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AMIA Annual Symposium Proceedings (1)
The Open Medical Informatics Journal (1)
Lunenfeld, Eitan (2)
Bu, Davis (1)
Cantor, Michael (1)
Hatsek, Avner (1)
Hripcsak, George (1)
Kaiser, Gail E. (1)
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Landesberg, Giora (1)
Patel, Vimla L. (1)
Peleg, Mor (1)
Shahar, Yuval (1)
Shalom, Erez (1)
Shortliffe, Edward H. (1)
Taieb-Maimon, Meirav (1)
Tu, Samson W. (1)
Wang, Dongwen (1)
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A Scalable Architecture for Incremental Specification and Maintenance of Procedural and Declarative Clinical Decision-Support Knowledge
The Open Medical Informatics Journal
Clinical guidelines have been shown to improve the quality of medical care and to reduce its costs. However, most guidelines exist in a free-text representation and, without automation, are not sufficiently accessible to clinicians at the point of care. A prerequisite for automated guideline application is a machine-comprehensible representation of the guidelines. In this study, we designed and implemented a scalable architecture to support medical experts and knowledge engineers in specifying and maintaining the procedural and declarative aspects of clinical guideline knowledge, resulting in a machine comprehensible representation. The new framework significantly extends our previous work on the Digital electronic Guidelines Library (DeGeL) The current study designed and implemented a graphical framework for specification of declarative and procedural clinical knowledge, Gesher. We performed three different experiments to evaluate the functionality and usability of the major aspects of the new framework: Specification of procedural clinical knowledge, specification of declarative clinical knowledge, and exploration of a given clinical guideline. The subjects included clinicians and knowledge engineers (overall, 27 participants). The evaluations indicated high levels of completeness and correctness of the guideline specification process by both the clinicians and the knowledge engineers, although the best results, in the case of declarative-knowledge specification, were achieved by teams including a clinician and a knowledge engineer. The usability scores were high as well, although the clinicians’ assessment was significantly lower than the assessment of the knowledge engineers.
Medical informatics; clinical guidelines; decision support systems; knowledge representation; knowledge acquisition; knowledge bases; ontologies; information retrieval; human computer interaction; artificial intelligence; digital libraries; service oriented architecture.
GESDOR – A Generic Execution Model for Sharing of Computer-Interpretable Clinical Practice Guidelines
Tu, Samson W.
Kaiser, Gail E.
Patel, Vimla L.
Shortliffe, Edward H.
AMIA Annual Symposium Proceedings
We developed the Guideline Execution by Semantic Decomposition of Representation (GESDOR) model to share guidelines encoded in different formats at the execution level. For this purpose, we extracted a set of generalized guideline execution tasks from the existing guideline representation models. We then created the mappings between specific guideline representation models and the set of the common guideline execution tasks. Finally, we developed a generic task-scheduling model to harmonize the existing approaches to guideline task scheduling. The evaluation has shown that the GESDOR model can be used for the effective execution of guidelines encoded in different formats, and thus realizes guideline sharing at the execution level.
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