Use of declarative statements in creating and maintaining computer-interpretable knowledge bases for guideline-based care

Tu SW, Hrabak KM, Campbell JR, Glasgow J, Nyman MA, McClure R, McClay J, Abarbanel R, Mansfield JG, Martins SM, Goldstein MK, Musen MA. Use of declarative statements in creating and maintaining computer-interpretable knowledge bases for guideline-based care. AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium. 2006 Nov 1; 784-8.

Related HSR&D Project(s)

• CPI 99-275 – Guidelines for Drug Therapy of Hypertension: Multi-Site Implementation
• CPG 97-006 – Guidelines for Drug Therapy of Hypertension: Closing the Loop

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Abstract:

Developing computer-interpretable clinical practice guidelines (CPGs) to provide decision support for guideline-based care is an extremely labor-intensive task. In the EON/ATHENA and SAGE projects, we formulated substantial portions of CPGs as computable statements that express declarative relationships between patient conditions and possible interventions. We developed query and expression languages that allow a decision-support system (DSS) to evaluate these statements in specific patient situations. A DSS can use these guideline statements in multiple ways, including: (1) as inputs for determining preferred alternatives in decision-making, and (2) as a way to provide targeted commentaries in the clinical information system. The use of these declarative statements significantly reduces the modeling expertise and effort required to create and maintain computer-interpretable knowledge bases for decision-support purpose. We discuss possible implications for sharing of such knowledge bases.