Liyanage H, Liaw S-T, Kuziemsky C, Terry A L, Jones S, Soler J K, de Lusignan S
University of Surrey, Clinical Informatics & Health Outcomes research group, Department of Health Care Policy and Management, GUILDFORD, Surrey GU2 7XH, United Kingdom. E-mail:
Yearb Med Inform. 2013;8:147-54.
Most chronic diseases are managed in primary and ambulatory care. The chronic care model (CCM) suggests a wide range of community, technological, team and patient factors contribute to effective chronic disease management. Ontologies have the capability to enable formalised linkage of heterogeneous data sources as might be found across the elements of the CCM.
To describe the evidence base for using ontologies and other semantic integration methods to support chronic disease management.
We reviewed the evidence-base for the use of ontologies and other semantic integration methods within and across the elements of the CCM. We report them using a realist review describing the context in which the mechanism was applied, and any outcome measures.
Most evidence was descriptive with an almost complete absence of empirical research and important gaps in the evidence-base. We found some use of ontologies and semantic integration methods for community support of the medical home and for care in the community. Ubiquitous information technology (IT) and other IT tools were deployed to support self-management support, use of shared registries, health behavioural models and knowledge discovery tools to improve delivery system design. Data quality issues restricted the use of clinical data; however there was an increased use of interoperable data and health system integration.
Ontologies and semantic integration methods are emergent with limited evidence-base for their implementation. However, they have the potential to integrate the disparate community wide data sources to provide the information necessary for effective chronic disease management.
大多数慢性病在初级和门诊护理中进行管理。慢性病护理模式（CCM）表明，广泛的社区、技术、团队和患者因素有助于有效的慢性病管理。本体能够实现异构数据源的形式化链接，就像在CCM的各个要素中可能找到的那样。
描述使用本体和其他语义集成方法支持慢性病管理的证据基础。
我们回顾了在CCM要素内部和之间使用本体和其他语义集成方法的证据基础。我们使用现实主义综述报告它们，描述应用该机制的背景以及任何结果指标。
大多数证据是描述性的，几乎完全没有实证研究，证据基础存在重大差距。我们发现本体和语义集成方法在一定程度上用于社区对医疗之家的支持以及社区护理。部署了普及信息技术（IT）和其他IT工具来支持自我管理支持、共享登记册的使用、健康行为模型和知识发现工具，以改善交付系统设计。数据质量问题限制了临床数据的使用；然而，可互操作数据和卫生系统集成的使用有所增加。
本体和语义集成方法是新兴的，其实施的证据基础有限。然而，它们有潜力整合不同的社区范围数据源，以提供有效慢性病管理所需的信息。
