Abstract
Automated support for guideline-based care would be enhanced considerably by a standard representation of clinical guidelines. To faciliate use and reuse, we suggest a representation that includes the explicit intentions of the guideline's author. These intentions include the desirable actions of the care provider and the patient states to be achieved before, during, and after the administration of the guideline. Intentions are temporal patterns of provider actions or patient states to be maintained, achieved, or avoided. We view automated support as a collaborative effort of the health-care provider and an automated assistant and involves several different tasks. We defined the syntax and, the semantics of a text-based language (ASBRU) for representation and annotation of clinical guidelines. The language supports maintenance of the automated assistant's knowledge base and could improve the quality and flexibility of the automated assistant's recommendations. In the ASGAARD project, we are developing reasoning mechanisms that use the ASBRU language for execution and critiquing tasks in conjunction with online electronic patient medical records.
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Selected References
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- Barnes M., Barnett G. O. An architecture for a distributed guideline server. Proc Annu Symp Comput Appl Med Care. 1995:233–237. [PMC free article] [PubMed] [Google Scholar]
- Grimshaw J. M., Russell I. T. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 1993 Nov 27;342(8883):1317–1322. doi: 10.1016/0140-6736(93)92244-n. [DOI] [PubMed] [Google Scholar]
- Herbert S. I., Gordon C. J., Jackson-Smale A., Salis J. L. Protocols for clinical care. Comput Methods Programs Biomed. 1995 Sep-Oct;48(1-2):21–26. doi: 10.1016/0169-2607(95)01655-d. [DOI] [PubMed] [Google Scholar]
- Hickam D. H., Shortliffe E. H., Bischoff M. B., Scott A. C., Jacobs C. D. The treatment advice of a computer-based cancer chemotherapy protocol advisor. Ann Intern Med. 1985 Dec;103(6 ):928–936. doi: 10.7326/0003-4819-103-6-928. [DOI] [PubMed] [Google Scholar]
- Liem E. B., Obeid J. S., Shareck E. P., Sato L., Greenes R. A. Representation of clinical practice guidelines through an interactive World-Wide-Web interface. Proc Annu Symp Comput Appl Med Care. 1995:223–227. [PMC free article] [PubMed] [Google Scholar]
- Musen M. A., Carlson R. W., Fagan L. M., Deresinski S. C., Shortliffe E. H. T-HELPER: automated support for community-based clinical research. Proc Annu Symp Comput Appl Med Care. 1992:719–723. [PMC free article] [PubMed] [Google Scholar]
- Musen M. A., Gennari J. H., Eriksson H., Tu S. W., Puerta A. R. PROTEGE-II: computer support for development of intelligent systems from libraries of components. Medinfo. 1995;8(Pt 1):766–770. [PubMed] [Google Scholar]
- Shahar Y., Musen M. A. Knowledge-based temporal abstraction in clinical domains. Artif Intell Med. 1996 Jul;8(3):267–298. doi: 10.1016/0933-3657(95)00036-4. [DOI] [PubMed] [Google Scholar]
- Sherman E. H., Hripcsak G., Starren J., Jenders R. A., Clayton P. Using intermediate states to improve the ability of the Arden Syntax to implement care plans and reuse knowledge. Proc Annu Symp Comput Appl Med Care. 1995:238–242. [PMC free article] [PubMed] [Google Scholar]
- van der Lei J., Musen M. A. A model for critiquing based on automated medical records. Comput Biomed Res. 1991 Aug;24(4):344–378. doi: 10.1016/0010-4809(91)90034-t. [DOI] [PubMed] [Google Scholar]