A Versatile, User Driven, Flexible And Scalable Decision Making Tool In Toxicology

Abstract

Background. Drug poisoning is a frequent problem in emergency services. Rapid decision making in toxicological assessment is very important especially in acute poisoning. Since their limited experience, non-toxicologist physician in emergency services usually needs extra information, i.e. decision support tools, to manage acute situation. Reasoning systems could be go either in a known intoxication to give physicians better advice about drugs ingested or in an unknown intoxication to identify products according to clinical manifestations. The aim of this study is to provide a user driven, flexible, scalable and easy to use computer-based decision support system for toxicological assessment.
Methods. Our system offers access to the information available in clinical toxicology. Towards this goal, decision making could be used either to refer to a predefined structured database obtained from relevant reports from the textbook, namely predefined system -default-, or to carry out a part of medical reasoning which could be defined by user, namely user defined structure. This system was developed by using Microsoft Visual Basic programing language and Access is the database management system. The system mainly based on answering predefined or user created questions, i.e. what is the heart rate of the patients, to determine drugs affecting cardiovascular system. It is easy to maintain the whole stucture of the system even if some questions could also be inserted to in any of the others anytime. Advices to an assessment question or a group of related questions could be defined as a decision making purpose. In addition, answers to question could be exported as a report file which very useful for either clinican or for laboratory staff and it also could be exported as a database file for statistical evaluation and future considerations.
Results. Preliminary evaluations upon our toxicological assessment system promising and it offers higher clinical success and higher user satisfaction. It is easy to use and easy to maintain. It enables continous improvement in the knowledge of clinical toxicology and to transfer it from experienced staff to non-toxicologist pyhsician. Further evaluation will be conducted to clarify the effectiveness of the system.
Conclusion. We have developed a versatile, user driven, flexible, scalable, easy to use and easy to maintain toxicological assessment system which promises higher user satisfaction and higher clinical effectiveness. Since it enables user driven usage, our developed decision making tool could be easily adopted to other medical area