Clinical Knowledge Hub - Conceptual Integration of Rules, Data Sets, and Queries

临床知识中心 - 规则、数据集和查询的概念集成

• 批准号: 7655042
• 负责人: GUNTHER SCHADOW
• 金额: $ 25.49万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7655042
• 关键词: Academic Medical Centers; Accident and Emergency department; Adopted; Adoption; American; Australia; Automation; Back; Binding; Caring; Centers for Disease Control and Prevention (U.S.); Child health care; Classification; Clinical; Clinical Data; Clinical Decision Support Systems; Clinical Research; Code; Collaborations; Communities; Computers; Continuity of Patient Care; Data; Data Element; Data Set; Databases; Dictionary; Drug Interactions; Glomerular Filtration Rate; Goals; Health Care Costs; Individual; Informatics; Institutes; Institution; Knowledge; Language; Libraries; Logic; Logical Observation Identifiers Names and Codes; Malignant Neoplasms; Maps; Measures; Medical; Methodology; Methods; Modality; Modeling; Names; Netherlands; Online Systems; Pathology; Pharmaceutical Preparations; Plant Roots; Population; Product Labeling; Protocols documentation; Publishing; Research; Research Project Grants; Research Support; Resources; Semantics; Source; Structure; Surgical Pathology; System; Terminology; Testing; Translating; base; clinical care; clinically relevant; college; feeding; health care quality; improved; information organization; innovation; instrument; knowledge base; lexical; open source; software development; success; syntax; tool

DESCRIPTION (provided by applicant): This project aims at sharing clinical decision support (CDS) knowledge that has been proven in practice. CDS knowledge interchange standards have existed for as long as clinical data interchange standards (about 2 decades), yet sharing of computable, actionable knowledge in practice is extremely limited. Diverging forces abound in the highly innovative CDS research field and developed methods and content are deeply incompatible even though each piece may have been validated in practice. This project will impact the present CDS knowledge sharing impasse at its roots by creating, validating and refining a methodology for conceptual integration of CDS knowledge through systematic application on a large body of high value, practically validated, but incompatible resources. Initially a web-based Clinical Knowledge Library is established that will grow in contents and in its degree of integration. The contents include (i) the Regenstrief Institute's data dictionaries and complete CDS knowledge base; (ii) the published Columbia University Medical Center' Arden Syntax Medical Logic Modules (MLM), (iii) MLMs of the Child Health Improvement through Computer Automation (CHICA) system; (iv) FDA/NLM published Structured Product Labels (SPL) enhanced with the VA's NDF-RT medication knowledge base, (v) Clinical data sets and templates published by various continuity of care projects in the U.S., Netherlands, U.K. NHS, Australia, (vi) The CDC Data Elements for Emergency Departments, clinical LOINC panels, and other detailed clinical models, (vii) Cancer data protocols (e.g., College of American Pathology Cancer Protocols). Applications and tools for editing and adapting the content, as well as for implementation on a diverse set of systems will also be disseminated. The integration of content will reach all levels: (1) lexical integration, i.e., mapping of all idiosyncratic codes to standard terminologies; (2) syntactic integration across different representation languages including Arden Syntax Medical Logic Modules (MLM) and Regenstrief CARE and G-CARE languages; (3) semantic integration, including the transformation procedural knowledge (e.g., CARE and MLMs) into declarative ones (e.g., G- CARE); and finally (4) pragmatic integration across different knowledge modalities including (a) CDS reminder rules, (b) declarative CDS knowledge representations (e.g., drug-interaction tables), (c) definitions of calculated observation rules (e.g., glomerular filtration rate estimate), (d) clinical data sets, templates and assessment instruments, (e) healthcare quality measures, and (f) clinical research queries for both individual and population data. Thus widely useful CDS knowledge will be unlocked from its concrete representations, conceptualizations and applications, and adaptation and adoption will be simplified by the software developed and released in open source collaborations.

描述（由申请人提供）： 该项目旨在分享临床决策支持（CDS）知识，已在实践中得到证明。CDS知识交换标准的存在时间与临床数据交换标准一样长（约20年），但在实践中可计算、可操作的知识共享极为有限。分歧的力量比比皆是，在高度创新的CDS研究领域和发达国家的方法和内容是深刻的不兼容，即使每一块可能已经在实践中得到验证。该项目将影响目前的CDS知识共享僵局的根源，通过创建，验证和完善的CDS知识的概念整合的方法，通过系统的应用程序上的大量的高价值，实际验证，但不兼容的资源。最初，建立一个基于网络的临床知识库，其内容和整合程度将不断增长。内容包括（i）Regenstrief研究所的数据词典和完整的CDS知识库;（ii）哥伦比亚大学医学中心出版的Arden医学逻辑模块（MLM）;（iii）通过计算机自动化改善儿童健康（CHICA）系统的MLM;（iv）FDA/NLM发布的结构化产品标签（SPL），增强了VA的NDF-RT药物知识库，（v）美国各种护理连续性项目发布的临床数据集和模板，荷兰、英国NHS，澳大利亚，（vi）CDC急诊科数据元素，临床LOINC面板和其他详细的临床模型，（vii）癌症数据协议（例如，美国病理学院癌症方案）。还将传播用于编辑和调整内容以及在各种系统上实施的应用程序和工具。内容的整合将达到各个层面：（1）词汇整合，即，将所有特质代码映射到标准术语;（2）跨不同表示语言的句法集成，包括ArdenTM医学逻辑模块（MLM）和RegenstriefCARE和G-CARE语言;（3）语义集成，包括转换过程知识（例如，关怀和MLMs）转化为声明性的（例如，G-CARE）;以及最后（4）跨不同知识模态的实用集成，包括（a）CDS提醒规则，（B）声明性CDS知识表示（例如，药物相互作用表），（c）计算的观察规则的定义（例如，肾小球滤过率估计），（d）临床数据集、模板和评估工具，（e）医疗保健质量测量，以及（f）针对个体和群体数据的临床研究查询。因此，广泛有用的CDS知识将从其具体的表示，概念化和应用中解锁，并且通过在开源合作中开发和发布的软件来简化适应和采用。