| Summary: | Introduction
Acute stroke is the leading cause of hospitalisation and mortality in Hong Kong over the past years. With advancement of medical treatment, stroke mortality is decreasing which leads to increasing number of stroke survivors. Strategies to maximise stroke recovery is of paramount importance to healthcare system, society, stroke patients and carers. In February 2014, the Hong Kong Hospital Authority (HA) commissioned a project to the Hong Kong Institute of Integrative Medicine (HKIIM), Faculty of Medicine, the Chinese University of Hong Kong, to evaluate the diagnostic patterns of Chinese Medicine (CM), correlations with western medicine, as well as the clinical outcomes of stroke patients receiving integrative medicine (combined Chinese and western medicine). The target subjects were identified using ICD-9 diagnostic codes of acute stroke captured in the Clinical Management System (CMS) in Prince of Wales Hospital over a period of 3 years (1.2010 to 12.2012), and matched with the database of Chinese Medicine Information System (CMIS) of the tripartite CM clinics. In collaboration with the HA Chinese Medicine Department (HACMD), and the Traditional Chinese Medicine informatics team (iTCM) of the School of Information Technologies, the University of Sydney (USYD), data extraction, linkage, data mining and complex analysis were performed based on pre-specified objectives. Method
Data Extraction:
- Extract clinical data of stroke patients admitted into HA hospitals from CMS
- Selection period: 1-1-2009 to 31-12-2012 (inclusive)
- Observation period: 3 months pre-stroke to 12 months post-stroke (15-month data per subject)
- Search period: 1-10-2008 to 31-12-2013 (inclusive)
- Use HKID as the unique identifiers to match with CMIS
- Extract data of matched subjects with stroke as primary diagnosis
- Search period: 1-10-2008 to 31-12-2013 (inclusive)
Analysis:
- Data mining to generate patterns of diseases and CM &WM Usage
- Compare the readmission rate of acute stroke patients with or without CM services
- Have an exploratory analysis of effectiveness from CM prescriptions
- Determine the commonly used CM, WM, integrative WM + CM treatments and interventions and their efficacy
Conclusion
This pilot project was the first study to link CMS and CMIS databases for complex data driven analysis. We demonstrated that through setting up a data-mining platform such that the complex relationship between herbs, acupoints, CM diagnoses, syndromes, treatment approaches, and interactions with medications can be analysed, and the association with clinical outcomes, such as mortality or readmissions, can be assessed. This knowledge discovery platform is critical for further development in integrative medicine for Hong Kong. |