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Title:
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COMPUTATIONAL WORKFLOWS FOR ETHICAL PRIORITISATION OF PREVENTIVE SCREENING |
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Author(s):
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Edward C. Conley , Adina Riposana , Ian J. Taylora , Omer Rana , David R. Owens |
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ISBN:
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978-972-8924-81-2 |
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Editors:
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Mário Macedo |
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Year:
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2009 |
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Edition:
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Single |
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Keywords:
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Disease early detection, disease prevention, preventative screening, evidence-based service remodelling; computational
workflow; diabetes, diabetic retinop |
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Type:
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Full Paper |
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First Page:
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51 |
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Last Page:
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58 |
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Language:
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English |
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Cover:
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Full Contents:
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click to dowload 
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Paper Abstract:
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Currently, screening services aimed at prevention of disease tend to be delivered at a level irrespective of whether
individuals need them or not. This situation is wasteful and economically unsustainable. In order to develop patientcentred
services responsive to individual needs, we must find more efficient ways to evaluate relative need in an ethical
manner on the basis of trusted clinical evidence. With disease prevention as the central principle, we have evolved new
computational methods to challenge the one service fits all model of provision. To accomplish this, we had to redefine
mechanisms for evidence-based adjustment of screening frequency away from default (typically annual) frequencies to
ones prioritised on the basis of individualised needs. For the majority of patients, this has potential to save many
unnecessary hospital appointments whilst maintaining safety. For people with greater needs, it has the potential to
radically improve efficiency and timeliness of screening episodes. We have applied advanced methods of computational
workflow to collate, transform and analyse a range of data to compute disease risk status. Status and risk is indicated by
patterns of physiological and metabolic variables/trends (e.g. data derived from regular clinics/telehealth services) in
relation to patient outcomes (where either disease has developed or no disease has developed). A body of outcomesinferential
evidence was used to support the validation of these computational models for optimizing screening
frequencies. The workflows have been designed for application to prioritisation problems in the specialised field of
diabetic retinopathy with a view to their generic application in preventative screening services. |
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