Madhusanka Sajith, Walisadeera Anusha, Dantanarayana Gilmini, Goonetillake Jeevani, Ginige Athula
Department of Computer Science, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka.
Department of Information Systems Engineering, University of Colombo School of Computing, University of Colombo, Colombo 00700, Sri Lanka.
Healthcare (Basel). 2020 Dec 18;8(4):573. doi: 10.3390/healthcare8040573.
Health professionals should follow the clinical guidelines to decrease healthcare costs to avoid unnecessary testing and to minimize the variations among healthcare providers. In addition, this will minimize the mistakes in diagnosis and treatment processes. To this end, it is possible to use Clinical Decision Support Systems that implement the clinical guidelines. Clinical guidelines published by international associations are not suitable for developing countries such as Sri Lanka, due to the economic background, lack of resources, and unavailability of some laboratory tests. Hence, a set of clinical guidelines has been formulated based on the various published international professional organizations from a Sri Lankan context. Furthermore, these guidelines are usually presented in non-computer-interpretable narrative text or non-executable flow chart formats. In order to fill this gap, this research study finds a suitable approach to represent/organize the clinical guidelines in a Sri Lankan context that is suitable to be used in a clinical decision support system. To this end, we introduced a novel approach which is an ontological model based on the clinical guidelines. As it is revealed that there are 4 million diabetes patients in Sri Lanka, which is approximately twenty percent of the total population, we used diabetes-related guidelines in this research. Firstly, conceptual models were designed to map the acquired diabetes-related clinical guidelines using Business Process Model and Notation 2.0. Two models were designed in mapping the diagnosis process of Type 1 and Type 2 Diabetes, and Gestational diabetes. Furthermore, several conceptual models were designed to map the treatment plans in guidelines by using flowcharting. These designs were validated by domain experts by using questionnaires. Grüninger and Fox's method was used to design and evaluate the ontology based on the designed conceptual models. Domain experts' feedback and several real-life diabetic scenarios were used to validate and evaluate the developed ontology. The evaluation results show that all suggested answers based on the proposed ontological model are accurate and well addressed with respect to the real-world scenarios. A clinical decision support system was implemented based on the ontological knowledge base using the Jena Framework, and this system can be used to access the diabetic information and knowledge in the Sri Lankan context. However, this contribution is not limited to diabetes or a local context, and can be applied to any disease or any context.
医疗专业人员应遵循临床指南，以降低医疗成本，避免不必要的检查，并尽量减少医疗服务提供者之间的差异。此外，这将最大限度地减少诊断和治疗过程中的错误。为此，可以使用实施临床指南的临床决策支持系统。由于经济背景、资源匮乏以及一些实验室检查无法获得，国际协会发布的临床指南不适用于斯里兰卡等发展中国家。因此，基于斯里兰卡的背景，根据各种已发布的国际专业组织制定了一套临床指南。此外，这些指南通常以非计算机可解释的叙述文本或不可执行的流程图格式呈现。为了填补这一空白，本研究在斯里兰卡的背景下找到了一种合适的方法来表示/组织临床指南，以便在临床决策支持系统中使用。为此，我们引入了一种新颖的方法，即基于临床指南的本体模型。据透露，斯里兰卡有400万糖尿病患者，约占总人口的20%，因此我们在本研究中使用了与糖尿病相关的指南。首先，使用业务流程模型和符号2.0设计概念模型，以映射获取的糖尿病相关临床指南。在映射1型和2型糖尿病以及妊娠糖尿病的诊断过程时设计了两个模型。此外，还使用流程图设计了几个概念模型，以映射指南中的治疗计划。这些设计由领域专家通过问卷调查进行了验证。基于设计的概念模型，使用Grüninger和Fox的方法来设计和评估本体。领域专家的反馈和几个实际的糖尿病病例用于验证和评估所开发的本体。评估结果表明，基于所提出的本体模型的所有建议答案在实际场景方面都是准确且得到充分解决的。使用Jena框架基于本体知识库实现了一个临床决策支持系统，该系统可用于在斯里兰卡的背景下获取糖尿病信息和知识。然而，这一贡献不仅限于糖尿病或本地背景，还可应用于任何疾病或任何背景。
