Toward Personalized Pressure Ulcer Care Planning: Development of a Bioinformatics System for Individualized Prioritization of Clinical Pratice Guideline
Technical Report,30 Sep 2015,29 Sep 2016
Cleveland VA Medical Research and Education Foundation Cleveland United States
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Over 200 risk factors for pressure ulcer and deep tissue injury PUDTI development have been reported spanning multiple domains Veterans with chronic spinal cord injury SCI have incidence rates as high as 62-80 and 34 will require at least three hospitalizations. PUDTI may lead to other serious medical complications, such as osteomyelitis, sepsis and even death. Clinical practice guidelines CPGs aid clinicians in primary PUDTI prevention through evidence based practice and expert opinion. However, there are many factors to consider and limited guidance on how to prioritize for individuals. Correction of all PUDTI risk factors can be both overwhelming and impractical to implement in clinical practice. The relative importance of risk factors has not yet been investigated, limiting care planning and prioritization of interventions. The need to develop effective clinical tools to prioritize the multiple recommendations of CPG has been identified by experts in the field. We will use bioinformatics to enable data extraction, storage, and analysis to support clinical decision support and user-interface development for complex clinical challenges. Our central hypothesis is that the individuals risk factor profile can provide the basis for adaptive personalized PU prevention care planning based on CPG prioritization. The overall objective is to provide weighted systemic insight to PU risk in persons with SCI to support personalized care plans for primary and secondary PU prevention. The SCIPUD Resource will be developed using data sets extracted from VINCI together with cross-sectional study of tissue health profiles and validated using an observation cohort study.