WDT3 Abbildung der Leitlinie Brennen beim Wasserlassen in GLIF

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1 WDT3 Abbildung der Leitlinie Brennen beim Wasserlassen in GLIF Andreas Gerst, Kristina Grunewald, Caspar Wehland

Protégé-2000 is a tool which allows the user to: construct a domain ontology customize data entry forms enter data a platform which can be extended with graphical widgets for

2 Protégé-2000 is a tool which allows the user to: construct a domain ontology customize data entry forms enter data a platform which can be extended with graphical widgets for tables, diagrams, animation components to access other knowledge-based systems embedded applications a library which other applications can use to access and display knowledge bases.

3 GuideLine Interchange Format A format for sharing clinical guidelines independent of platforms and systems Based on an object-oriented logical model of concepts Has an XML-based syntax (RDF Schema)

4 Guideline Abstraction Levels GLIF enables modeling gl in 3 levels of abstraction Level A: abstract flowchart. Gl at this level can be used for browsing and reading in gl viewing programs. Cannot be used for computation for decision support. Level B: computable level. Gl specified at Level B may be validated for logical consistency and completeness (not correctness). Level C: implementable level. Gl are appropriate for incorporation into institutional information system environments. (may have non-sharable concepts defined within them)

5 GLIF concepts 1. Guideline 2. Guideline steps 3. Complexity Management 4. Expressions 5. Data Model / Domain Ontology 6. Events and Exceptions 7. Supplemental Material

6 1. Guideline Root concept. A guideline has attributes fordefining the algorithm, guideline maintenance information, eligibility criteria, intention,didactics, exceptions for leaving the guideline, and the default viewer.

7 2. Guideline steps Action steps: recommendations for clinical actions to be performed e.g., Prescribe aspirin

8 2. Guideline steps Decision steps: decision criteria for conditional flowchart traversal e.g., if patient has pain then

9 2. Guideline steps (decision steps) Case Step represent a deterministic decision between guideline steps. Decision options are mutually exclusive. Choice Step represent a non-deterministic decision between guideline steps. Decision options are not necessarily mutually exclusive. If the condition matches more than one of a set of values specified by the choices, a person will have to determine the next guideline step at runtime.

10 2. Guideline steps Branch and synchronization steps: Allow concurrency

11 2. Guideline steps Patient-state step: characterizes patient s clinical state

12 3. Complexity Managment 3 mechanisms to manage the complexity of guidelines 1. Nesting 2. Views 3. Macros

13 3. Complexity Managment Nesting

14 3. Complexity Managment Views control the amount of detail displayed by default for each viewer A macro step represents a pattern that often appears in guidelines and is equivalent to a sequence of non-macro GLIF steps

15 4. Expressions GLIF supports specification of different types of expressions: criteria, temporal expression, list expression, numerical expression and string expression. Based on Arden Syntax.

16 5. Data Model / Domain Ontology is organized into 3 layers: -Core GLIF -RIM-Reference Information Model -Medical Ontology

17 6. Events and exceptions Action steps and decision steps have an attribute, called triggering_events, which specifies what events trigger the start of the step Action steps and decision steps and the guideline class have an attribute, called exceptions, which specifies an exception-event that should be checked for during execution. -(guarding) condition - next step.

18 7. Supplemental material -Local_Material that points to locally stored material -WWW_Material that references a URL -Keyword_Didactic that is used to reference keywords that can be used for search purposes.

19 Ansatz der Modellierung Grundlage: Kurzfassung der LL Identifikation der Elemente im Hinblick auf GLIFs Modellierungsmöglichten Aktionen (Anamnese, Untersuchungen, Therapie), deren Bedingungen (Geschlecht, Schwangerschaft, Testergebnisse) Entscheidungsbaum

20 Vorgehen bei der Umsetzung Orientierung an Beispielen Ziemlich planlos Zusammenfassen gleicher Elemente Verfeinerung der Entscheidungsstruktur Iterativ

21 Übersicht

22 Action step programming oriented action

23 Branch/synchronization steps

24 Decision step decision option

25 Action step - Subguideline

26 Nutzungsmöglichkeiten GuideLine Execution Engine (GLEE) für GLIF3 Integration/Austausch in andere Systeme Demonstration Medical education Guideline development and testing

27 Einschränkungen der Repräsentation Keine bedingten branch-steps? Decision options: RuleIns müssen sich gegenseitig ausschliessen

28 Probleme 100 Seiten technische Spezifikation Protege als authoring tool teilweise unübersichtlich Keine Beispiele zur aktuellen Version von GLIF

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