Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California 92093-0728, USA.
J Am Med Inform Assoc. 2011 Dec;18 Suppl 1(Suppl 1):i132-9. doi: 10.1136/amiajnl-2011-000334. Epub 2011 Nov 3.
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.
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.
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.
将指南知识编码为可移植到不同临床地点的形式存在一些挑战，包括临床决策支持 (CDS) 工具、患者数据表示和工作流程的异质性。
我们开发了一个多层知识表示框架，用于为在各种 CDS 环境中实施的指南建议进行结构化。在这个框架中，指南建议通过四个层次逐渐进行结构化，将叙述性文本建议逐步转换为 CDS 系统的输入。我们使用这个框架为基于三个指南的 CDS 服务实施规则。我们还进行了初步评估，邀请了四个机构的 CDS 专家对三个指南中的六个建议的可实施性进行评分。
使用该框架的经验和初步评估表明，这种方法在创建可用于跨组织的 CDS 系统的结构化知识方面具有很大的潜力。
