Abstract
General technical challenges in providing a standardized semantic, structural, and conceptual foundation for comprehensive Clinical Decision Support (CDS) are introduced. The prerequisite requirements for a) standard representations of domain data, b) standard vocabularies to unambiguously define and declare domain concepts, and c) an expressive description logic syntax with which to articulate and encode domain knowledge are examined with reference to the use of CDS in automating Clinical Practice Guidelines. Semantic web, uncertainty and other cognitive technologies are discussed in the context of improving the reliability and adaptability of clinical guidelines in real-world scenarios. Select opportunities for incorporating standards and technology capabilities available in non-medical communities are highlighted when appropriate.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Abbasi, M., Kashiyarndi, S.: Clinical Decision Support Systems: A Discussion on Different Methodologies Used in Health Care (2010)
Anselma, L., Montani, S.: Supporting and Optimizing Clinical Guidelines Execution. Citeseer (2008)
Beale, T.: The OpenEHR Archetype System. 1, 1–19 (2003)
Bottrighi, A., Chesani, F., Mello, P., Montali, M., Montani, S.: Conformance Checking of Executed Clinical Guidelines in Presence of Basic Medical Knowledge. Event (London), 1–12
Boxwala, A., Peleg, M., Tu, S., Ogunyemi, O., Zeng, Q., Wang, D., Patel, V., Greenes, R., Shortliffe, E.: GLIF3: a Representation Format for Sharable Computer-Interpretable Clinical Practice Guidelines. Journal of Biomedical Informatics 37(3), 147–161 (2004)
Buchanan, B.G., Shortliffe, E.H.: Rule-based Expert Systems: The MYCIN Experiments of the Stanford Heuristic Programming Project. Addison-Wesley, Reading (1984)
Ceccarelli, M., Stasio, A.D., Donatiello, A., Vitale, D.: A Guideline Engine For Knowledge Management in Clinical Decision Support Systems (CDSSs)
Ceusters, W., Smith, B., Flanagan, J.: Ontology and Medical Terminology: Why Description Logics Are Not Enough. Computing (2003)
Che, C., Monson, K., Poon, K.B., Shakib, S.C., Lau, L.M.: Managing Vocabulary Mapping Services. In: AMIA Annual Symposium Proceedings, vol. 2005, p. 916. American Medical Informatics Association (2005)
Ciccarese, P., Caffi, E., Quaglini, S., Stefanelli, M.: Architectures and Tools for Innovative Health Information Systems: The Guide Project. International Journal of Medical Informatics 74(7-8), 553–562 (2005)
Coyle, J., Mori, A., Huff, S.: Standards for Detailed Clinical Models as the Basis for Medical Data Exchange and Decision Support. International Journal Of Medical Informatics 69(2-3), 157–174 (2003)
Doerr, M.: Semantic Problems of Thesaurus Mapping. Journal of Digital Information 1(8), 1–27 (2001)
Eccles, M., Mason, J.: How to Develop Cost-Conscious Guidelines. Health Technology Assessment (Winchester, England) 5(16), 1–69 (2001)
Goossen, W., Goossen-Baremans, A., van der Zel, M.: Detailed Clinical Models: A Review. Healthcare Informatics Research 16(4), 201–214 (2010)
Greenes, R.A.: Clinical Decision Support: The Road Ahead. Academic Press (2006)
Hersh, W.: Health and Biomedical Informatics: Opportunities and Challenges for a Twenty-First Century Profession and Its Education. Yearb. Med. Inform., 157–164 (2008)
Hrabak, K.M., Campbell, J.R., Tu, S.W., McClure, R., Weida, R.T.: Creating Interoperable Guidelines: Requirements of Vocabulary Standards in Immunization Decision Support.. Studies In Health Technology And Informatics 129(Pt 2), 930–934 (January 2007)
Hripcsak, G., Clayton, P., Pryor, T.: The Arden Syntax for Medical Logic Modules. In: 14. Annual Symposium on Computer Applications in Medical Care, pp. 200–204 (1990)
Jaspers, M.W.M., Smeulers, M., Vermeulen, H., Peute, L.W.: Effects of Clinical Decision-Support Systems on Practitioner Performance and Patient Outcomes: A Synthesis of High-Quality Systematic Review Findings. Journal of the American Medical Informatics Association 18(3), 327–334 (2011)
Jenders, R.A., Sujansky, W., Broverman, C.A., Chadwick, M.: Towards Improved Knowledge Sharing: Assessment of the HL7 Reference Information Model to Support Medical Logic Module Queries. In: Proceedings of the AMIA Annual Fall Symposium, pp. 308–312 (January 1997)
Johnson, P.D., Tu, S., Booth, N., Sugden, B., Purves, I.N.: Using Scenarios in Chronic Disease Management Guidelines for Primary Care. In: Proceedings of the AMIA Annual Fall Symposium, pp. 389–393 (January 2000)
Jovic, A., Prcela, M., Gamberger, D.: Ontologies in Medical Knowledge Representation. In: 29th International Conference on Information Technology Interfaces, pp. 535–540 (June 2007)
Kashyap, V., Morales, A.: On Implementing Clinical Decision Support: Achieving Scalability and Maintainability by Combining Business Rules and Ontologies. In: AMIA Annual Symposium, vol. 40(C) (2006)
Kawamoto, K., Del Fiol, G., Strasberg, H., Hulse, N., Curtis, C., Cimino, J., Rocha, B., Maviglia, S., Fry, E., Scherpbier, H., et al.: Multi-National, Multi-Institutional Analysis of Clinical Decision Support Data Needs to Inform Development of the HL7 Virtual Medical Record Standard. In: AMIA Annual Symposium Proceedings, vol. 2010, p. 377. American Medical Informatics Association (2010)
Kong, G., Xu, D., Yang, J., Body, R., Mackway-Jones, K., Carley, S.: A Belief Rule-Based Decision Support System for Clinical Risk Assessment of Cardiac Chest Pain. pp. 1–31
Kong, G., Xu, D.L., Yang, J.B.: Clinical Decision Support Systems: a Review of Knowledge Representation and Inference Under Uncertainties. International Journal of Computational Intelligence Systems 1(2), 159 (2008)
Liu, J.C.S., Shiffinan, R.N.: Operationalization of Clinical Practice Guidelines Using Fuzzy Logic. Medical Informatics, 283–287
McCray, a.T., Nelson, S.J.: The Representation of Meaning in the UMLS. Methods of Information in Medicine 34(1-2), 193–201 (1995)
Mirhaji, P., Zhu, M., Vagnoni, M., Bernstam, E.V., Zhang, J., Smith, J.W.: Ontology Driven Integration Platform for Clinical and Translational Research. BMC Bioinformatics 10(suppl. 2), S2 (2009)
Montani, S.: Case-Based Reasoning for Managing Noncompliance with Clinical Guidelines. Computational Intelligence 25(3), 196–213 (2009)
Onisko, A., Lucas, P., Druzdzel, M.J.: Comparison of Rule-Based and Bayesian Network Approaches in Medical Diagnostic Systems
Osheroff, J.A., Teich, J.M., Middleton, B., Steen, E.B., Wright, A., Detmer, D.E.: A Roadmap for National Action on Clinical Decision Support. Journal of the American Medical Informatics Association 14(2), 141 (2007)
Parker, C.G., Rocha, R.A., Campbell, J.R., Tu, S.W., Huff, S.M.: Detailed Clinical Models for Sharable, Executable Guidelines. Studies in Health Technology and Informatics 107(Pt 1), 145–148 (2004)
Quinlan, J.R.: Generating Production Rules From Decision Trees.. In: Proceedings of the Tenth International Joint Conference on Artificial Intelligence, vol. 30107, pp. 304–307. Citeseer (1987)
Rector, A., Bechhofer, S., Goble, C., Horrocks, I., Nowlan, W., Solomon, W.: The GRAIL Concept Modelling Language for Medical Terminology. Artificial Intelligence in Medicine 9(2), 139–171 (1997)
Shahar, Y., Miksch, S., Johnson, P.: The Asgaard Project: A Task-Specific Framework for the Application and Critiquing of Time-Oriented Clinical Guidelines. Artificial Intelligence in Medicine 14(1-2), 29–51 (1998)
Sherman, E.H., Hripcsak, G., Starren, J., Jenders, R.A., Clayton, P.: Using Intermediate States to Improve the Ability of the Arden Syntax to Implement Care Plans and Reuse Knowledge.. In: Proceedings of the Annual Symposium on Computer Application in Medical Care, p. 238. American Medical Informatics Association (1995)
Smets, P.: Imperfect Information: Imprecision and Uncertainty, pp. 225–254 (1996)
Sordo, M., Boxwala, A.A., Ogunyemi, O., Greenes, R.A.: Description and Status Update on GELLO: A Proposed Standardized Object-Oriented Expression Language for Clinical Decision Support. Studies in Health Technology and Informatics 107(Pt 1), 164–168 (2004)
Tu, S.W., Musen, M.A.: The EON Model of Intervention Protocols and Guidelines. In: Proceedings of the AMIA Annual Fall Symposium, pp. 587–591 (January 1996)
Tu, S., Campbell, J., Glasgow, J., Nyman, M., McClure, R., McClay, J., Parker, C., Hrabak, K., Berg, D., Weida, T., et al.: The SAGE Guideline Model: Achievements and Overview. Journal of the American Medical Informatics Association 14(5), 589 (2007)
Warren, J., Beliakov, G., Zwaag, B.V.D.: Fuzzy Logic in Clinical Practice Decision Support Systems. Computing 00(c), 1–10 (2000)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Fry, E., Sottara, D. (2011). Standards, Data Models, Ontologies, Rules: Prerequisites for Comprehensive Clinical Practice Guidelines. In: Olken, F., Palmirani, M., Sottara, D. (eds) Rule-Based Modeling and Computing on the Semantic Web. RuleML 2011. Lecture Notes in Computer Science, vol 7018. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-24908-2_27
Download citation
DOI: https://doi.org/10.1007/978-3-642-24908-2_27
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-24907-5
Online ISBN: 978-3-642-24908-2
eBook Packages: Computer ScienceComputer Science (R0)