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Towards a Machine-Understandable Model Representing the Medical Decision


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DOI: https://doi.org/10.15866/iremos.v13i3.18695

Abstract


The aim of this paper is to represent the medical decision in an understandable machine format. This representation is made possible by exploiting the powerful expressivity of semantic web languages. A major obstacle in modeling a medical decision is the frequent lack of evidence; it is usually based on the intuition and expertise of clinical practitioners. Therefore, Evidence-Based Medicine is a real solution to this problem. It is a medical approach created to make medicine an evidence-based science, like mathematics and physics. The result of this work is an OWL ontology presented in the Visual Notation for OWL Ontologies. This ontology represents the new format called Ontological Medical Decision Format and models medical decisions using an evidence-based approach. Unlike related works and in addition to being machine understandable, the proposed format allows a global representation of an evidence-based decision and enables Clinical Decision Support Systems to reach proven and justified decisions. The ontology development and evaluation process is also detailed.
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Keywords


Clinical Decision Support Systems; Clinical Model; Evidence Based Medicine; Knowledge Representation; Ontology; Semantic Web

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References


Health Level Seven International, HL7 Version 3 Standard: Virtual Medical Record (vMR) Logical Model, September 2018. http://www.hl7.org/implement/standards/product_brief.cfm?product_id=338

openEHR Foundation, openEHR Architecture Overview, January 2020. http://www.openehr.org/releases/BASE/latest/docs/architecture_overview/architecture_overview.html

Health Level Seven International, CDA® Release 2, June 2010. http://www.hl7.org/implement/standards/product_brief.cfm?product_id=7

Health Level Seven International, Health Level Seven Arden Syntax for Medical Logic Systems - Version 2.10, November 2014. http://www.hl7.org/implement/standards/product_brief.cfm?product_id=372

W3C OWL Working Group, Web Ontology Language (OWL), December 2012. https://www.w3.org/OWL

Evidence-Based Medicine Working Group, Evidence-based medicine. A new approach to teaching the practice of medicine, Jama, Vol. 268(Issue 17):2420-2425, November 1992.
https://doi.org/10.1001/jama.268.17.2420

D. Sackett and W. Rosenberg, The need for evidence-based medicine, Journal of the Royal Society of Medicine, Vol. 88(Issue 11):620-524, November 1995.

J. Brank, M. Grobelnik, D. Mladenić, A survey of ontology evaluation techniques, Conference on Data Mining and Data Warehouses (SiKDD 2005), pp. 166-170, Citeseer Ljubljana, Slovenia, October 2005.

J. Yu, J.A. Thom, A. Tam, Ontology evaluation using wikipedia categories for browsing, 16th ACM Conference on information and knowledge management (CIKM07), pp. 223-232, Lisbon, Portugal, November 2007.
https://doi.org/10.1145/1321440.1321474

T.R. Gruber, Toward principles for the design of ontologies used for knowledge sharing?, International journal of human-computer studies, Vol. 43(Issue 5-6):907-928, November 1995.
https://doi.org/10.1006/ijhc.1995.1081

F. Boudin, J.-Y. Nie, M. Dawes, Positional language models for clinical information retrieval, 2010 Conference on Empirical Methods in Natural Language Processing, pp. 108-115, MIT, Cambridge, MA, USA, October 2010.

S. Lohmann, S. Negru, F. Haag, and T. Ertl, Visualizing ontologies with VOWL, Semantic Web, Vol. 7(Issue 4):399-419, May 2016.
https://doi.org/10.3233/sw-150200

S.A. Mussavirizi and A. Roudsari, A Survey of Standard Information Models for Clinical Decision Support Systems, Building Capacity for Health Informatics in the Future, Vol. 234:249-255, January 2017.

P.D. Johnson, S.W. Tu, M.A. Musen, I. Purves, A virtual medical record for guideline-based decision support, 2001 AMIA Symposium, pp. 294-298, Washington, USA, November 2001.

C. Marcos, A. González-Ferrer, M. Peleg, and C. Cavero, Solving the interoperability challenge of a distributed complex patient guidance system: a Data integrator based on HL7’s virtual medical record standard, Journal of the American Medical Informatics Association, Vol. 22(Issue 3):587-599, May 2015.
https://doi.org/10.1093/jamia/ocv003

H. Kashfi, R. Jairo Jr, Towards a Case-Based Reasoning Method for openEHR-Based Clinical Decision Support, 3rd International Workshop on Knowledge Representation for Health Care (KR4HC’11), pp. 182-195, Bled, Slovenia, July 2011.

G. Hripcsak, P. Ludemann, T.A. Pryor, O.B. Wigertz, and P.D. Clayton, Rationale for the Arden syntax, Computers and Biomedical Research, Vol. 27(Issue 4):291-324, August 1994.
https://doi.org/10.1006/cbmr.1994.1023

G. Hripcsak, Writing Arden Syntax medical logic modules, Computers in biology and medicine, Vol. 24(Issue 5):331-363, September 1994.
https://doi.org/10.1016/0010-4825(94)90002-7

M. Samwald, K. Fehre, J. De Bruin, and K.-P. Adlassnig, The Arden Syntax standard for clinical decision support: Experiences and directions, Journal of biomedical informatics, Vol. 45(Issue 4):711-718, August 2012.
https://doi.org/10.1016/j.jbi.2012.02.001

M. Sordo, A.A. Boxwala, O. Ogunyemi, and R.A. Greenes, Description and status update on GELLO: a proposed standardized object-oriented expression language for clinical decision support, Studies in Health Technology and Informatics, Vol. 107:164-168, 2004.

J. Fox, N. Johns, A. Rahmanzadeh, and R. Thomson, PROforma: A method and language for specifying clinical guidelines and protocols, Studies in Health Technology and Informatics, Vol. 34:516-520, 1996.

A.A. Boxwala et al., GLIF3: a representation format for sharable computer-interpretable clinical practice guidelines, Journal of biomedical informatics, Vol. 37(Issue 3):147-161, June 2004.
https://doi.org/10.1016/j.jbi.2004.04.002

J. Fox, N. Johns, and A. Rahmanzadeh, Disseminating medical knowledge: the PROforma approach, Artificial intelligence in medicine, Vol. 14(Issue 1-2):157-182, October 1998.
https://doi.org/10.1016/s0933-3657(98)00021-9

M.A. Musen, S.W. Tu, A.K. Das, and Y. Shahar, EON: A component-based approach to automation of protocol-directed therapy, Journal of the American Medical Informatics Association, Vol. 3(Issue 6):367-388, December 1996.
https://doi.org/10.1136/jamia.1996.97084511

Y. Shahar, S. Miksch, and P. Johnson, The Asgaard project: a task-specific framework for the application and critiquing of time-oriented clinical guidelines, Artificial intelligence in medicine, Vol. 14(Issue 1-2):29-51, October 1998.
https://doi.org/10.1016/s0933-3657(98)00015-3

M. Peleg et al., GLIF3: the evolution of a guideline representation format, 2000 AMIA Symposium, pp. 645-649, Los Angeles, USA, November 2000.

J. Bury, J. Fox, and D. Sutton, The PROforma guideline specification language: progress and prospects, Studies in Health Technology and Informatics, Vol. 12(Issue 83):13-29, January 2001.

D.M. Pisanelli, A. Gangemi, G. Steve, The role of ontologies for an effective and unambiguous dissemination of clinical guidelines, 12th International Conference on Knowledge Engineering and Knowledge Management (EKAW 2000), pp. 129-139, Juan-les-Pins, France, October 2000.
https://doi.org/10.1007/3-540-39967-4_10

A. Seyfang, S. Miksch, and M. Marcos, Combining diagnosis and treatment using Asbru, International Journal of Medical Informatics, Vol. 68(Issue 1-3):49-57, December 2002.
https://doi.org/10.1016/s1386-5056(02)00064-3

O. Mohammed and R. Benlamri, Developing a semantic web model for medical differential diagnosis recommendation, Journal of medical systems, Vol. 38(Issue 10):79-97, October 2014.
https://doi.org/10.1007/s10916-014-0079-0

R.-C. Chen, H.Q. Jiang, C.-Y. Huang, and C.-T. Bau, Clinical Decision Support System for Diabetes Based on Ontology Reasoning and TOPSIS Analysis, Journal of Healthcare Engineering, Vol. 2017(Issue 5):1-14, October 2017.
https://doi.org/10.1155/2017/4307508

M. Krishnamurthy, P. Marcinek, K.M. Malik, and M. Afzal, Representing social network patient data as evidence-based knowledge to support decision making in disease progression for comorbidities, IEEE Access, Vol. 6:12951-12965, February 2018.
https://doi.org/10.1109/access.2018.2810702

S. Hussain, S.R. Abidi, S.S.R. Abidi, Semantic web framework for knowledge-centric clinical decision support systems, 11th Conference on Artificial Intelligence in Medicine (AIME 2007), pp. 451-455, Amsterdam, The Netherlands, July 2007.
https://doi.org/10.1007/978-3-540-73599-1_60

R.F. Alharbi, J. Berri, S. El-Masri, Ontology based clinical decision support system for diabetes diagnostic, 2015 Science and Information Conference (SAI), pp. 597-602, London, UK, July 2015.
https://doi.org/10.1109/sai.2015.7237204

A. Galopin, J. Bouaud, S. Pereira, and B. Séroussi, An Ontology-Based Clinical Decision Support System for the Management of Patients with Multiple Chronic Disorders, Studies in Health Technology and Informatics, Vol. 216:275-279, January 2015.

D. Giet, General medicine: is it concerned with EBM?, Revue medicale de Liege, Vol. 55(Issue 4):239-243, April 2000.

W. Rosenberg and A. Donald, Evidence based medicine: an approach to clinical problem-solving, BMJ: British Medical Journal, Vol. 310(Issue 6987):1122-1126, April 1995.
https://doi.org/10.1136/bmj.310.6987.1122

D. Sackett, S. Straus, W. Scott Richardson, W. Rosenberg, R. Haynes, Evidence-Based Medicine: How to Practice and Teach EBM (Churchill Livingstone, 2000).
https://doi.org/10.1177/088506660101600307

H.S. Grover, S. Kapoor, and N. Kaushik, Evidence Based Practice-Need Of An Hour, Journal of Advanced Medical and Dental Sciences Research, Vol. 3(Issue 1):96-105, March 2015.

M. Staunton, Evidence-based radiology: steps 1 and 2—asking answerable questions and searching for evidence, Radiology, Vol. 242(Issue 1):23-31, January 2007.
https://doi.org/10.1148/radiol.2421052135

N. Lai, Evidence Based Medicine Series: Asking Focused Answerable Clinical Questions, Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia, Vol. 4(Issue 1):23-25, April 2009.

F. Aminpour, Research performance of Isfahan University of Medical Sciences in 1385 (April 2006-March 2007), Journal of research in Medical Sciences, Vol. 12(Issue 6):308-314, November 2007.

K.N. Lohr, M.J. Field, Clinical Practice Guidelines: Directions for a New Program (National Academies Press, 1990).

World Health Organization, WHO Guideline Development for Handbook. (World Health Organization, 2014).

A.K. Akobeng, Principles of evidence based medicine, Archives of disease in childhood, Vol. 90(Issue 8):837-840, August 2005.
https://doi.org/10.1136/adc.2005.071761

G.E. Gray, Concise Guide to Evidence-Based Psychiatry (American Psychiatric Pub, 2008).

D. Taniar, Web Semantics & Ontology (Igi Global, 2006).

M. Rani, A.K. Dhar, and O. Vyas, Semi-automatic terminology ontology learning based on topic modeling, Engineering Applications of Artificial Intelligence, Vol. 63:108-125, August 2017.
https://doi.org/10.1016/j.engappai.2017.05.006

D. L. McGuinness, F. Van Harmelen, OWL web ontology language overview, February 2004. http://www.w3.org/TR/owl-features

P. Hitzler, M. Krotzsch, S. Rudolph, Foundations of Semantic Web Technologies (CRC press, 2009).
https://doi.org/10.1201/9781420090512

P. Beeson, D. Kortenkamp, R.P. Bonasso, A. Persson, A. Loutfi, J.P. Bona, An ontology-based symbol grounding system for human-robot interaction, AAAI 2014 Fall Symposium Series, pp. 13-15, Arlington, MA, USA, November 2014.

P.D. Haghighi, F. Burstein, A. Zaslavsky, and P. Arbon, Development and evaluation of ontology for intelligent decision support in medical emergency management for mass gatherings, Decision Support Systems, Vol. 54(Issue 2):1192-1204, January 2013.
https://doi.org/10.1016/j.dss.2012.11.013

D. Jin, P. Szolovits, PICO Element Detection in Medical Text via Long Short-Term Memory Neural Networks, BioNLP 2018 workshop, pp. 67-75, Melbourne, Australia, July 2018.
https://doi.org/10.18653/v1/w18-2308

S.N. Kim, D. Martinez, L. Cavedon, and L. Yencken, Automatic classification of sentences to support evidence based medicine, BMC bioinformatics, Vol. 12:S5, March 2011.
https://doi.org/10.1186/1471-2105-12-s2-s5

P. Davis-Desmond, D. Mollá, Detection of evidence in clinical research papers, 5th Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2012), Vol. 129, pp. 13-20, Melbourne, Australia, January-February 2012.

J. Yu, Requirements-Oriented Methodology for Evaluating Ontologies, Ph.D. dissertation, School of Computer Science and Information Technology, RMIT Univ., Melbourne, Australia, 2008.


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