Georg Georg, Séroussi Brigitte, Bouaud Jacques
Mission Recherche en Sciences et Technologies de l'Information Médicale, DPA / DSI / AP-HP & INSERM ERM 202, UFR Broussais - Hôtel-Dieu, Paris, France.
AMIA Annu Symp Proc. 2003;2003:254-8.
The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to standardize the terms used to characterize clinical situations, we created the GEM-encoded instance of the guideline. We developed a module for the automatic derivation of a rule base, BR-GEM, from the instance. BR-GEM was then compared to the rule base, BR-ASTI, embedded within the critic mode of ASTI, and manually built by two physicians from the same Canadian guideline. As compared to BR-ASTI, BR-GEM is more specific and covers more clinical situations. When evaluated on 10 patient cases, the GEM-based approach led to promising results.
这项工作的目的是确定基因编码步骤是否能够改善临床实践指南作为形式化知识库的表现。我们采用了1999年加拿大高血压管理建议，将其选为ASTI项目的知识来源。我们首先通过提出治疗策略的解释框架，澄清了指南中推荐的治疗序列的语义模糊性。然后，在进行形式化步骤以规范用于描述临床情况的术语之后，我们创建了该指南的基因编码实例。我们开发了一个模块，用于从该实例自动推导规则库BR-GEM。然后将BR-GEM与嵌入在ASTI批评模式中的规则库BR-ASTI进行比较，BR-ASTI是由两名医生根据同一加拿大指南手动构建的。与BR-ASTI相比，BR-GEM更具体，涵盖更多临床情况。在对10个患者病例进行评估时，基于基因编码的方法取得了令人鼓舞的结果。
