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A toolbox to improve algorithms for insulin-dosing decision support

Journal: Applied Clinical Informatics
ISSN: 1869-0327
DOI: https://doi.org/10.4338/ACI-2014-04-RA-0033
Issue: Vol. 5: Issue 2 2014
Pages: 548-556

A toolbox to improve algorithms for insulin-dosing decision support

Research Article

Special Topic: eHealth2014

K. Donsa (1), P. Beck (1), J. Plank (2), L. Schaupp (2), J. K. Mader (2), T. Truskaller (1), B. Tschapeller (1), B. Höll (1), S. Spat (1), T. R. Pieber (1, 2)

(1) HEALTH – Institute for Biomedicine and Health Sciences, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria; (2) Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria

Keywords

Computer Simulation, Algorithms, Clinical decision support systems, workflow, diabetes mellitus type 2

Summary

Background: Standardized insulin order sets for subcutaneous basal-bolus insulin therapy are recommended by clinical guidelines for the inpatient management of diabetes. The algorithm based GlucoTab system electronically assists health care personnel by supporting clinical workflow and providing insulin-dose suggestions.

Objective: To develop a toolbox for improving clinical decision-support algorithms. Methods: The toolbox has three main components. 1) Data preparation: Data from several heterogeneous sources is extracted, cleaned and stored in a uniform data format. 2)

Simulation: The effects of algorithm modifications are estimated by simulating treatment workflows based on real data from clinical trials. 3) Analysis: Algorithm performance is measured, analyzed and simulated by using data from three clinical trials with a total of 166 patients. Results: Use of the toolbox led to algorithm improvements as well as the detection of potential individualized subgroup-specific algorithms.

Conclusion: These results are a first step towards individualized algorithm modifications for specific patient subgroups.

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