医疗大数据在学习型健康医疗系统中的应用

doi:10.11959/j.issn.2096-0271.2020042

摘要/Abstract

摘要：

将医疗大数据应用于旨在加快知识生成和临床转化应用的学习型健康医疗系统（LHS）中，满足患者和医疗决策者的知识需求，有助于推动精准医学的发展。在系统阐述医疗大数据与LHS发展现状的基础上，结合LHS的典型应用案例，重点分析医疗大数据在LHS中的应用特点及面临的挑战。最后总结了我国发展LHS面临的挑战，并对未来进行了展望。

关键词: 医疗大数据, 学习型健康医疗系统, 医疗决策

Abstract:

The learning health system (LHS) aims at accelerating the process of knowledge generation,transformation and application in clinical practice.Applying medical big data in LHS to meet the knowledge needs of patients and healthcare decision makers would help to promote the development of precision medicine.Firstly,the current status of medical big data and LHS were reviewed,then the characteristics and challenges of applying medical big data in LHS were analyzed by refering to some typical application cases.Finally,the challenges faced by LHS in China were addressed and the prospect of applying medical big data to LHS in the future was provided.

Key words: medical big data, learning health system, medical decision-making

中图分类号:

柴扬帆, 孔桂兰, 张路霞. 医疗大数据在学习型健康医疗系统中的应用[J]. 大数据, 2020, 6(5): 29-44.

Yangfan CHAI, Guilan KONG, Luxia ZHANG. Application of medical big data in learning health system[J]. Big Data Research, 2020, 6(5): 29-44.

图/表 3

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LHS中大数据、数据平台及功能组件分析"

参考文献	国家和地区	年份	项目名称	数据规模	数据平台及基础功能组件	拟解决/改善的医学问题
23]	美国	2014年	PEDSnet	覆盖22个州、8家医疗机构、3个特殊儿科疾病网，超过2 100万患者	数据共享平台（I2B2）、集中式数据协调中心（支持分布式数据查询）、数据采集组件（REDCap、Epic PRO）	通过疾病风险预测及施加相应干预措施来预防肥胖、先天性心脏病、肠炎等
6]	欧盟	2015年	TRANSFoRm	10个国家、21家机构、800万人口	数据共享处理平台、查询工作台、临床试验监测工具和诊断支持插件	针对糖尿病、胃食管反流、胸痛等开展的基于临床风险预测辅助临床决策支持研究，以及基于基因组数据集的表观遗传流行病学研究
27]	美国	2014年	PORTAL	覆盖9 个州、11 个研究中心和哥伦比亚特区的1 100万用户	分布式数据共享处理平台（PopMedNet）	针对直肠癌、先天性心脏病、肥胖、罕见病等疾病治疗方案的有效性研究，以及比较不同临床护理环境下疾病预后的比较性研究
24]	美国	2014年	pSCANNER	覆盖50个州，超过2 100万患者	数据共享处理平台（UC-ReX、iDASH）	通过早期风险预测及施加相应干预措施来预防充血性心力衰竭、川崎病等
29]	美国	2014年	SCILHS	10家医疗机构，超过1 000万患者	数据共享处理平台（I2B2、SHRINE）、具有编程接口和应用程序的SMART平台、数据采集组件（REDCap）	对于糖尿病并发症预测、直肠癌发病预测等多个医学问题，通过对高危人群的早期干预来改善健康结果
30]	美国	2011年	SCOAP	60家医院（华盛顿州），占华盛顿州外科手术治疗的90%	数据共享处理平台（具备数据监测与自动纠错、对决策信息进行评估与更新的功能）	提高外科手术风险预测准确率，改善外科手术预后

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