Design of a Rule-based Decision Model for Assessment of Chronic Wounds [article]

Haadi Mombini, Bengisu Tulu, Diane Strong, Emmanuel Agu, Holly Nguyen, Peder Pedersen, Clifford Lindsay, Raymond Dunn, Lorraine Loretz
2020 Figshare  
Chronic wounds are expensive to treat and have a significant impact on patients' quality of life [1]. Due to lack of access to wound experts, patients usually receive care from non-expert clinicians who have limited chronic wound assessment skills. Clinical decision support systems (CDSS) can assist these non-expert clinicians. This research in progress is part of an ongoing project working on developing a smartphone based wound CDSS to support non-expert clinicians during wound assessments in
more » ... emote settings. Since each chronic wound type has a different assessment and management procedure, this paper focused on building a decision model that supports users in determining the type of chronic wounds so that we can later guide them on the proper evidence based decision path.We used design science research methodology (DSRM) model by Peffers et al. [2] to design rule-based decision models that can assess chronic wound type efficiently using wound photos and simple clinical values as input. We chose the rule-based decision models because they are intuitive, explainable and likely more trusted among clinicians.The meta-requirement gathering phase involved collection of chronic wound descriptors extracted from clinical guidelines and expert knowledge using 4 semi- structured interviews with two experts (a dually credentialed podiatric surgeon/vascular nurse practitioner and a plastic surgeon from UMass Memorial Medical Center). We received IRB approval for using wound photo repository maintained by the UMass Medical School. During the interviews, each expert 1) looked at 15 wound photos, 2) assessed wound type and conditions, and 3) explained how certain wound descriptors affected their decision. Using clinical wound management guidelines and analysis of our interview data, we identified design requirements and finally define our design principles (DPs) as: (1) design for simple explanation and (2) design for decision making under uncertainty. Following the design of the high level decision framework (see Fig.1), we d [...]
doi:10.6084/m9.figshare.11719617 fatcat:gc7lquasdvd27jkj7as34hitia