Cardiologia Croatica, Vol. 14 No. 1-2, 2019.
Review article
https://doi.org/10.15836/ccar2019.3
Development of Software for Choosing Therapeutic Modalities in Atrial Fibrillation
Edin Begić
orcid.org/0000-0001-6842-262X
; General Hospital «Prim. dr. Abdulah Nakaš», Sarajevo, Bosnia and Herzegovina
Mensur Mandžuka
; Netlight Consulting GmbH, Munich, Germany
Elnur Smajić
; University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
Enisa Hodžić
; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Amer Iglica
; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Aida Mujaković
; General Hospital «Prim. dr. Abdulah Nakaš», Sarajevo, Bosnia and Herzegovina
Faris Zvizdić
; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Amra Dobrača
; Faculty of Medicine, Tuzla, Bosnia and Herzegovina
Azra Durak-Nalbantić
orcid.org/0000-0002-5175-8941
; linical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Abstract
Atrial fibrillation (AF) is the most common tachyarrhythmia that requires treatment and represents constant clinical problem for general practitioners and cardiologists. Several bleeding risk scores have been developed for estimating bleeding risk in patients with AF. These include: HASBLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, age >65 years, drugs/alcohol concomitantly), ORBIT (older age, reduced hemoglobin/hematocrit/anemia, bleeding history, insufficient kidney function, treatment with antiplatelets), ABC (age, biomarkers, clinical history), ATRIA (anemia, severe renal disease, age ≥75 years,
previous hemorrhage, and diagnosed hypertension), and HEMORR(2)HAGES (Hepatic or Renal Disease, Ethanol Abuse, Malignancy, Older Age, Reduced Platelet Count or Function, Re-Bleeding, Hypertension, Anemia, Genetic Factors, Excessive Fall Risk, and Stroke). The use of oral anticoagulants is still the standard in stroke prevention in AF but should be balanced against the associated bleeding risk. The aim of this article was to describe the development of a clinical decision support system (CDSS) that will enable clinicians to perform a quick assessment of bleeding risk in patients with AF in order to optimize anticoagulation therapy in patients with AF. The software was developed in the form of a web application. The responsive design of the interface was key to optimal user interaction, providing seamless control of every step of the process regardless of the type of device used, whether a laptop or a smartphone. The backend of the application was developed in Python. More specifically, a web framework named Flask was utilized. It is considered to be a good choice for rapid prototyping and development and deployment of small- to medium-sized applications. The application separates the decision process into three steps. Displaying the first step prompts the user to select the type of score they want calculated. The following step includes entering anamnestic data, laboratory findings, symptoms, and comorbidities. The final screen displays the calculated score, which assists the user in determining the course of the treatment. This software represents a CDSS that enables faster and easier assessment of bleeding risk in patients with AF in order to achieve a better therapeutic modality. The responsive design and the web application format makes the software easily accessible on a wide range of devices.
Keywords
atrial fibrillation; clinical decision support system; anticoagulants; risk; bleeding
Hrčak ID:
218030
URI
Publication date:
18.3.2019.
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