Executable medical guidelines with Arden Syntax-Applications in dermatology and obstetrics.

Introduction: Clinical decision support systems (CDSSs) are being developed to assist physicians in processing extensive data and new knowledge based on recent scientific advances. Structured medical knowledge in the form of clinical alerts or reminder rules, decision trees or tables, clinical proto...

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Publicado en:Artificial Intelligence in Medicine Vol. 92; pp. 71 - 82
Autores principales: Seitinger, Alexander, Rappelsberger, Andrea, Leitich, Harald, Binder, Michael, Adlassnig, Klaus-Peter
Formato: Journal Article
Publicado: Elsevier B.V. Nov2018
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Executable medical guidelines with Arden Syntax-Applications in dermatology and obstetrics.
      aug:
        au:
          Seitinger, Alexander
          Rappelsberger, Andrea
          Leitich, Harald
          Binder, Michael
          Adlassnig, Klaus-Peter
        affil: Medexter Healthcare GmbH, Borschkegasse 7/5, A-1090 Vienna, Austria
      sug:
        subj:
          Obstetrics
          Expert Systems
          Decision Support Systems, Clinical Administration
          Hospital Information Systems Administration
          Dermatology
          Programming Languages
          Lyme Disease Diagnosis
          Reminder Systems
          Dermatology Standards
          Hospital Information Systems Standards
          Decision Support Systems, Clinical Standards
          Artificial Intelligence
          Practice Guidelines
          Obstetrics Standards
          Lyme Disease Therapy
          Medical Informatics
          Logic
          Scales
      ab: Introduction: Clinical decision support systems (CDSSs) are being developed to assist physicians in processing extensive data and new knowledge based on recent scientific advances. Structured medical knowledge in the form of clinical alerts or reminder rules, decision trees or tables, clinical protocols or practice guidelines, score algorithms, and others, constitute the core of CDSSs. Several medical knowledge representation and guideline languages have been developed for the formal computerized definition of such knowledge. One of these languages is Arden Syntax for Medical Logic Systems, an International Health Level Seven (HL7) standard whose development started in 1989. Its latest version is 2.10, which was presented in 2014. In the present report we discuss Arden Syntax as a modern medical knowledge representation and processing language, and show that this language is not only well suited to define clinical alerts, reminders, and recommendations, but can also be used to implement and process computerized medical practice guidelines.Methods: This section describes how contemporary software such as Java, server software, web-services, XML, is used to implement CDSSs based on Arden Syntax. Special emphasis is given to clinical decision support (CDS) that employs practice guidelines as its clinical knowledge base.Results: Two guideline-based applications using Arden Syntax for medical knowledge representation and processing were developed. The first is a software platform for implementing practice guidelines from dermatology. This application employs fuzzy set theory and logic to represent linguistic and propositional uncertainty in medical data, knowledge, and conclusions. The second application implements a reminder system based on clinically published standard operating procedures in obstetrics to prevent deviations from state-of-the-art care. A to-do list with necessary actions specifically tailored to the gestational week/labor/delivery is generated.Discussion: Today, with the latest versions of Arden Syntax and the application of contemporary software development methods, Arden Syntax has become a powerful and versatile medical knowledge representation and processing language, well suited to implement a large range of CDSSs, including clinical-practice-guideline-based CDSSs. Moreover, such CDS is provided and can be shared as a service by different medical institutions, redefining the sharing of medical knowledge. Arden Syntax is also highly flexible and provides developers the freedom to use up-to-date software design and programming patterns for external patient data access.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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