| Objective:Explore the data cloud aggregation dynamic clinical research model based on Internet and its feasibility. Responding to a large number of clinical feedback data loss situation, the preliminary exploration of smartphones as a source of information of medical data acquisition, dynamic analysis of clinical research model. In this study, the hypothesis of clinical practice and test the feasibility and scientific nature.Method:1. literature research:In recent years by analysis of clinical patient reported outcomes (pro) in the treatment of cancer research progress and analysis of patient reported outcomes (pro) analysis pro scale and the necessity of the role in the evaluation of the curative effect of TCM combination with internet information progress.2. to propose a new model of the data cloud based on the Internet.To establish the hypothesis of the dynamic analysis of the data cloud aggregation, and to analyze the meaning of the elements in the new model, according to the needs of medical and clinical research. New content:according to the phone as information, the Internet as a link, from the cell phone terminal comprehensive collection patient data, upload data, cloud aggregation, and real-time dynamic analysis, the effect of warning, timely optimization scheme research to rapidly get research results, to promote the new situation of the integration of internet medical and medical research, opens the big data for collective intelligence mode.The test and practice of the new model hypothesis of the 3 data cloud aggregation dynamic medical clinical researchTo establish a "medical+platform:the patient through the platform of feedback data, medical researchers through the platform implementation of the program, data collection, the clouds gathered dynamic study on the mode need through the platform to achieve patients, platform, medical researchers interaction, to achieve the medical data of the cloud and dynamic analysis.PROs composite volume table:the mobile terminal data acquisition achieved by patients report outcomes Pro composite scales, the patient reported outcomes with doctors reported outcomes, physiological reported outcomes, traditional Chinese medicine in song form the patient reported outcomes PROs composite scales for. According to the patients report outcomes scale production processes, development of production of lung volume table, combined with biochemical reported outcomes such as multiple scale and traditional Chinese medicine (TCM) elements, through the establishment of the item pool, through the pre investigation table, formal scale analysis, statistical tests, and ultimately the formation of lung cancer patients report the results Pro compound quantity table.Clinical research:through in TCM Intervention Chemotherapy in patients with malignant tumor after thrombocytopenia in clinical studies, a prospective cohort study, on the study of patients with lung cancer using lung cancer PROs composite scales, by app platform for patient data collection, and export of the data analysis, explore the data cloud dynamic model of clinical research on in Chinese medicine individualized treatment evaluation practice and possibility.Result1. patient reported outcome scale is an important means of patient feedback dataPatient reported outcomes (pro) combined with internet information, become Internet Medical feedback condition of patients with an important way, plays an important role in evaluating therapeutic effect of traditional Chinese medicine, the scale from the patients with end data collection, change clinical data feedback loss, has the feasibility, operability.2. the practice of data cloud poly dynamic clinical research modelThe establishment of the "+" Chinese medicine "tumor" prototype platform using HTML5 technology, can be achieved in patients with APP and save the installation or download on WeChat public number, page through the platform can achieve a variety of patients report outcomes login, reporting, medical credit, doctor-patient consultation, online forums, learning, publishing, medicine clinical program exchange mall, the conventional network needs of life services, hospital appointment, platform sharing, medical science and research data view is derived, can achieve data cloud dynamic model of clinical research on patients with terminal data acquisition and cloud storage, and the implementation scheme of real-time data view, derivation, analysis, dynamic analysis of the possible.Patients report outcomes PROs composite volume table were collected feedback form and development of lung cancer PROs quantity of composite table and make statistical analysis. Through the interviews of 30 patients were established 91 preparation amount of table entries, through the correlation coefficient method, factor analysis method. Cronbach's coefficient method, item response theory, discrete trend method analysis,5 analysis method in at least 3 required to retain delete 20, the remaining 71. again a formal investigation and analysis determined 66 for scale items.Feasibility analysis to meet the requirements, the reliability analysis:all areas of semi reliability coefficients were:physical field is 0.919, psychology 0.945,0.857 of social field and treatment in the field of 0.891, and overall scale 0.933. The consistency of the various fields of Krone Bach alpha coefficient, do not for the physiological field 0.981, psychological field 0.845, social field O.809, treatment field 0.833, the entire scale 0.923. Overall, the Krone Bach alpha coefficient of the scale is high. Validity analysis:each item and summary, and its related entries in a dimension, each dimension and the summary of correlation coefficient was above 0.6, with strong correlation, factor analysis results show that the structure and theoretical model is basically the same, clear structure, has good construct validity. There were significant differences in the scores of all dimensions of lung cancer patients and healthy people, and there were significant differences in the total score. It shows that the scale has a relatively high degree of division, the scale has a high ability to distinguish.Clinical trial research in the use of prospective cohort study, the treatment group, the control group of 60 cases, the control group of 59 cases of effective medical records, the two groups were statistically significant difference. Results platelet maximum value comparison and statistical analysis of P=0.0023< 0.01, the difference is statistically significant, indicating that the two groups in platelet maximum value has a significant difference, in platelet recovery time, efficiency and stability were, with statistical significance. Among lung cancer patients in the control group (22 cases) and treatment group (23 cases), through the composite volume of traditional Chinese medicine "tumor" acquisition platform of patient reported outcomes PROs,7 days are analyzed:Patients after chemotherapy, thrombocytopenia, chemotherapy of patients have effect, compared with the control group at 5,15,24,40,42,43,44,52, 53,56,61,65 item response, Chinese medicine treatment group, restore faster, mainly in the physical, appetite, mood and confidence, the other two groups no significant difference, the treatment of 7 days, these two groups no significant difference. The total score was 211±18.55,19.92±230 in the control group, and there was no difference between the two groups. After the use of traditional Chinese medicine, there were no differences between the two groups. Description, improve the evaluation of the 14 days and 20 days of the 5.6,15,19,24,40,42,43,44,52,53,56, 61,65 item response. Chinese medicine treatment group, recovery faster, mainly in physical strength, loss of appetite, mood, confidence, etc., especially the 15,19,24, fatigue, and diet is particularly evident, but in the overall score of 178±2.52, and the control group 226±23.22,14 days between the two different patients in the use of traditional Chinese medicine, not only in the local symptoms have improved, the overall performance is better than the control group, with statistical significance.Conclusion:1.The current clinical diagnosis and treatment of patients with the lack of feedback data can be resolved through the new research model.2. The proposed based on Internet data cloud poly dynamic model of clinical research on the hypothesis can be achieved, the research model has practical clinical value and the clinical diagnosis, treatment and medical research through integration, to meet the actual needs of patients, doctors, medical research, after the actual test and practice, the hypothesis is feasible and scientific. Data cloud poly dynamic clinical research model for the future of Internet medicine research and development is of great significance.3. "Traditional Chinese medicine tumor" platform is just a prototype of "medical+" platform, it is a platform for the implementation of the data cloud poly dynamic clinical research model, which has important practical role.4.The development of lung cancer PROs complex scale, after reliability, validity and other tests with credibility, feasibility, in the data cloud poly dynamic clinical research model has an important role.5.The data cloud poly dynamic model of clinical research on suitable for clinical evaluation of traditional Chinese medicine, promote traditional Chinese medicine open group study mode and does not lose the individual diagnosis and treatment of Chinese medicine characteristics, can promote the study of TCM clinical research and evaluation of curative effect.6.The future of all medical data dynamic cloud poly, large data dynamic analysis, the group of research is not only a new form of development of traditional Chinese medicine, but also may be of great significance to the clinical study of human medicine. |
PDF Full Text Request