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INTELLIGENT CRITIQUING OF CLINICAL-GUIDELINE APPLICATION

对临床指南应用的智能批评

基本信息

批准号：
6637556
负责人：
MARY K. Goldstein
金额：
$ 27.92万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-04-01 至 2005-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6637556
关键词：
artificial intelligence behavioral /social science research tag clinical research computer assisted medical decision making computer system design /evaluation experimental designs health care quality health services research tag human data medical records vocabulary development for information system

项目摘要

Clinical guidelines are a powerful method for standardization and uniform improvement of the quality of medical care. In the proposed research project, which we call Asgaard/DeGel, we will design and implement software solutions that support the design, application, and, in particular, quality assessment of the application of clinical guidelines by care providers. Our long-term objectives include provision of a standardized computational framework for specification, application, and runtime as well as retrospective quality assessment of clinical-guidelines. We will provide these solutions by using a novel framework for specification and interpretation of clinical guidelines. The new framework encodes explicitly both the therapeutic actions indicated by the guideline and the intermediate clinical process and outcome goals of the guideline designers, which we refer to as intentions. Intentions are represented as temporal patterns of care-provider actions or patient states to be maintained, achieved or avoided, using results from our previous work on interpretation and summarization of time-oriented clinical data. Intentions include both the intermediate and overall process pattern (care provider actions) to follow and the expected intermediate and final outcome pattern (patient states). The tasks that we are focusing on include (1) design-time tasks, such as specification, validation, and verification of the guideline, and (2) runtime tasks such as automated support to application of the guideline, recognition of care providers' intentions from their actions, and real-time as well as retrospective critiquing and quality assessment of care providers' application of he guideline, given the guideline and its intentions, the patient's medical record, and the analysis of the care provider's perceived intentions. In our previous work, we have designed a formal, machine-interpretable language, called Asbru, to represent and to annotate guidelines based on our framework, and implemented a small prototype interpreter for it. We will implement a full interpreter for the Asbru language and a set of software tools for specification, validation, and verification of Asbru guidelines. We will also design and implement a set of computational methods for runtime (during application) and retrospective quality assessment of clinical guideline application, both for individual patients and for populations of patients, using our intention-based model. We will rigorously test, validate, and evaluate our methodologies using collaborators in clinical areas such as oncology, hypertension, and endocrinology.

临床指南是标准化和统一提高医疗质量的有力方法。在拟议的研究项目（我们称之为 Asgaard/DeGel）中，我们将设计和实施软件解决方案，以支持护理提供者对临床指南应用的设计、应用，特别是质量评估。我们的长期目标包括为规范、应用和运行时间以及临床指南的回顾性质量评估提供标准化计算框架。我们将通过使用新颖的临床指南规范和解释框架来提供这些解决方案。新框架明确编码了指南所指示的治疗行为以及指南设计者的中间临床过程和结果目标，我们将其称为意图。意图被表示为护理人员行动的时间模式或要维持、实现或避免的患者状态，使用我们之前对面向时间的临床数据的解释和总结工作的结果。意图包括要遵循的中间和整体过程模式（护理提供者行动）以及预期的中间和最终结果模式（患者状态）。我们重点关注的任务包括（1）设计时任务，例如指南的规范、验证和验证，以及（2）运行时任务，例如对指南应用的自动支持、从护理提供者的行为中识别护理提供者的意图，以及根据指南及其意图、患者的医疗记录和患者的医疗记录，对护理提供者对指南的应用进行实时和回顾性批评和质量评估。分析护理提供者的感知意图。在我们之前的工作中，我们设计了一种正式的、机器可解释的语言，称为 Asbru，来表示和注释基于我们的框架的指南，并为其实现了一个小型原型解释器。我们将为 Asbru 语言实现一个完整的解释器，以及一套用于 Asbru 指南规范、验证和验证的软件工具。我们还将使用我们基于意图的模型，为个体患者和患者群体设计和实施一套用于运行时（应用期间）和回顾性质量评估的计算方法。我们将与肿瘤学、高血压和内分泌学等临床领域的合作者一起严格测试、验证和评估我们的方法。

项目成果

期刊论文数量（25）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A multiple-ontology customizable search interface for retrieval of clinical guidelines.

用于检索临床指南的多本体可定制搜索界面。

DOI：
发表时间：
2004
期刊：
Studies in health technology and informatics.
影响因子：
0
作者：
Moskovitch,Robert;Shahar,Yuval
通讯作者：
Shahar,Yuval

The Digital electronic Guideline Library (DeGeL): a hybrid framework for representation and use of clinical guidelines.

数字电子指南库 (DeGeL)：用于表示和使用临床指南的混合框架。

DOI：
发表时间：
2004
期刊：
Studies in health technology and informatics.
影响因子：
0
作者：
Shahar,Yuval;Young,Ohad;Shalom,Erez;Mayaffit,Alon;Moskovitch,Robert;Hessing,Alon;Galperin,Maya
通讯作者：
Galperin,Maya

Medical informatics: between science and engineering, between academia and industry.

医学信息学：科学与工程之间、学术界与工业界之间。

DOI：
发表时间：
2002
期刊：
Methods of information in medicine
影响因子：
1.7
作者：
Shahar,Y
通讯作者：
Shahar,Y

A Web-Based system for interactive visualization and exploration of time-oriented clinical data and their abstractions.

一个基于网络的系统，用于交互式可视化和探索面向时间的临床数据及其抽象。

DOI：
发表时间：
2003
期刊：
AMIA ... Annual Symposium proceedings. AMIA Symposium
影响因子：
0
作者：
Shahar,Yuval;Boaz,David;Tahan,Gil;Galperin,Maya;Goren-Bar,Dina;Kaizer,Herbert;Basso,LawrenceV;Martins,SusanaB;Goldstein,MaryK
通讯作者：
Goldstein,MaryK

A distributed, collaborative, structuring model for a clinical-guideline digital-library.

临床指南数字图书馆的分布式协作结构化模型。

DOI：
发表时间：
2003
期刊：
AMIA ... Annual Symposium proceedings. AMIA Symposium
影响因子：
0
作者：
Shahar,Yuval;Shalom,Erez;Mayaffit,Alon;Young,Ohad;Galperin,Maya;Martins,Susana;Goldstein,Mary
通讯作者：
Goldstein,Mary