Research On Professor Liu Weisheng's Clinical Decision Support System For Lung Cancer Based On Ontology

ObjectiveThe main purpose is to use the academic thought,clinical experience and syndrome differentiation methods implied in the diagnosis and treatment of lung cancer by using Ontology of modern information science technology,and finally provide expert medical experience support for clinical decision-making.Using Knowledge Graph as a new method by professor Liu Weisheng's treatment on lung cancer ontology,from his medical records,the clinical diagnosis and treatment in the pathological diagnosis of lung cancer cases,collect related data of Chinese and western medicine diagnosis and treatment,follow-up for patients information,establish database of cases,use natural language processing technology and data mining techniques to realize the relationship between the nodes within cancer Knowledge graph,which helps to accomplish traditional Chinese medicine diagnosis decision making and treatment for lung cancer,simultaneously inherit and develop the Chinese medicine to guide the clinical practice.Methods1.Establish database of diagnosis and treatment of lung cancer by Professor Liu WeishengBy retrospective investigation his treatment of lung cancer from 2007 to 2017 outpatient cases information,basic clinical characteristics of patients,disease characteristics,tumor stages,western medicine diagnosis and treatment process,four diagnostic data,TCM syndrome differentiation,diagnosis,treatment and other indicators,for the confirmation of a clear pathological diagnosis of lung cancer and follow-up for survival data,then using the single factor analysis and multifactor analysis survival indicators,to accomplish his treatment of lung cancer database which rely on evidence-based medicine.2.Based on Professor Liu Weisheng's TCM clinical knowledge graph of diagnosis and treatment of lung cancer using ontologyBy using the Intelligent profile analysis and recommendation based on TCM knowledge graph,developed by the big data analysis team of our hospital,the data his lung-cancer diagnosis and treatment database information was imported into the system,analyzed and mined automatically,then drawn by computer patient basic clinical characteristics,disease characteristics,tumor stages,western medicine diagnosis and treatment after,four diagnostic data,TCM syndrome differentiation,diagnosis,treatment,and other knowledge graph,using natural language processing technology and data mining techniques to find out the interrelationship of nodes within cancer knowledge graph,such as cluster analysis,the traditional Chinese medicine syndrome differentiation of traditional Chinese medicine syndrome differentiation,with four diagnostic data for data mining,drug combination,compatibility,etc.The knowledge graph and analytical portrait can be intelligently drawn to disclose underlying and invisible rules or experience of diagnosis and treatment of doctors of TCM.3.Digging experienceThe TCM clinical knowledge graph designed by professor Liu Weisheng's diagnosis and treatment of lung cancer and its semantic relation is a huge diagram showing professor Liu Weisheng's experience in differentiation and treatment of lung cancer.Combined with the artificial analysis of the TCM pathology(such as the multi-level sub-concepts of disease,etiology,pathogenesis and symptoms,etc.)and the treatment of syndrome differentiation(including the sub-concepts of syndrome differentiation methods,syndromes,therapeutic principles,prescriptions,and the return of sexual flavor to the classic),which is an accomplishment of diagnosis and treatment of lung cancer based on ontology research by professor LiuWeisheng.4.Development and application of clinical decision support system for famous lung cancer doctorsThe clinical decision making support system of famous lung cancer doctors consists two parts:front stage and back stage.Professor LiuWeisheng's TCM clinical knowledge graph for lung cancer diagnosis and treatment based on ontology was established on the backstage,and the database of medical examination by famous doctors included reasoning machine for intelligent decision-making,semantic processing and ontology mapping technology.The design of the front stage interface includes the natural language input port of clinical cases and the knowledge output window,which can output the intelligent discrimination and treatment results for the reference of doctors.For example,the imported case features can be exported according to the dialectical analysis,treatment principle,treatment method and prescription of Professor Liu Weisheng's experience,and sorted by statistical probability.Results1.This study includes 250 cases.By the end of the follow-up on October 30,2017,148 deaths were reported,accounted for 59.2%,and 102 survived.Overall mean survival time was 78.9 months,median survival time was 43.0 months(95%CI:33.6 to 52.4 months),1-year survival rate was 84.8%,3-year survival rate was 56.7%,and 5-year survival rate was 41.3%.In survival analysis of single factor analysis,gender,age group,pathologic stage,surgery,chemotherapy,have an impact on the median survival time(logrank test or Breslow test P<0.05),the specific result:female patients survival period longer than males,the younger patient survival longer,the pathological stage severer survival shorter,the longer surgery survival longer,chemotherapy treatment survival longer.On the other hand,there was no significant difference in survival time between tumor pathological types,radiotherapy and immunotherapy(targeted drugs)(log-rank test and Breslow test P>0.05).2.Based on ontology concept,the rational and intelligent processing system of big data developed by our hospital database team successfully build professor Liu Weisheng's TCM clinical knowledge graph of diagnosis and treatment of lung cancer.By developing the knowledge graph,obtained following results:2.1 High frequency of use drugs:Schulellaria barbata,Herba Hedyotis,scorpion,fructus ligustri lucidi,liquorice,fructus schisandrae,ophiopogon root,peach kernel,centipede,Aceranthus sagittatus,fructus psotaleae,semen coicis,teasel root,radix pseudostellariae,phizoma phragmitis,herba houttuyniae,radix aconiti,Wax gourd kernel,Astragalus mongholicus,herba rhodiolae,ternate buttercup root,scutellaria baicalensis.2.2 Commonly use therapeutic principles:clearing away heat and toxic material,dispelling phlegm and dissipate the knot,replenishing the vital essence and removing heat,tonifying the kidney,nourishing qi and strengthening the positive,promoting blood circulation for removing blood stasis,warmly invigorating yang for endogenous qi.Corresponding to the seven major syndrome differentiation documents,mainly:toxic heat,phlegm-dampness,Yin deficiency,kidney deficiency,vital energy deficiency,blood stasis,Yang deficiency and water flooding,and phlegm-dampness syndrome as the central syndrome2.3 Core prescription:Schulellaria barbata,Herba Hedyotis,liquorice,scorpion,fructus ligustri lucidi,ophiopogon root,schisandra chinensis,centipede,herba epimedii,peach kernel.2.4 Accomplish comprehensive analysis of traditional Chinese medicine treatment and survival status,the patients with the application of the warming yang for activating qi flowing method was the best for survival,followed up by the tonifying the kidney,nourishing qi and strengthening the positive,which is flexible and direct for obtaining the relationship between each node and survival.3.Developed the interface of clinical decision support system,preliminarily accomplished clinical decision making simultaneous.Conclusions1.The survival rate of 250 patients with lung cancer is better.The gender,age and stage of the patient are important factors affecting the survival period.In this group of cases,surgery,chemotherapy and Chinese medicine treatment have made their benefits.However,the benefits of radiotherapy are limited,and the targeted therapy is only for the beginning,which needs to be researched further.2.In the diagnosis and treatment of lung cancer,Professor Liu Weisheng researched into the core pathogenesis of lung cancer,clinically focused on the relationship between syndrome differentiation(Qi deficiency,Yin deficiency,Kidney deficiency and Yang deficiency)and pathogenic excess(heat toxicity,dampness,blood stasis and retained fluid),used the corresponding rule of treatment as well as traditional Chinese medicine on the basis of the core side to achieve good therapeutic results.3.Based on the ontology constructed Professor Liu Weisheng's diagnosis and treatment for the clinical knowledge graph of lung cancer.,there is a multi-dimensional visual analysis and mining,knowledge graph and knowledge reasoning function which are flexible and powerful.It is convenient for clinical experience and regularization of famous doctors.It is also an effective tool to study the experience of traditional Chinese medicine diagnosis and treatment by facilitating natural language entry and facilitating decision-making.