A Clinical Decision Support System for Assessing the Risk of Cardiovascular Diseases in Diabetic Hemodialysis Patients

Background: One of the greatest challenges in the field of medicine is the increasing burden of chronic diseases, such as diabetes. Diabetes may cause several complications, such as kidney failure which is followed by hemodialysis and an increasing risk of cardiovascular diseases. Objective: The purpose of this research was to develop a clinical decision support system for assessing the risk of cardiovascular diseases in diabetic patients undergoing hemodialysis by using a fuzzy logic approach. Methods: This study was conducted in 2018. Initially, the views of physicians on the importance of assessment parameters were determined by using a questionnaire. The face and content validity of the questionnaire was approved by the experts in the field of medicine. The reliability of the questionnaire was calculated by using the test-retest method (r = 0.89). This system was designed and implemented by using MATLAB software. Then, it was evaluated by using the medical records of diabetic patients undergoing hemodialysis (n=208). Results: According to the physicians' point of view, the most important parameters for assessing the risk of cardiovascular diseases were glomerular filtration, duration of diabetes, age, blood pressure, type of diabetes, body mass index, smoking, and C reactive protein. The system was designed and the evaluation results showed that the values of sensitivity, accuracy, and validity were 85%, 92% and 90%, respectively. The K-value was 0.62. Conclusion: The results of the system were largely similar to the patients’ records and showed that the designed system can be used to help physicians to assess the risk of cardiovascular diseases and to improve the quality of care services for diabetic patients undergoing hemodialysis. By predicting the risk of the disease and classifying patients in different risk groups, it is possible to provide them with better care plans.