title: Knowledge-Based Personal Health System to empower outpatients of diabetes mellitus by means of P4 Medicine.
abstract: Diabetes Mellitus (DM) affects hundreds of millions of people worldwide and it imposes a large economic burden on healthcare systems. We present a web patient empowering system (PHSP4) that ensures continuous monitoring and assessment of the health state of patients with DM (type I and II). PHSP4 is a Knowledge-Based Personal Health System (PHS) which follows the trend of P4 Medicine (Personalized, Predictive, Preventive, and Participative). It provides messages to outpatients and clinicians about the achievement of objectives, follow-up, and treatments adjusted to the patient condition. Additionally, it calculates a four-component risk vector of the associated pathologies with DM: Nephropathy, Diabetic retinopathy, Diabetic foot, and Cardiovascular event. The core of the system is a Rule-Based System which Knowledge Base is composed by a set of rules implementing the recommendations of the American Diabetes Association (ADA) (American Diabetes Association: http://www.diabetes.org/ ) clinical guideline. The PHSP4 is designed to be standardized and to facilitate its interoperability by means of terminologies (SNOMED-CT [The International Health Terminology Standards Development Organization: http://www.ihtsdo.org/snomed-ct/ ] and UCUM [The Unified Code for Units of Measure: http://unitsofmeasure.org/ ]), standardized clinical documents (HL7 CDA R2 [Health Level Seven International: http://www.hl7.org/index.cfm ]) for managing Electronic Health Record (EHR). We have evaluated the functionality of the system and its users' acceptance of the system using simulated and real data, and a questionnaire based in the Technology Acceptance Model methodology (TAM). Finally results show the reliability of the system and the high acceptance of clinicians.
authors.affiliation: Grupo de Informática Biomédica, Instituto ITACA, Universitat Politècnica de València, Edificio 8G, Camino de Vera, S/N, 46022, València, Spain, adbregua@upvnet.upv.es.
authors.forename: Adrián
authors.initials: A
authors.lastname: Bresó
authors.forename: Carlos
authors.initials: C
authors.lastname: Sáez
authors.forename: Javier
authors.initials: J
authors.lastname: Vicente
authors.forename: Félix
authors.initials: F
authors.lastname: Larrinaga
authors.forename: Montserrat
authors.initials: M
authors.lastname: Robles
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: García-Gómez
mesh_terms: D000328:Adult; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D051188:Knowledge Bases; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010358:Patient Participation / Q000379:methods*; D057285:Precision Medicine / Q000379:methods*; D018570:Risk Assessment