A framework for a distributed, hybrid, multiple-ontology clinical-guideline library, and automated guideline-support tools

  • Authors:

  • Yuval Shahar;Ohad Young;Erez Shalom;Maya Galperin;Alon Mayaffit;Robert Moskovitch;Alon Hessing

  • Affiliations:

  • Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben Gurion University, Beer Sheva 84105, Israel

  • Venue:
  • Journal of Biomedical Informatics
  • Year:
  • 2004

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Abstract

Clinical guidelines are a major tool in improving the quality of medical care. However, most guidelines are in free text, not in a formal, executable format, and are not easily accessible to clinicians at the point of care. We introduce a Web-based, modular, distributed architecture, the Digital Electronic Guideline Library (DeGeL), which facilitates gradual conversion of clinical guidelines from text to a formal representation in chosen target guideline ontology. The architecture supports guideline classification, semantic markup, context-sensitive search, browsing, run-time application, and retrospective quality assessment. The DeGeL hybrM meta-ontology includes elements common to all guideline ontologies, such as semantic classification and domain knowledge; it also includes four content-representation formats: free text, semi-structured text, semi-formal representation, and a formal representation. These formats support increasingly sophisticated computational tasks. The DeGeL tools for support of guideline-based care operate, at some level, on all guideline ontologies. We have demonstrated the feasibility of the architecture and the tools for several guideline ontologies, including Asbru and GEM.