Skip to main content

The Role of Ontologies and Decision Frameworks in Computer-Interpretable Guideline Execution

  • Chapter
  • First Online:
Synergies Between Knowledge Engineering and Software Engineering

Part of the book series: Advances in Intelligent Systems and Computing ((AISC,volume 626))

Abstract

Computer-Interpretable Guidelines (CIGs) are machine readable representations of Clinical Practice Guidelines (CPGs) that serve as the knowledge base in many knowledge-based systems oriented towards clinical decision support. Herein we disclose a comprehensive CIG representation model based on Web Ontology Language (OWL) along with its main components. Additionally, we present results revealing the expressiveness of the model regarding a selected set of CPGs. The CIG model then serves as the basis of an architecture for an execution system that is able to manage incomplete information regarding the state of a patient through Speculative Computation. The architecture allows for the generation of clinical scenarios when there is missing information for clinical parameters.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Available at https://www.guideline.gov/.

References

  1. Engelmore, R.S.: Artificial intelligence and knowledge based systems: origins, methods and opportunities for NDE. In: Review of Progress in Quantitative Nondestructive Evaluation, vol. 6 A, pp. 1–20 (1987)

    Google Scholar 

  2. Studer, R., Benjamins, V.R., Fensel, D.: Knowledge engineering: principles and methods. Data Knowl. Eng. 25(1–2), 161–197 (1998)

    Article  MATH  Google Scholar 

  3. Kalogeropoulos, D.A., Carson, E.R., Collinson, P.O.: Towards knowledge-based systems in clinical practice: development of an integrated clinical information and knowledge management support system. Comput. Methods Programs Biomed. 72(1), 65–80 (2003)

    Article  Google Scholar 

  4. Miller, M., Kearney, N.: Guidelines for clinical practice: development, dissemination and implementation. Int. J. Nurs. Stud. 41(7), 813–821 (2004)

    Article  Google Scholar 

  5. Silberstein, S.: Clinical practice guidelines. J. Neurosurg. Pediatr. 25(10), 765–766 (2005)

    Google Scholar 

  6. Woolf, S.H., Grol, R., Hutchinson, A., Eccles, M., Grimshaw, J.: Potential benefits, limitations, and harms of clinical guidelines. BMJ Br. Med. J. 318(7182), 527–530 (1999)

    Article  Google Scholar 

  7. Toker, A., Shvarts, S., Perry, Z.H., Doron, Y., Reuveni, H.: Clinical guidelines, defensive medicine, and the physician between the two. Am. J. Otolaryngol. Head Neck Med. Surg. 25(4), 245–250 (2004)

    Google Scholar 

  8. Peleg, M.: Computer-interpretable clinical guidelines: a methodological review. J. Biomed. Inform. 46(4), 744–763 (2013)

    Article  Google Scholar 

  9. Oliveira, T., Novais, P., Neves, J.: Development and implementation of clinical guidelines: an artificial intelligence perspective. Artif. Intell. Rev. 999–1027 (2014)

    Google Scholar 

  10. Latoszek-Berendsen, A., Tange, H., van den Herik, H.J., Hasman, A.: From clinical practice guidelines to computer-interpretable guidelines. A literature overview. Methods Inf. Med. 49(6), 550–570 (2010)

    Article  Google Scholar 

  11. Codish, S., Shiffman, R.N.: A model of ambiguity and vagueness in clinical practice guideline recommendations. In: AMIA Annual Symposium Proceedings, vol. 2005, p. 146 (2005)

    Google Scholar 

  12. de Clercq, P.A., Blom, J.A., Korsten, H.H.M., Hasman, A.: Approaches for creating computer-interpretable guidelines that facilitate decision support. Artif. Intell. Med. 31(1), 1–27 (2004)

    Article  Google Scholar 

  13. Novais, P., Oliveira, T., Neves, J.: Moving towards a new paradigm of creation, dissemination, and application of computer-interpretable medical knowledge. Prog. Artif. Intell. 1–7 (2016)

    Google Scholar 

  14. Lipshitz, R., Strauss, O.: Coping with uncertainty: a naturalistic decision-making analysis. Organ. Behav. Hum. Decis. Process. 69(2), 149–163 (1997)

    Article  Google Scholar 

  15. Babrow, A., Kasch, C., Ford, L.: The many meanings of uncertainty in illness: toward a systematic accounting. Health Commun. 10(1), 1–23 (1998)

    Article  Google Scholar 

  16. Mishel, M.H.: The measurement of uncertainty in illness. Nurs. Res. 30(5), 258–263 (1981)

    Article  Google Scholar 

  17. Han, P.K.J., Klein, W.M.P., Arora, N.K.: Varieties of uncertainty in health care: a conceptual taxonomy. Med. Decis. Mak. Int. J. Soc. Med. Decis. Mak. 31(6), 828–38 (2011)

    Article  Google Scholar 

  18. Gardner, R.M., Pryor, T., Warner, H.R.: The HELP hospital information system: update 1998. Int. J. Med. Inform. 54(3), 169–182 (1999)

    Article  Google Scholar 

  19. Samwald, M., Fehre, K., de Bruin, J., Adlassnig, K.P.: The Arden Syntax standard for clinical decision support: experiences and directions. J. Biomed. Inform. (2012)

    Google Scholar 

  20. Peleg, M., Boxwala, A.A., Bernstam, E., Tu, S., Greenes, R.A., Shortliffe, E.H.: Sharable representation of clinical guidelines in GLIF: relationship to the Arden Syntax. J. Biomed. Inform. 34(3), 170–181 (2001)

    Article  Google Scholar 

  21. Boxwala, A.A., Peleg, M., Tu, S., Ogunyemi, O., Zeng, Q.T., Wang, D., Patel, V.L., Greenes, R.A., Shortliffe, E.H.: GLIF3: a representation format for sharable computer-interpretable clinical practice guidelines. J. Biomed. Inform. 37(3), 147–161 (2004)

    Article  Google Scholar 

  22. Shahar, Y., Miksch, S., Johnson, P.: The Asgaard project: a task-specific framework for the application and critiquing of time-oriented clinical guidelines. Artif. Intell. Med. 14(1–2), 29–51 (1998)

    Article  Google Scholar 

  23. Seyfang, A., Miksch, S., Marcos, M.: Combining diagnosis and treatment using ASBRU. Int. J. Med. Inform. 68(1–3), 49–57 (2002)

    Article  Google Scholar 

  24. Terenziani, P., Montani, S., Bottrighi, A., Torchio, M., Molino, G., Correndo, G.: The GLARE approach to clinical guidelines: main features. Stud. Health Technol. Inform. 101(3), 162–166 (2004)

    Google Scholar 

  25. Tu, S.W., Campbell, J.R., Glasgow, J., Nyman, M.A., McClure, R., McClay, J., Parker, C., Hrabak, K.M., Berg, D., Weida, T., Mansfield, J.G., Musen, M.A., Abarbanel, R.M.: The SAGE guideline model: achievements and overview. J. Am. Med. Inform. Assoc. 14(5), 589–598 (2007)

    Article  Google Scholar 

  26. Cornet, R., Schulz, S.: Relationship groups in SNOMED CT. Stud. Health Technol. Inform. 150, 223–227 (2009)

    Google Scholar 

  27. Dugas, M., Thun, S., Frankewitsch, T., Heitmann, K.U.: LOINC(R) codes for hospital information systems documents: a case study. J. Am. Med. Inform. Assoc. 16(3), 400–403 (2009)

    Article  Google Scholar 

  28. Open Clinical: Methods and tools for representing computerised clinical guidelines. http://www.openclinical.org/gmmsummaries.html (2013)

  29. Fox, J., Ma, R.T.: Decision support for health care: the PROforma evidence base. Inform. Prim. Care 14(1), 49–54 (2006)

    Google Scholar 

  30. Ciccarese, P., Kumar, A., Quaglini, S.: NEW-GUIDE: a new approach to representing clinical practice guidelines. In: Advances in Clinical Knowledge Management (Figure 1), pp. 15–18 (2002)

    Google Scholar 

  31. Costa, R., Neves, J., Novais, P., Machado, J., Lima, L., Alberto, C.: Intelligent Mixed Reality for the Creation of Ambient Assisted Living, pp. 323–331. Springer, Berlin (2007)

    Google Scholar 

  32. Wang, D., Peleg, M., Tu, S.W., Boxwala, A.A., Ogunyemi, O., Zeng, Q., Greenes, R.A., Patel, V.L., Shortliffe, E.H.: Design and implementation of the GLIF3 guideline execution engine. J. Biomed. Inform. 37(5), 305–318 (2004)

    Article  Google Scholar 

  33. Young, O., Shahar, Y.: The spock system: developing a runtime application engine for hybrid-asbru guidelines. Artif. Intell. Rev. 3581(1), 166–170 (2005)

    Google Scholar 

  34. Isern, D., Moreno, A.: Computer-based execution of clinical guidelines: a review. Int. J. Med. Inform. 77(12), 787–808 (2008)

    Article  Google Scholar 

  35. McGuinness, D.L., Van Harmelen, F.: OWL Web Ontology Language Overview. https://www.w3.org/TR/owl-features/ (2004)

  36. Oliveira, T., Novais, P., Neves, J.: Representation of clinical practice guideline components in OWL. In: Pérez, J.B., Hermoso, R., Moreno, M.N., Rodríguez, J.M.C., Hirsch, B., Mathieu, P., Campbell, A., Suarez-Figueroa, M.C., Ortega, A., Adam, E., Navarro, E. (eds.) Advances in Intelligent Systems and Computing, vol. 221, pp. 77–85. Springer International Publishing, Berlin (2013)

    Google Scholar 

  37. Oliveira, T., Satoh, K., Novais, P., Neves, J., Hosobe, H.: A dynamic default revision mechanism for speculative computation. Auton. Agents Multi-Agent Syst. 1–40 (2016)

    Google Scholar 

  38. Jamieson, S.: Likert scales: how to (ab)use them. Med. Edu. 38(12), 1217–1218 (2004)

    Article  Google Scholar 

  39. Hosobe, H., Satoh, K., Codognet, P.: Agent-based speculative constraint processing. IEICE Trans. Inf. Syst. E90–D(9), 1354–1362 (2007)

    Article  Google Scholar 

  40. Visscher, S., Lucas, P.J.F., Schurink, C.A.M., Bonten, M.J.M.: Modelling treatment effects in a clinical Bayesian network using Boolean threshold functions. Artif. Intell. Med. 46(3), 251–266 (2009)

    Article  Google Scholar 

  41. Van der Heijden, M., Lucas, P.J.F.: Describing disease processes using a probabilistic logic of qualitative time. Artif. Intell. Med. 59(3), 143–155 (2013)

    Article  Google Scholar 

  42. Korb, K., Nicholson, A.: Bayesian Artificial Intelligence, 2nd edn. CRC Press, London (2003)

    Book  MATH  Google Scholar 

  43. Benson, A., Bekaii-Saab, T., Chan, E., Chen, Y.J., Choti, M., Cooper, H., Engstrom, P.: NCCN Clinical Practice Guideline in Oncology Rectal Cancer. Techical report, National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp (2013)

Download references

Acknowledgements

This work has been supported by COMPETE: POCI-01-0145-FEDER-0070 43 and FCT Fundação para a Ciência e Tecnologia within the Project Scope UID/CEC/00319/2013. The work of Tiago Oliveira is supported by a FCT grant with the reference SFRH/BD/85291/ 2012. This work was partially developed during an internship program of the National Institute of Informatics (NII) of Japan by Tiago Oliveira.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paulo Novais .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Novais, P., Oliveira, T., Satoh, K., Neves, J. (2018). The Role of Ontologies and Decision Frameworks in Computer-Interpretable Guideline Execution. In: Nalepa, G., Baumeister, J. (eds) Synergies Between Knowledge Engineering and Software Engineering. Advances in Intelligent Systems and Computing, vol 626. Springer, Cham. https://doi.org/10.1007/978-3-319-64161-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64161-4_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64160-7

  • Online ISBN: 978-3-319-64161-4

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics