Miller D W, Frawley S J, Miller P L
Center for Medical Informatics, Yale University School of Medicine, New Haven, CT 06520-8009, USA.
Comput Methods Programs Biomed. 1999 Mar;58(3):267-80. doi: 10.1016/s0169-2607(98)00090-x.
The paper describes Commander, a prototype computer program designed to help verify the completeness of a computer-based clinical practice guideline built using if then rules. It also describes the application of Commander to a guideline for childhood immunization. Commander is designed to help identify incomplete rule sets, where there are clinically meaningful conditions to which the guideline does not respond. To allow this, the user defines semantic constraints, in the form of if-then statements, which indicate combinations of conditions which are not meaningful. In an iterative process, Commander takes the guideline rules, together with an increasingly refined set of constraints and helps focus in on any combinations of conditions to which the guideline does not respond. When applied to the clinical guideline for childhood immunization, Commander was able to dramatically reduce the number of potential combinations of conditions for consideration and also identified several areas of incompleteness in the rules.
本文介绍了“指挥官”（Commander），这是一个原型计算机程序，旨在帮助验证使用if-then规则构建的基于计算机的临床实践指南的完整性。本文还描述了“指挥官”在儿童免疫接种指南中的应用。“指挥官”旨在帮助识别不完整的规则集，即存在指南未响应的具有临床意义的情况。为了实现这一点，用户以if-then语句的形式定义语义约束，这些约束指示无意义的条件组合。在一个迭代过程中，“指挥官”将指南规则与一组日益完善的约束相结合，并帮助聚焦于指南未响应的任何条件组合。当应用于儿童免疫接种临床指南时，“指挥官”能够显著减少需要考虑的潜在条件组合数量，并识别出规则中的几个不完整区域。
