<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-4157</journal-id>
<journal-title><![CDATA[Biomédica]]></journal-title>
<abbrev-journal-title><![CDATA[Biomed.]]></abbrev-journal-title>
<issn>0120-4157</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-41572025000600052</article-id>
<article-id pub-id-type="doi">10.7705/biomedica.7945</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Sistema de apoyo a las decisiones clínicas basado en el conocimiento para clasificar automáticamente la anemia de pacientes en hemodiálisis]]></article-title>
<article-title xml:lang="en"><![CDATA[Knowledge-based clinical decision support system for the automated classification of anemia in hemodialysis patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tenorio]]></surname>
<given-names><![CDATA[Sebastián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valderrama]]></surname>
<given-names><![CDATA[Luis Alfonso]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arango]]></surname>
<given-names><![CDATA[José Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lozano]]></surname>
<given-names><![CDATA[Luz Amparo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mojica]]></surname>
<given-names><![CDATA[Iván Leonardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,SYNLAB Colombia  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Clínica Imbanaco  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Asociación Colombiana de Medicina Interna - ACMI  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>45</volume>
<fpage>52</fpage>
<lpage>70</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-41572025000600052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-41572025000600052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-41572025000600052&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción. La anemia es una complicación frecuente de los pacientes con enfermedad renal crónica y en hemodiálisis, asociada con mayor morbimortalidad y uso de recursos. Su clasificación adecuada es esencial para optimizar el tratamiento con hierro intravenoso y agentes estimulantes de la eritropoyesis. Los sistemas de apoyo a las decisiones clínicas basados en el conocimiento permiten estandarizar esta clasificación.  Objetivo. Describir el desarrollo y el funcionamiento de un sistema de apoyo a las decisiones clínicas -basado en el conocimiento- para la clasificación automatizada de la anemia de los pacientes en hemodiálisis, utilizando datos reales de laboratorio.  Materiales y métodos. Se llevó a cabo un estudio observacional retrospectivo de 883 pacientes adultos en hemodiálisis prevalente durante el 2023. Se construyó un algoritmo con base en las guías clínicas de la Sociedad Latinoamericana de Nefrologia e Hipertensión (SLANH),  Kidney Disease: Improving Global Outcomes (KDIGO),  National Institute for Health and Care Excellence (NICE) para clasificar a los pacientes con hemoglobina menor de 12 g/dl en tres categorías: déficit absoluto de hierro, déficit funcional de hierro y candidatos a prueba terapéutica con hierro intravenoso. También, se identificaron los casos con sospecha de hiperparatiroidismo secundario grave [paratohormona (PTH) mayor de 800 pg/ml]. Se usaron los datos del sistema de laboratorio y del sistema de apoyo a las decisiones clínicas, y se analizaron con estadísticas descriptivas.  Resultados. El sistema de apoyo a las decisiones clínicas clasificó a los pacientes en los siguientes grupos: déficit funcional de hierro (39,2 %), hiperparatiroidismo secundario grave (26,7 %), déficit absoluto de hierro (17,7 %) y candidatos a la prueba terapéutica (16,4 %). Un subgrupo (9,5 % con déficit funcional de hierro) presentó elevación de la PTH, lo cual sugiere resistencia a los agentes estimulantes de la eritropoyesis. Se observaron diferencias clínicas entre los grupos.  Conclusiones. El sistema de apoyo a las decisiones clínicas permitió hacer una clasificación automatizada de la anemia en hemodiálisis, apoyando aquellas basadas en la evidencia. Su implementación representa un avance en la salud digital, con potencial para mejorar la calidad del manejo de la enfermedad renal crónica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction. Anemia is a frequent complication in patients with chronic kidney disease undergoing hemodialysis and is associated with increased morbidity, mortality, and healthcare burden. Accurate classification is essential to optimize treatment with intravenous iron and erythropoiesis-stimulating agents. Rule-based clinical decision support systems (CDSS) provide a strategy to standardize this process.  Objective. To describe the development and implementation of a knowledge-based clinical decision support system for the automated classification of anemia in hemodialysis patients using laboratory data.  Materials and methods. This retrospective observational study included 883 adult patients receiving prevalent hemodialysis during 2023. An algorithm was developed based on established clinical guidelines  [Sociedad Latinoamericana de Nefrología e Hipertensión (SLANH)], KDIGO, NICE to classify patients with hemoglobin below 12 g/dl into three categories: absolute iron deficiency, functional iron deficiency, and candidates for therapeutic trial with intravenous iron. The system also flagged cases with suspected severe secondary hyperparathyroidism (PTH &gt; 800 pg/ml). Data was obtained from the laboratory information system and the clinical decision support system. We applied a descriptive statistical analysis.  Results. The clinical decision support system automatically classified patients into the following categories: functional iron deficiency (39.2%), severe hyperparathyroidism (26.7%), absolute iron deficiency (17.7%), and candidates for intravenous iron trial (16.4%). A subgroup (9.5% within the functional iron deficiency group) also showed elevated PTH levels, suggesting potential resistance to erythropoiesis-stimulating agents. Distinct clinical profiles were observed across the groups.  Conclusions. The clinical decision support system enabled automated and standardized classification of anemia in hemodialysis patients, supporting evidence-based clinical decision-making. Its implementation represents a digital health innovation with the potential to improve the quality and safety of anemia management in chronic kidney disease.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[anemia]]></kwd>
<kwd lng="es"><![CDATA[insuficiencia renal crónica]]></kwd>
<kwd lng="es"><![CDATA[diálisis renal]]></kwd>
<kwd lng="es"><![CDATA[sistemas especialistas]]></kwd>
<kwd lng="es"><![CDATA[sistemas de apoyo a las decisiones clínicas]]></kwd>
<kwd lng="es"><![CDATA[ferritinas]]></kwd>
<kwd lng="es"><![CDATA[hormona paratiroidea]]></kwd>
<kwd lng="en"><![CDATA[Anemia]]></kwd>
<kwd lng="en"><![CDATA[renal insufficiency, chronic]]></kwd>
<kwd lng="en"><![CDATA[renal dialysis]]></kwd>
<kwd lng="en"><![CDATA[expert systems]]></kwd>
<kwd lng="en"><![CDATA[decision support systems, clinical]]></kwd>
<kwd lng="en"><![CDATA[ferritins]]></kwd>
<kwd lng="en"><![CDATA[parathyroid hormone]]></kwd>
</kwd-group>
</article-meta>
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