Placement of threaded devices, such as cages or bone dowels, was associated with a higher acute complication rate than was the placement of nonthreaded devices during anterior lumbar interbody fusion.

Abstract. Lately, there have been considerable efforts to computerize Clinical Practice Guidelines (CPG) so that they can be executed via Clinical Decision Support Systems (CDSS) at the point of care. We present a Semantic Web framework to both model and execute the knowledge within a CPG to develop knowledge-centric CDSS. Our approach entails knowledge modeling through a synergy between multiple ontologies-i.e. a domain ontology, CPG ontology and patient ontology. We develop decision-rules based on the ontologies, and execute them with a proof engine to derive CPG-based patient specific recommendations. We present a prototype of our CPG-based CDSS to execute the CPG for Follow-up after Treatment for Breast Cancer.

With the development of platforms enabling the integration and use of phenome, genome, and exposome data in the context of international research, data management challenges are increasing, and scalable solutions for cross border and cross domain semantic interoperability need to be developed. Reusing routinely collected clinical data, especially, requires computable portable phenotype algorithms running across different electronic health record (EHR) products and healthcare systems. We propose a framework for describing and comparing mediation platforms enabling cross border phenotype identification within federated EHRs. This framework was used to describe the experience gained during the EHR4CR project and the evaluation of the platform developed for accessing semantically equivalent data elements across 11 European participating EHR systems from 5 countries. Developers of semantic interoperability platforms are beginning to address a core set of requirements in order to reach the goal of developing cross border semantic integration of data.