|
Home → Modul 17 → Decision Support Systems → Gruppe 2: BRAINDEXWeb
BRAINDEXweb is an expert system for use in helping the diagnosis of brain death.
It is accessible over the web at the following address (opens in a new tab):
https://braindex.medunigraz.at
BRAINDEXweb was developed in-house at the Institute for Medical Informatics. This document outlines one example usage scenario of BRAINDEXweb, and highlights just some of its features. It is by no means conclusive, and should be used as a guide only. For your presentation at the end of the seminar, you will need to demonstrate that you have used the system thoroughly and that you understand how it works.
|
|
BRAINDEXweb works in terms of consultations, and each consultation can be saved for later use. For this tutorial we shall create a new consultation and work through it until it is finished.
After you have logged in, the following is shown:
|
Notice the tabs on the top of the page:
|
These tabs allow you to navigate through various features of BRAINDEXweb. For example, the Lexikon section contains definitions as well as media such as images and videos. Experiment with these tabs so that you are aware of what they do.
For this tutorial, we will create a new consultation. Go to the Konsulationen tab and click Neue Konsultation beginnen. The following screen appears:
|
In the centre of the screen you will see the current question that you must answer. In this case BRAINDEXweb is asking the type of brain lesion. On the left hand side you see the Verlauf. On the right hand side you can see the explanations section. It is important that you always review this section to see supplemental information regarding the question, and can include videos and images as well as explanations.
In this case select primäre Hirnläsion and click Weiter. You will see the following screen:
|
In this case we select supratentoriell. We will make selections to ensure that the result of the BRAINDEXweb is HIRNTOD.
Next we are asked about a HWS-Lesion:
|
We select nein.
Notice that the Anamnese section is now complete. We now move onto the Vorausetzungen. This is indicated by the section to the left of the screen, as seen in the image below:
|
Again, we select Nein and then click Weiter.
Answer the next few questions with the following answers:
| Hypovolämischer Schock: | Nein |
| Primäre Hypothermie: | Nein |
| Intoxikation: | Nein |
| Muskelrelaxantien: | Nein |
| Sedativa: | Nein |
The Voraussetzungen phase is over and we move to the Untersuchung stage of BRAINDEXweb. This is indicated by the change if status on the left of the screen, as seen in the figure below:
|
Regarding the Glasgow Coma Score, answer Ja. For the following, answer:
| Lichtreaction: | Nein | See: Lichtreaktion erhalten |
| Pupillenweite: | Weit | |
| Cornealreflex: | Nein | See: Cornealreflex erloschen |
| Oculocephaler Reflex: | Nein | See: Oculocephaler Reflex erloschen |
| Vestibulooculärer Reflex: | Nein | See: Vestibulooculärer Reflex erloschen |
| Ciliospinaler Reflex: | Nein | |
| Masseterreflex: | Nein | |
| Druck-/Schmerzreaktion: | Nein | |
| Würgereflex: | Nein | |
| Hustenreflex: | Nein | See: Hustenreflex auslösbar |
| Schlaffe Tetraplegie: | Ja | |
| Spinale Reaktionen: | Nein | See: Registerkarte Reflexphänomene |
| HF-Anstieg beim Atropintest: | Nein | |
| Apnoetest durchgeführt: | Ja | See: Apnoetest Anleitung |
| pCO2 am ende des Apnoetests: | ≥60 mmHg | |
| Apnoe: | Ja |
We are approaching the end of the questionnaire. For the following questions, answer:
| EEG (Elektroenzephalogramm) abgeleitet: | Ja | |
| Isoelektrisches EEG: | Ja | |
| TCD (transcranielle Dopplersonographie) durchgeführt: | Ja | See: OSR-Empfehlungen 2005 |
| TCD-Strömungsmuster: | Pendelströmung | See: All Videos |
| FDS (farbcodierte Duplex-Sonographie) durchgeführt: | Nein | |
| CTA (CT-Angiographie) durchgeführt: | Nein | |
| Ident zur 1. Untersuchungen: | Ja |
The consultation is now over. Result: Status mit dem Hirntod vereinbar.
After a consultation has been completed, you will see the following consultation report, which can also be printed for future reference:
|
Pay close attention to the section on the right of the screen, under the section Erläuterungen. This section often contains useful information regarding the current question.
When presenting the system to the other students, ensure that you show them a few of the videos that appear there. They can include images, videos, and references to medical journal articles.
Example Image, Cornea Reflex Arc:
|
Be sure to also look at features such as the Reflex Phenomenon Chart:
|