| Description |
The task of comparing and evaluating the performance of different computer-based clinical protocols is difficult and expensive to accomplish. This dissertation explores methods to compare and evaluate computer-based insulin infusion protocols based on an in silico analytical framework iteratively developed for this study, using data from the intensive care unit (ICU). In Methods for Aim 1, we used a pairwise comparative technique to evaluate two computer-based insulin infusion protocols. Our result showed that the pairwise method can rapidly identify a promising computer-based clinical protocol but with limitations. In Methods for Aim 2, we used a ranking strategy to evaluate six computer-based insulin infusion protocols. The ranking method enabled us to overcome a key limitation in Methods for Aim 1, making it possible to compare multiple computer-based clinical protocols simultaneously. In Methods for Aim 3, we developed a more comprehensive in silico method based on multiple-criteria decision analysis that included user-defined performance evaluation criteria examining different facets of the computer-based insulin infusion protocols. The in silico method appears to be an efficient way for identifying promising computer-based clinical protocols suitable for clinical evaluation. We discuss the advantages and disadvantages for each of the presented methods. We also discuss future research work and the generalizability of the framework to other potential clinical areas. |
