Clinical Decision Support for Retroactive Molecular Marker Testing
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Solution Overview
Problem
Current clinical practices face challenges in timely and efficient ordering of molecular marker tests due to the constant evolution of available tests and the need for physicians to maintain up-to-date knowledge, leading to potential delays or omissions of effective treatments.
Innovation Solution
An integrated system comprising a catalog of molecular marker tests with clinical applicability annotations, an electronic patient medical record for genetic sequencing data, and a clinical decision support system that automatically identifies relevant tests based on patient context and catalog updates, allowing for in silico testing without additional tissue samples.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If physicians manually track and order molecular marker tests based on their knowledge, then they can make informed clinical decisions, but the process becomes time-consuming and prone to delays as the catalog of tests constantly evolves
Solution Approach 1:
The system enables self-service by automatically monitoring the catalog of molecular marker tests and clinically relevant genetic variants, and proactively identifying applicable tests for patients based on their genetic data and clinical context, eliminating the need for physicians to manually track test catalogs
Solution Approach 2:
The system implements feedback mechanisms where results from molecular marker tests automatically trigger notifications to physicians, and the system continuously monitors for new tests and variants that may be applicable to existing patients, creating a closed-loop information flow that keeps physicians updated without their active involvement
2Reliability
If multiple molecular marker tests are ordered to ensure comprehensive assessment, then diagnostic accuracy improves, but the number of required patient samples and procedures increases
Solution Approach 1:
The system performs multiple functions using a single patient sample: it stores the sample data, screens against the catalog of molecular marker tests, identifies applicable tests, and enables retrospective analysis for new tests and variants. This multi-functional approach eliminates the need to draw separate samples for each test
Solution Approach 2:
The system performs preliminary screening and identification of applicable tests before actual testing is conducted. By pre-processing patient data and matching it against the catalog, the system determines which tests are relevant, preventing unnecessary testing and sample collection
3Adaptability or versatility
If physicians stay updated on the constantly expanding catalog of molecular marker tests, then they can order appropriate tests, but the complexity of maintaining current knowledge increases
Solution Approach 1:
The system performs self-updating by automatically monitoring the catalog of molecular marker tests and clinically relevant genetic variants for changes, new tests, and new variants, and retroactively evaluating existing patient data against these updates without requiring physician intervention
Solution Approach 2:
The system acts as an intermediary between the complex catalog of tests and the physician, translating the evolving catalog information into actionable insights by automatically identifying which tests apply to which patients based on their genetic profiles and clinical context
4Productivity
If retrospective analysis of existing patient data is performed for new molecular marker tests, then expedited adoption of new tests is enabled, but data processing complexity increases
Solution Approach 1:
The system performs preliminary processing and storage of patient genetic data in a structured format that facilitates future analysis. By pre-organizing the data and maintaining an updated catalog with inclusion criteria, the system enables rapid retrospective analysis when new tests are added to the catalog
Solution Approach 2:
The system's data infrastructure serves multiple purposes: it stores patient genetic data for current test ordering, enables retrospective analysis for new tests, supports catalog updates, and facilitates continuous learning. This universal data platform handles diverse analytical tasks without requiring separate processing systems
Data Source
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AI summary
A catalog (34) of molecular marker tests specifies molecular marker tests annotated with clinical applicability annotations. An electronic patient medical record (22) stores genetic sequencing data (20) of a patient. A clinical decision support (CDS) system (30) is configured to track the clinical context of the patient wherein the clinical context includes at least a disease diagnosis and a current patient care stage. A catalog search module (32) is configured to search the catalog of molecular marker tests to identify a molecular marker test having clinical applicability to the patient in the clinical context tracked by the CDS system. The search is automatically triggered by occurrence of a trigger event defined by a set of triggering rules. A testing module (44) is configured to perform a molecular marker test identified by the identification module in silico using the genetic sequencing data of the patient stored in the electronic patient medical record.