Abstract
We report on new projection engine which was developed in order to implement a distributed guideline-based decision support system (DSS) within the European project MobiGuide.In this model, small portions of the guideline knowledge are projected, i.e. ‘downloaded’, from a central DSS server to a local DSS in the patient’s mobile device, which then applies that knowledge using the mobile device’s local resources. Furthermore, the projection engine generates guideline projections which are adapted to the patient’s previously defined preferences and, implicitly, to the patient’s current context, which is embodied in the projected knowledge. We evaluated this distributed guideline application model for two complex guidelines: one for Gestational Diabetes Mellitus, and one for Atrial Fibrillation. We found that the initial specification of what we refer to as the customized guideline should be in the terms of the distributed DSS, i.e., include two levels: one for the central DSS, and one for the local DSS. In addition, we found significant differences between the customized, distributed versions of the two guidelines, indicating further research directions and possibly additional ways to analyze and characterize guidelines.
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References
Quaglini, S., Ciccarese, P., Micieli, G., et al.: Guideline application for decision making in ischemic stroke (GLADIS) study group. Stud. Health Technol. Inform. 101, 75–87 (2004)
Granger, B.B., Bosworth, H.B.: Medication adherence: emerging use of technology. CurrOpinCardiol. 26(4), 279–287 (2011)
Peleg, M., Shahar, Y., Quaglini, S.: Making healthcare more accessible, better, faster, and cheaper: the MobiGuide Project. Eur. J. ePractice: Issue Mob. eHealth 20, 5–20 (2014)
Chomutare, T., Fernandez-Luque, L., Arsand, E., Hartvigsen, G.: Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. J. Med. Internet Res. 13(3), e65 (2011). doi:10.2196/jmir.1874
Farmer, A.J., Gibson, O.J., Dudley, C., Bryden, K., Hayton, P.M., Tarassenko, L., Neil, A.: A randomized controlled trial of the effect of real-time telemedicine support on glycemic control in young adults with type 1 diabetes. Diabetes Care 28(11), 2697–2702 (2005)
Besana, Paolo, Barker, Adam: Towards decentralised clinical decision support systems. In: Brahnam, Sheryl, Jain, Lakhmi C. (eds.) Adv. Comput. Intell. Paradigms in Healthcare 5. SCI, vol. 326, pp. 27–44. Springer, Heidelberg (2010)
Shalom, E., Shahar, Y., Goldstein, A., et al.: Enhancing Guideline-based decision support with distributed computation through local mobile application. In: Prohealth 2014
Bottrighi, G.M., Montani, S., Terenziani, P., Torchio, M.: Supporting a distributed execution of clinical guidelines. Comput. Methods Programs Biomed. 112, 200–210 (2013)
Sacchi, L., Fux, A., Napolitano, C., Panzarasaa, S., Peleg, M., Quaglini, S., Shalom, E., Soffer, P., Tormene, P.: Patient-tailored Workflow Patterns from Clinical Practice Guidelines Recommendations. In: Medinfo 2013 (2013)
Shalom, E., Shahar, Y., Taieb-Maimon, M., Lunenfeld, E., Bar, G., Yarkoni, A., Young, O., Martins, S.B., Vaszar, L.T., Goldstein, M.K., Liel, Y., Leibowitz, A., Marom, T., Lunenfeld, E.: A quantitative evaluation of a methodology for collaborative specification of clinical guidelines at multiple representation levels. J. BioMed. Inf. 41(6), 889–903 (2008)
Hatsek, A., Shahar, Y., Taieb-Maimon, M., Shalom, E., Klimov, D., Lunenfeld, E.: A scalable architecture for incremental specification and maintenance of procedural and declarative clinical decision-support knowledge. Open Med. Info. J. 4, 255–277 (2010)
Shahar, Y., Young, O., Shalom, E., Galperin, M., Mayaffit, A., Moskovitch, R., et al.: A framework for a distributed, hybrid, multiple-ontology clinical-guideline library, and automated guideline-support tools. J. Biomed. Inform. 37(5), 325–344 (2004)
Shahar, Y., Miksch, S., Johnson, P.: The Asgaard project: A task-specific framework for the application and critiquing of time-oriented clinical guidelines. A I. Med. 14, 29–51 (1998)
Shalom, E., Shahar, Y., Parmet, Y., Lunenfeld, E.: A multiple-scenario assessment of the effect of a continuous-care, guideline-based decision support system on clinicians’ compliance to clinical guidelines. Int. J. Med. Inform. (in press). doi:10.1016/j.ijmedinf.2015.01.004
Jones, V., Bults, R., Konstantas, D., Vierhout, P.: Healthcare PANs: Personal Area Networks for trauma care and home care. In: Fourth International Symposium on Wireless Personal Multimedia Communications (WPMC), Aalborg, Denmark (2001)
Larburu, N., Van-Schooten, B., Shalom, E., Fung, N., Hermens, H., Jones, V.A: Quality Aware Mobile Decision Support System for Patients with Chronic Illnesses. In: Prohealth 2015 (2015)
García-Sáez, G., Rigla, M., Martínez-Sarriegui, I., Shalom, E., Peleg, M., Broens, T., Pons, B., Caballero-Ruíz, E., Gómez, E.J., Hernando, M,E.: Patient-oriented computerized clinical guidelines for mobile decision support in gestational diabetes. J. Diabetes Sci. Technol. (2014). doi:10.1177/1932296814526492
Acknowledgements
The MobiGuide project (http://www.mobiguide-project.eu/) has received funding from the EU’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 287811.
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Shalom, E. et al. (2015). Implementation of a Distributed Guideline-Based Decision Support Model Within a Patient-Guidance Framework. In: Riaño, D., Lenz, R., Miksch, S., Peleg, M., Reichert, M., ten Teije, A. (eds) Knowledge Representation for Health Care. AIME 2015. Lecture Notes in Computer Science(), vol 9485. Springer, Cham. https://doi.org/10.1007/978-3-319-26585-8_8
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