A multi-layered framework for disseminating knowledge for computer-based decision support

A multi-layered framework for disseminating knowledge for computer-based decision support
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DOI:
10.1136/amiajnl-2011-000334
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发表时间:
2011-12-01
影响因子:
6.4
通讯作者:
Middleton, Blackford
Middleton, Blackford
中科院分区:
管理学2区
文献类型:
--
作者:
Boxwala, Aziz A.;Rocha, Beatriz H.;Middleton, Blackford

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背景有几个挑战,在编码指南知识的形式,是便携式到不同的临床站点,包括异质性的临床决策支持(CDS)工具,患者数据表示,和workflows.Methods的,我们已经开发出一个多层次的知识表示框架结构化的指南建议,在各种CDS的上下文中实施。在这个框架中,指南建议越来越多地通过四个层次来构建,依次将叙述性文本建议转化为CDS系统的输入。我们已经使用这个框架来实现基于三个准则的CDS服务的规则。我们还进行了初步评估,在那里我们要求CDS专家在四个机构,以率的可实施性的六项建议,从三个guidelines.Conclusion在使用框架和初步评估的经验表明,这种方法有希望在创建结构化的知识,实施CDS系统,这是可用的跨组织。
Background There are several challenges in encoding guideline knowledge in a form that is portable to different clinical sites, including the heterogeneity of clinical decision support (CDS) tools, of patient data representations, and of workflows.Methods We have developed a multi-layered knowledge representation framework for structuring guideline recommendations for implementation in a variety of CDS contexts. In this framework, guideline recommendations are increasingly structured through four layers, successively transforming a narrative text recommendation into input for a CDS system. We have used this framework to implement rules for a CDS service based on three guidelines. We also conducted a preliminary evaluation, where we asked CDS experts at four institutions to rate the implementability of six recommendations from the three guidelines.Conclusion The experience in using the framework and the preliminary evaluation indicate that this approach has promise in creating structured knowledge, to implement in CDS systems, that is usable across organizations.