modified CQ-M association data structure for the patient.

14. The non-transitory storage medium of claim 13, wherein the user interface enables the user to modify the CQ-M association data structure for the patient by operations including (1) removing an association of a computer-implemented analytical module with a clinical question and (2) associating a computer-implemented analytical module with a clinical question with which it was not previously associated by the CQ-M association data structure for the patient.

15. The non-transitory storage medium of any one of claims 13-14, wherein the user interface provides two or more display areas containing icons representing computer-implemented analytical modules of different categories, and enables the user to modify the CQ-M association data structure for the patient by dragging-and-dropping an icon from one display area into another display area.

16. The non-transitory storage medium of any one of claims 13-15, wherein:

the user interface enables the user to select a clinical question and said selection causes the user interface to display icons representing analytical modules associated by the CQ-M association data structure with the user-selected clinical question, and

the user interface enables the user to select an analytical module associated by the CQ-M association data structure with the user-selected clinical question by selecting its displayed icon and selection of the selected analytical module causes the user interface to display a window containing output generated by the selected analytical module.

17. The non-transitory storage medium of claim 16, wherein the user interface enables the user to select a second analytical module associated by the CQ-M association data structure with the user-selected clinical question by selecting its displayed icon and said selection of the second analytical module causes the user interface to display a second window containing output generated by the second analytical module while continuing to display the window containing output generated by the first selected analytical module.

18. The non-transitory storage medium of any one of claims 16-17, wherein the user interface is configured to limit the clinical questions available for user selection based on a current state of a workflow care cycle assigned to the patient.

19. The non-transitory storage medium of claim 18, wherein:

the clinical questions include at least one prognosis or diagnosis clinical question, at least one treatment clinical question, and at least one therapy response clinical question,

the workflow care cycle includes ordered stages (1) screening, (2) prognosis or diagnosis, (3) treatment, and (4) therapy response, and (5) monitoring

the user interface is configured to limit the clinical questions available for user selection to the at least one prognosis or diagnosis clinical question stage (1) and to the at least one prognosis or diagnosis clinical question and the at least one treatment clinical question in stage (2).

20. The non-transitory storage medium of any one of claims 16-19, wherein the user interface enables the user to update the CQ-M association data structure by moving an icon representing an analytical module from a display region grouping icons of one category to a display region grouping icons of a different category.

21. The non-transitory storage medium of any one of claims 13-20, wherein the clinical decision support method further comprises:

storing a record of user operations performed via the user interface;

generating a processing pipeline corresponding to the stored user operations; and

applying the processing pipeline to a different patient.

22. The non-transitory storage medium of any one of claims 13-20, wherein the clinical decision support method further comprises:

storing a record of user operations performed via the user interface to generate an audit trail; and

generating a clinical report based on the audit trail.

23. The non-transitory storage medium of any one of claims 1-22, wherein the displaying further includes:

displaying a comment section or user forum; and

enabling a user to add commentary to the comment section or user forum.

24. An apparatus comprising:

an electronic data processing device (10, 12); and

a non-transitory storage medium as set forth in one of claims 1-23;

the electronic data processing device configured to read and execute the instructions stored on the non-transitory storage medium to perform the clinical decision support method.

25. A clinical decision support method comprising:

computing outputs for a patient of a plurality of computer-implemented analytical modules associated with clinical questions;

displaying a list of the clinical questions;

receiving a selection of a listed clinical question; and

displaying information for the patient pertaining to the selected clinical question comprising outputs computed for the patient of one or more computer-implemented analytical modules associated with the selected clinical question.

26. The clinical decision support method of claim 25, wherein the computer-implemented analytical modules include a plurality of computer-implemented analytical modules configured to perform in silico genetic tests.

27. The clinical decision support method of any one of claims 25-26, further comprising:

generating a clinical question-module (CQ-M) data structure for the patient having one of rows and columns representing the clinical questions and the other of rows and columns representing the computer-implemented analytical modules;

wherein the displaying of information for the patient pertaining to the selected clinical question includes identifying the one or more computer-implemented analytical modules associated with the selected clinical question using the CQ-M data structure for the patient.

28. The clinical decision support method of claim 27, wherein the generating comprises:

copying a default CQ-M data structure to generate the CQ-M data structure for the patient.

29. The clinical decision support method of claim 28, further comprising:

receiving a modification of the CQ-M data structure for the patient from a user; and

updating the displaying to comprise outputs computed for the patient of one or more computer-implemented analytical modules associated by the modified CQ-M data structure with the selected clinical question

30. The clinical decision support method of claim 29, wherein the receiving comprises:

displaying two or more display areas containing icons representing computer-implemented analytical modules of different categories;

receiving a drag-and-drop operation transferring an icon from one display area to another display area; and

determining the modification of the CQ-M data structure for the patient based on the received drag-and-drop operation.

31. The clinical decision support method of any one of claims 25-30, further comprising:

receiving new or updated information;

re-computing the outputs for the patient of the one or more computer-implemented analytical modules associated with the selected clinical question based on the new or updated information; and

re-displaying the information for the patient pertaining to the selected clinical question comprising the outputs re-computed for the patient based on the new or updated information of the one or more computer-implemented analytical modules associated with the selected clinical question.

32. The clinical decision support method of any one of claims 25-31, further comprising:

displaying a comment section or user forum together with the displayed information for the patient pertaining to the selected clinical question;

receiving commentary from a user;

updating the comment section or user forum to include the received commentary; and

updating the displaying of the comment section or user forum to display the updated comment section or user forum.

33. The clinical decision support method of any one of claims 25-31, wherein the clinical questions pertain to breast cancer.