Merging Disease-Specific Clinical Guidelines to Handle Comorbidities in a Clinical Decision Support Setting

Jafarpour, Borna

doi:10.1007/978-3-642-38326-7_5

Cited by 29 publications

(27 citation statements)

References 5 publications

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“…The problem of automated detection and resolution of pathway conflicts in patients with multimorbidity is gaining considerable attention. In [9], ontologies are used to represent pathways, with one additional ontology (Merge Representation Ontology, MRO) created by interviewing clinicians to identify merging criteria, and instantiated to find merge points of two given pathways. No information is given, however, on how adaptable the approach is and whether the instantiation process is automatic.…”

Section: Related Workmentioning

confidence: 99%

A Flexible Approach for Finding Optimal Paths with Minimal Conflicts

Bowles

Caminati

2017

Formal Methods and Software Engineering

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Abstract. Complex systems are usually modelled through a combination of structural and behavioural models, where separate behavioural models make it easier to design and understand partial behaviour. When partial models are combined, we need to guarantee that they are consistent, and several automated techniques have been developed to check this. We argue that in some cases it is impossible to guarantee total consistency, and instead we want to find execution paths across such models with minimal conflicts with respect to a certain metric of interest. We present an efficient and scalable solution to find optimal paths through a combination of the theorem prover Isabelle with the constraint solver Z3. Our approach has been inspired by a healthcare problem, namely how to detect conflicts between medications taken by patients with multiple chronic conditions, and how to find preferable alternatives automatically.

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Section: Related Workmentioning

confidence: 99%

A Flexible Approach for Finding Optimal Paths with Minimal Conflicts

Bowles

Caminati

2017

Formal Methods and Software Engineering

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“…Therapeutic plans and clinical guidelines are typically disease specific without clear recommendations for handling comorbidities (Jafarpour and Abidi 2013). There is concern that some decision support systems may in fact present harmful advice if they do not properly account for comorbidities (Fraccaro et al 2015).…”

Section: Mechanisms and Possible Heterogeneous Effects Of Emr Adoptionmentioning

confidence: 99%

Information Technology and Patient Health: Analyzing Outcomes, Populations, and Mechanisms

Freedman

Lin

Prince

2015

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We study the effect of hospital adoption of electronic medical records (EMRs) on health outcomes, particularly patient safety indicators (PSIs). We find evidence of a positive impact of EMRs on PSIs via decision support rather than care coordination. Consistent with this mechanism, we find an EMR with decision support is more effective at reducing PSIs for less complicated cases, using several different metrics for complication. These findings indicate the negligible impacts for EMRs found by previous studies focusing on the Medicare population and/or mortality do not apply in all settings.

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“…A model-based automatic merge of CIGs is then purposed in , through the definition of a combining operator. Jafarpour & Abidi (Jafarpour & Abidi 2013) use semantic-web rules and an ontology for the merging criteria. Given these, an Execution Engine dynamically merges several CIGs according to merge criteria.…”

Section: Related Work and Conclusionmentioning

confidence: 99%

Temporal Detection of Guideline Interactions

Piovesan

Anselma

Terenziani

2015

Proceedings of the International Conference on Health Informatics

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Abstract:Clinical practice guidelines are widely used to support physicians, but only on individual pathologies. On the other hand, the treatment of patients affected by multiple diseases is one of the main challenges for the modern healthcare. This requires the development of new methodologies, supporting physicians in the detection of interactions between guidelines. In a previous work, we proposed a flexible and user-driven approach, helping physicians in the detection of possible interactions between guidelines, supporting focusing and analysis at multiple levels of abstractions. However, it did not cope with the fact that interactions occur in time. For instance, the effects of two actions may potentially conflict, but practical conflicts happen only if such effects overlap in time. In this paper, we extend the ontological model to deal with the temporal aspects, and the detection algorithms to cope with them. Different types of facilities are provided to physicians, supporting the analysis of interactions between both guidelines "per se", and the concrete application of guidelines to specific patients. In both cases, different temporal facilities are provided to user physicians, based on Artificial Intelligence temporal reasoning techniques.

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Merging Disease-Specific Clinical Guidelines to Handle Comorbidities in a Clinical Decision Support Setting

Cited by 29 publications

References 5 publications

A Flexible Approach for Finding Optimal Paths with Minimal Conflicts

A Flexible Approach for Finding Optimal Paths with Minimal Conflicts

Information Technology and Patient Health: Analyzing Outcomes, Populations, and Mechanisms

Temporal Detection of Guideline Interactions

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