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The ARTEMIS data and knowledge base for hypertension

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Databases for Cardiology

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 115))

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Abstract

In a medical care unit, computerized programs can be used to memorize patients’ individual records and profiles, to facilitate patient management and follow-up, to store medical knowledge and to provide facilities for decision making at the level either of the individual patient or of the population followed up. An integrated approach, progressively implemented in the ARTEMIS system since 1975, is described for the computerized management of hypertensive patients. The methodology used integrates data and knowledge management facilities into the same software. Five hypertension clinics are presently using the system in France and more than 25000 records have been registered. A simplified version of the ARTEMIS system, called ARTEL, has been made accessible through the French videotex system and is presently tested by two groups of general practitioners. Patient database interrogation can be used to evaluate the sensitivity and specificity of various signs and symptoms for the diagnosis of secondary hypertension, and to predict, for each patient, his/her cardiovascular risk, the risk of drop-out, the risk of insufficient blood pressure control and the probable blood pressure level. An evaluation of the diagnostic performances of the expert system has been performed on 7020 patients records stored in the ARTEMIS database. Agreement between the ES proposals, the expert initial decisions and the expert final diagnosis was evaluated using the Kappa coefficient, sensitivity and specificity. The predicting values for cases of secondary hypertension were calculated for the ES proposals, separately or combined to the expert proposals. Optimization of the decision’s threshold of the ES was performed on a randomized learning sample of 3510 patients and found to be robust on a test sample. The results suggest that a strategy combining data and knowledge management might help the physician to supplement theoretical knowledge derived from the academic environment, and in some cases to replace it by a more pragmatic knowledge derived from his experience stored in the computer.

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Author information

Authors and Affiliations

  1. Medical Informatics Department, Broussais University Hospital, 96, rue Didot, 75014, Paris, France

    Patrice Degoulet & Marion Lavril

  2. Hypertension Clinic, Broussais Hospital, Paris, France

    Pierre-François Plouin, Gilles Chatellier & Joël Ménard

Authors
  1. Patrice Degoulet
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  2. Marion Lavril
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  3. Pierre-François Plouin
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  4. Gilles Chatellier
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  5. Joël Ménard
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Editor information

Editors and Affiliations

  1. Interuniversity Institute of Cardiology, Utrecht, The Netherlands

    Geert T. Meester

  2. Department of Bioengineering, Politecnico di Milano, Milan, Italy

    Francesco Pinciroli

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© 1991 Springer Science+Business Media Dordrecht

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Degoulet, P., Lavril, M., Plouin, PF., Chatellier, G., Ménard, J. (1991). The ARTEMIS data and knowledge base for hypertension. In: Meester, G.T., Pinciroli, F. (eds) Databases for Cardiology. Developments in Cardiovascular Medicine, vol 115. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3720-1_9

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  • DOI: https://doi.org/10.1007/978-94-011-3720-1_9

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5653-3

  • Online ISBN: 978-94-011-3720-1

  • eBook Packages: Springer Book Archive

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