کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
516885 1449137 2013 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Fuzzy cognitive map in differential diagnosis of alterations in urinary elimination: A nursing approach
موضوعات مرتبط
مهندسی و علوم پایه مهندسی کامپیوتر نرم افزارهای علوم کامپیوتر
پیش نمایش صفحه اول مقاله
Fuzzy cognitive map in differential diagnosis of alterations in urinary elimination: A nursing approach
چکیده انگلیسی

PurposeTo develop a decision support system to discriminate the diagnoses of alterations in urinary elimination, according to the nursing terminology of NANDA International (NANDA-I).MethodsA fuzzy cognitive map (FCM) was structured considering six possible diagnoses: stress urinary incontinence, reflex urinary incontinence, urge urinary incontinence, functional urinary incontinence, total urinary incontinence and urinary retention; and 39 signals associated with them. The model was implemented in Microsoft Visual C++® Edition 2005 and applied in 195 real cases. Its performance was evaluated through the agreement test, comparing its results with the diagnoses determined by three experts (nurses). The sensitivity and specificity of the model were calculated considering the expert's opinion as a gold standard. In order to compute the Kappa's values we considered two situations, since more than one diagnosis was possible: the overestimation of the accordance in which the case was considered as concordant when at least one diagnoses was equal; and the underestimation of the accordance, in which the case was considered as discordant when at least one diagnosis was different.ResultsThe overestimation of the accordance showed an excellent agreement (kappa = 0.92, p < 0.0001); and the underestimation provided a moderate agreement (kappa = 0.42, p < 0.0001). In general the FCM model showed high sensitivity and specificity, of 0.95 and 0.92, respectively, but provided a low specificity value in determining the diagnosis of urge urinary incontinence (0.43) and a low sensitivity value to total urinary incontinence (0.42).ConclusionsThe decision support system developed presented a good performance compared to other types of expert systems for differential diagnosis of alterations in urinary elimination. Since there are few similar studies in the literature, we are convinced of the importance of investing in this kind of modeling, both from the theoretical and from the health applied points of view.LimitationsIn spite of the good results, the FCM should be improved to identify the diagnoses of urge urinary incontinence and total urinary incontinence.


► The FCM is an area barely explored in its health applications, but in development.
► A FCM was used for the differential diagnosis of alterations in urinary elimination.
► Possible diagnoses were those over a threshold of 12% of the highest value.
► The model determined the diagnosis in total or partial agreement in 94.9% of cases.
► A great advantage of FCM is that it is able to manipulate incomplete information.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Medical Informatics - Volume 82, Issue 3, March 2013, Pages 201–208
نویسندگان
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