A web-based information and decision support system for appropriateness in medicine

doi:10.1016/S0950-7051(99)00052-0

Knowledge-Based Systems

Volume 13, Issue 1, February 2000, Pages 11-19

https://doi.org/10.1016/S0950-7051(99)00052-0 Get rights and content

Abstract

In the last few years, the WWW has frequently been used in a variety of applications, to provide up-to-date and platform-independent access to relevant information. In medicine, building and sharing knowledge about new theories, technologies and discoveries is of major concern. In this respect, there is a real need for physicians to be provided with efficient tools that offer targeted access to information about literature, expert opinions, medical statistics and epidemiology, in order to help them in their decision process. In this paper we describe the design and implementation of a generic Web-based environment that provides physicians with an integrated access to medical information as well as decision making support facilities. The emphasis is given on the design issues and the benefits of combining several approaches: using structured documents and databases to manage information and, argumentation tools to support the communication.

Introduction

Emerging at the beginning of this decade, the Web rapidly imposed itself as a new medium for interconnecting people throughout the world. Overstepping the initial publishing purpose, Web applications currently evolve towards the setting-up of virtual working and communication spaces, intended to be used by specific communities of users. However, the integration of a wide variety of heterogeneous tools and their use by non-computer scientists remains an important, and only partially solved, problem. It clearly emphasizes the needs for an appropriate information system design approach, allowing update and access to relevant information as well as reuse of pieces of information in a tailored communication process.

This paper describes the design and implementation of a generic information system that supports decision making among physicians concerning the appropriateness of clinical procedures in various fields of medicine. It concentrates on the design methods for handling, updating and accessing heterogeneous information through a Web hypertext interface. More specifically it provides features about our document technology approach to deal with interoperability issues and, the integrated use of information retrieval and decision making tools.

The paper is organized in the following way. In Section 2 we present the specific problems and needs to be addressed in the medical framework. In Section 3 we present a detailed description of the CADAM (Computer Aided Decision for Appropriateness in Medicine) project and describe our technical choices. Finally, Section 4 presents discussion, open issues to be addressed and, future works.

Section snippets

The medical framework

The major objectives of health services research are to improve the quality of care, to optimize health care utilization and to foster transfer of results from medical research into clinical practice. Assisting the physicians by providing them access to medical knowledge, in order to evaluate the effectiveness of medical interventions, is an important aspect to be dealt with in this perspective. Medical studies [17] show that the most important needs in the context of information access for

The CADAM project

The environment is developed in the framework of CADAM, a joint project between the MEDIA Research group at the Swiss Federal Institute of Technology in Lausanne (Switzerland) and the Institute of Social and Preventive Medicine at the University of Lausanne.

CADAM aims at providing a Web based information and decision support system to assist physicians in the decision making process by providing them with an integrated access to the relevant sources of information discussed in Section 2. This

Discussion

A Web based information system has been developed, intended to support the physicians in the elaboration of a second opinion about medical cases. It emphasizes the benefits to be gained by combining and integrating, through a Web-based platform, appropriate information and communication technologies.

The majority of Web-based applications conform to a database approach, generating dynamically HTML documents through requests initiated by the users. In the CADAM project, modelling the clinical

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A web-based information and decision support system for appropriateness in medicine

Abstract

Introduction

Section snippets

The medical framework

The CADAM project

Discussion

Capturing organizational memory

Making Hypermedia Work

The zeno argumentation framework

Proceedings of the ICAIL’97

CliniWeb: Managing clinical information on the WWW

JAMIA