DMSS-R: Dementia Management Support System - Revised version
The DMSS-R system provides tailored advice and support in individual patient cases in the dementia domain for the purpose of improving dementia care. This is accomplished by providing a continuing medical education in daily practice, easy access to evidence-based medicine at the point of care and a common ground for team work and consultations/cooperation between levels of care in the dementia domain.
DMSS-R (Dementia Management and Support System, revised version) is a clinical decision support system that is being developed in cooperation between the departments of Computing Science and Social Medicine and Rehabilitation, Geriatric division, Umeå University. The development is being done in close cooperation with the Geriatric Centre at the University Hospital in Umeå, and health care centres in the region contribute in evaluations. The cooperation has the past year been extended through the research consortium Swedish Brain Power to include also Karolinska Institutet and Nordanstig health care centre among others in as a national effort to increase the quality of dementia care in Sweden. International cooperation includes physicians, care providing organisations and ICT businesses in Japan, China and South Korea.
DMSS-R main purpose is providing support for physicians in their diagnostic reasoning and choice of interventions when meeting new patients with a suspected dementia disease. The knowledge in the system is primarily based on the clinical guidelines DSM-IV, consensus guidelines for MCI, FTD and DLB. For providing support also in atypical patient cases, the guidelines NINCDS-AIRENS for VaD and NINCDS-ADRDA for AD is being integrated as well as the new criteria for AD.
DMSS-R main functionality is support for physicians in their diagnostic reasoning when meeting new patients with a suspected dementia disease. Accurate and specific dementia diagnoses need to be assessed early in the disease progression in order to increase the quality of care. By providing the physician support in the gathering of data in the process of investigating a patient, and by providing the physician analyses of the evidence in a patient case, viewed using different contexts of interpretation (i.e. sets of evidence-based clinical guidelines), the diagnoses established by the physician can be supported and confirmed or questioned in an interactive process.
Additional support is integrated for supporting the team in gathering the information needed, which is used for assessing the patient's needs for intervention and providing the team tailored advice in both diagnostics and intervention.
Research focuses on the investigation and development of methods for representing the terminology and data structures, and interaction design for supporting reasoning processes. An ontology based on the clinical terminology SNOMED CT and the classification ICF is being developed and integrated in DMSS-R . The modeling of the investigation process as whole is based on ACTclin, a semi-formal framework for assessing clinical knowledge to be integrated in decision support systems. The reasoning process as part of the investigation process is being modelled using argumentation techniques for the purpose of improving the interactive clinical reasoning. This is currently being done using ACKTUS.
Evaluation studies 2009/2010:
in clinical practice involving two health care centres in the county of Västerbotten and the geratric clinic in Umeå.
Evaluation studies 2009-2011:
in clinical practice in collaboration with the geratric clinic in Umeå and local clinics in South Korea, China and Japan.
General development tasks include the creation of a web based version for easier access and maintenance (DMSS-W).
Past work (DMSS Phase 1, 2002 - 2007) was financed by EU structural funds, the KK and Vårdal foundations, Äldrecentrum, AC County and the department of Computing Science, Umeå University. Current project was partly financed by the Swedish Brain Power consortium (July 2007 - June 2010).
DMSS is currently productified and customized by the spin-off company from Umeå University, Life Scintel AB.