Shahar Y, Miksch S, Johnson P
Section on Medical Informatics, Stanford University, CA 94305-5479, USA.
Artif Intell Med. 1998 Sep-Oct;14(1-2):29-51. doi: 10.1016/s0933-3657(98)00015-3.
Clinical guidelines can be viewed as generic skeletal-plan schemata that represent clinical procedural knowledge and that are instantiated and refined dynamically by care providers over significant time periods. In the Asgaard project, we are investigating a set of tasks that support the application of clinical guidelines by a care provider other than the guideline's designer. We are focusing on the application of the guideline, recognition of care providers' intentions from their actions, and critique of care providers' actions given the guideline and the patient's medical record. We are developing methods that perform these tasks in multiple clinical domains, given an instance of a properly represented clinical guideline and an electronic medical patient record. In this paper, we point out the precise domain-specific knowledge required by each method, such as the explicit intentions of the guideline designer (represented as temporal patterns to be achieved or avoided). We present a machine-readable language, called Asbru, to represent and to annotate guidelines based on the task-specific ontology. We also introduce an automated tool for the acquisition of clinical guidelines based on the same ontology, developed using the PROTEGE-II framework.
临床指南可被视为通用的框架性模式，它代表着临床程序知识，并在相当长的时间段内由医护人员动态地实例化和完善。在Asgaard项目中，我们正在研究一系列任务，这些任务支持除指南设计者之外的医护人员应用临床指南。我们专注于指南的应用、从医护人员的行为中识别其意图，以及根据指南和患者病历对医护人员的行为进行评判。给定一个正确表示的临床指南实例和一份电子医疗患者记录，我们正在开发能在多个临床领域执行这些任务的方法。在本文中，我们指出了每种方法所需的精确的特定领域知识，比如指南设计者的明确意图（表示为要实现或避免的时间模式）。我们提出一种名为Asbru的机器可读语言，用于基于特定任务的本体来表示和注释指南。我们还介绍了一种基于相同本体的临床指南获取自动化工具，该工具是使用PROTEGE-II框架开发的。
