Skip to main content
NCBI home page
Proceedings of the AMIA Annual Fall Symposium logoLink to Proceedings of the AMIA Annual Fall Symposium
. 1996:582–586.

Representing CARE rules in a decision-theoretic formalism.

M M Wagner 1, J M Overhage 1, E Rodriguez 1, G F Cooper 1
PMCID: PMC2233210  PMID: 8947733

Abstract

Improvement in the performance of reminder systems may be facilitated by the use of new representations. A decision-theoretic representation, for example, may enable a reminder system to represent and reason about the probabilities that a reminder will be a true or a false alarm and the relative utilities of these events. We extended a previously described decision-theoretic model to include such events. The model now represents explicitly the uncertainty, costs, and benefits of sending a reminder. We also extended the model to remove an assumption of reminder independence. As a step towards testing a hypothesis that this approach will support better performance than a rule-based approach, we analyzed a set of CARE rules and showed that our representation can represent these rules.

Full text

PDF
582

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Das A. K., Musen M. A. A comparison of the temporal expressiveness of three database query methods. Proc Annu Symp Comput Appl Med Care. 1995:331–337. [PMC free article] [PubMed] [Google Scholar]
  2. Fordham D., McPhee S. J., Bird J. A., Rodnick J. E., Detmer W. M. The Cancer Prevention Reminder System. MD Comput. 1990 Sep-Oct;7(5):289–295. [PubMed] [Google Scholar]
  3. Hogan W. R., Wagner M. M. Using belief networks to enhance sharing of medical knowledge between sites with variations in data accuracy. Proc Annu Symp Comput Appl Med Care. 1995:218–222. [PMC free article] [PubMed] [Google Scholar]
  4. Johnston M. E., Langton K. B., Haynes R. B., Mathieu A. Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research. Ann Intern Med. 1994 Jan 15;120(2):135–142. doi: 10.7326/0003-4819-120-2-199401150-00007. [DOI] [PubMed] [Google Scholar]
  5. Larsen R. A., Evans R. S., Burke J. P., Pestotnik S. L., Gardner R. M., Classen D. C. Improved perioperative antibiotic use and reduced surgical wound infections through use of computer decision analysis. Infect Control Hosp Epidemiol. 1989 Jul;10(7):316–320. doi: 10.1086/646035. [DOI] [PubMed] [Google Scholar]
  6. Litzelman D. K., Dittus R. S., Miller M. E., Tierney W. M. Requiring physicians to respond to computerized reminders improves their compliance with preventive care protocols. J Gen Intern Med. 1993 Jun;8(6):311–317. doi: 10.1007/BF02600144. [DOI] [PubMed] [Google Scholar]
  7. Mc Donald C. J. Use of a computer to detect and respond to clinical events: its effect on clinician behavior. Ann Intern Med. 1976 Feb;84(2):162–167. doi: 10.7326/0003-4819-84-2-162. [DOI] [PubMed] [Google Scholar]
  8. McDonald C. J., Hui S. L., Smith D. M., Tierney W. M., Cohen S. J., Weinberger M., McCabe G. P. Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Ann Intern Med. 1984 Jan;100(1):130–138. doi: 10.7326/0003-4819-100-1-130. [DOI] [PubMed] [Google Scholar]
  9. McDonald C. J. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med. 1976 Dec 9;295(24):1351–1355. doi: 10.1056/NEJM197612092952405. [DOI] [PubMed] [Google Scholar]
  10. McDonald C. J., Tierney W. M., Overhage J. M., Martin D. K., Wilson G. A. The Regenstrief Medical Record System: 20 years of experience in hospitals, clinics, and neighborhood health centers. MD Comput. 1992 Jul-Aug;9(4):206–217. [PubMed] [Google Scholar]
  11. Ornstein S. M., Garr D. R., Jenkins R. G., Rust P. F., Arnon A. Computer-generated physician and patient reminders. Tools to improve population adherence to selected preventive services. J Fam Pract. 1991 Jan;32(1):82–90. [PubMed] [Google Scholar]
  12. Overhage J. M., Mamlin B., Warvel J., Warvel J., Tierney W., McDonald C. J. A tool for provider interaction during patient care: G-CARE. Proc Annu Symp Comput Appl Med Care. 1995:178–182. [PMC free article] [PubMed] [Google Scholar]
  13. Starren J. B., Hripcsak G., Jordan D., Allen B., Weissman C., Clayton P. D. Encoding a post-operative coronary artery bypass surgery care plan in the Arden Syntax. Comput Biol Med. 1994 Sep;24(5):411–417. doi: 10.1016/0010-4825(94)90010-8. [DOI] [PubMed] [Google Scholar]
  14. Starren J., Xie G. Comparison of three Knowledge Representation formalisms for encoding the NCEP Cholesterol Guidelines. Proc Annu Symp Comput Appl Med Care. 1994:792–796. [PMC free article] [PubMed] [Google Scholar]
  15. Wagner M. M., Cooper G. F. Decision-theoretic information pretrieval: a generalization of reminding. Proc Annu Symp Comput Appl Med Care. 1993:512–516. [PMC free article] [PubMed] [Google Scholar]
  16. Wagner M. M., Cooper G. F. Evaluation of a belief-network-based reminder system that learns from utility feedback. Proc Annu Symp Comput Appl Med Care. 1995:666–672. [PMC free article] [PubMed] [Google Scholar]

Articles from Proceedings of the AMIA Annual Fall Symposium are provided here courtesy of American Medical Informatics Association

RESOURCES