The Arden Syntax standard for clinical decision support: Experiences and directions

Abstract

Arden Syntax is a widely recognized standard for representing clinical and scientific knowledge in an executable format. It has a history that reaches back until 1989 and is currently maintained by the Health Level 7 (HL7) organization. We created a production-ready development environment, compiler, rule engine and application server for Arden Syntax. Over the course of several years, we have applied this Arden - Syntax - based CDS system in a wide variety of clinical problem domains, such as hepatitis serology interpretation, monitoring of nosocomial infections or the prediction of metastatic events in melanoma patients. We found the Arden Syntax standard to be very suitable for the practical implementation of CDS systems. Among the advantages of Arden Syntax are its status as an actively developed HL7 standard, the readability of the syntax, and various syntactic features such as flexible list handling. A major challenge we encountered was the technical integration of our CDS systems in existing, heterogeneous health information systems. To address this issue, we are currently working on incorporating the HL7 standard GELLO, which provides a standardized interface and query language for accessing data in health information systems. We hope that these planned extensions of the Arden Syntax might eventually help in realizing the vision of a global, interoperable and shared library of clinical decision support knowledge.

A fuzzy-ontology-oriented case-based reasoning framework for semantic diabetes diagnosis

“…It can convert CPGs into actionable rules to implement rule-based CDSS systems. Samwald et al [25] proposed a development environment including a compiler and rule engine for Arden Syntax rules. However, diabetes diagnosis is an ill-formed, theory-less, and experience based problems.…”

Recommendations Service for Chronic Disease Patient in Multimodel Sensors Home Environment

“…Recently HL7 has published HL7 Arden Syntax version 2.8 for future enhancements. 18 Arden Syntax provides a standard base format that resembles natural language without dependency on a common programing language and any particular implementation of a specific healthcare system. This key feature turns to make it easier in understanding for nonexperts.…”

“…Moreover, the nondependency on healthcare systems makes it feasible to exchange clinical decision support knowledge across different systems and sites. 18 Arden Syntax focuses on representing knowledge bases in sets of Medical Logic Modules (MLMs). It helps in representing independent rules, formulas, or protocols in an amenable set of MLMs.…”

“…Finally, the clinical workflow was transformed into shareable clinical knowledge using HL7 Arden Syntax. 18 …”

Context Representation and Fusion: Advancements and Opportunities

“…Based on their social media interactions and activities, the system generates intelligent recommendations. The system presented in [45] was deployed in an Intensive Care Unit (ICU). It was connected to the microbiology lab and patient management system.…”