Merging Disease-Specific Clinical Guidelines to Handle Comorbidities in a Clinical Decision Support Setting

Abstract

From a clinical decision support perspective the treatment of co-morbid diseases is a challenge since it demands the coordination between the disease-specific therapeutic plans of the co-morbid diseases. Although clinical guidelines provide clinical recommendations, they focus on a single disease and for comorbid disease management there is a requirement to have multiple concurrently active clinical guidelines. Merging computerized clinical practice guidelines (CPG) related to comorbidities and using them in clinical decision support systems is a potential solution to manage comorbidities in a clinical decision support system. We have developed a CPG merging framework to merge computerized CPG. The central aspect of our framework is a merge representation ontology that captures the merging criteria to achieve the merging of multiple CPG whilst satisfying medical, workflow, institutional and temporal constraints. We have used our framework successfully to create therapy plans for patients treated for Atrial Fibrillation and Chronic Heart Failure comorbidity.