Closing the Loops in Biomedical Informatics From Theory to Daily Practice

Summary

Objectives This article presents the 2009 selection of the best papers in the special section dedicated to biomedical informatics and cybernetics.

Method Synopsis of the articles selected for the IMIA yearbook 2009

Results Five papers from international peer reviewed journals where selected for this section. Most of the papers have a strong practical orientation in clinical care. And this selection gives a good overview of what is done with “closing loop” approach, particularly during theyear 2008.

Conclusion While quite mature for some clinical applications such as mechanical ventilation, it remains a challenge where rules for the decision system could be difficult to identify due to the number of variables. More complex systems with greater Artificial Intelligence approaches will certainly be the next trend for closed-loop applications.

Keywords

Closed-loop - clinical care - cybernetic - control theory - feedback

• References

• 1 Westenskow DR. Closed-loop control of blood pressure, ventilation, and anesthesia delivery. Int J Clin Monit Comput 1987; 04 (02) 69-74.
• 2 Westenkow DR. Automating Patient Care with Closed-Loop Control. MD Comput 1986; 03 (02) 14-20.
• 3 McDonald CJ, Overhage JM, Tierney WM, Abernathy GR, Dexter PR. The promise of computerized feedback systems for diabetes care. Ann Intern Med 1996; Jan 1; 124 (1 Pt 2): 170-4.
• 4 Sailors RM, East TD. Clinical informatics: 2000 and beyond. Proc AMIA Symp 1999; 609-13.
• 5 Mahfouf M, Abbod MF, Linkens DA. A survey of fuzzy logic monitoring and control utilisation in medicine. Artif Intell Med 2001; Jan-Mar; 21 (13) 27-42.
• 6 Hazelzet JA. Can fuzzy logic make things more clear?. Crit Care. 2009; 13 (01) 116 Epub 2009 Feb 18.
• 7 Dominguez D, Grasso F, Miller T, Serafin R. PIPS: An Integrated Environment for Health Care Delivery and Healthy Lifestyle Support. Fourth Workshop on Agents Applied in Health Care, ECAI’06, Riva del Garda, Italy. August 2006
• 8 Kowalski AJ. Can we really close the loop and how soon? Accelerating the availability of an artificial pancreas: a roadmap to better diabetes outcomes. Diabetes Technol Ther 2009; 11 Suppl (Suppl. 01) S113-9.
• 9 Bott OJ, Hoffmann I, Bergmann J, Gusew N, Schnell O, Gómez EJ. et al. HIS modelling and simulation based cost-benefit analysis of a telemedical system for closed-loop diabetes therapy. Int J Med Inform 2007; 76 Suppl (Suppl. 03) S447-55.
• 10 Conley EC, Owens DR, Luzio SL, Subramanian M, Ali AS, Hardisty A. et al. Simultaneous trend analysis for evaluating outcomes in patient-centred health monitoring services. Health Care Manag Sci 2008; Jun; 11 (02) 152-66.
• 11 Mottaz A, Yip YL, Ruch P, Veuthey AL. Mapping proteins to disease terminologies: from UniProt to MeSH. BMC Bioinformatics 2008; Apr 29; 09 (Suppl. 05) S3.
• 12 Stead WW, Pater NR, Starmer JM. Closing the loop in practice to assure the desired performance. Trans Am Clin Climatol Assoc 2008; 119: 185-94 discussion 194-5..
• 13 Tehrani FT, Roum JH. Intelligent decision support systems for mechanical ventilation. Artif Intell Med 2008; Nov; 44 (03) 171-82 Epub 2008 Sep 2..