Challenges in using the Arden Syntax for computer-based nosocomial infection surveillance.
BACKGROUND
Detection of outbreaks of infection in the hospital typically requires daily manual review of microbiology laboratory test results. This process is time-consuming, tedious, prone to error and may miss trends in infection. A standard formalism for procedural knowledge representation, the Arden Syntax, provides a vehicle for implementing algorithms for detecting such infections.


OBJECTIVE
To design and implement a computer-based system for detection of concerning patterns of infection or antibiotic resistance.


METHODS
Computer-based event monitor and central patient data repository at the Columbia-Presbyterian Medical Center (CPMC).


RESULTS
We designed a two-phase system, including initial filtering of individual patient laboratory results by Arden Syntax Medical Logic Modules (MLMs) and subsequent aggregation and analysis across patients and locations using a statistical monitor. Preliminary data for the filtration phase demonstrate a 94.8% reduction in the volume of messages that must be considered in surveillance.


CONCLUSIONS
Filtering raw laboratory results using a standard formalism eases the process of aggregating data across patients and sites as well as detecting trends in infection. There is a need for augmenting such formalisms in order to enable population-based decision support.
Jenders
R A
RA
Department of Medical Informatics, Columbia University, New York, NY, USA.
Shah
A
A
D000465:Algorithms; D003428:Cross Infection / Q000175:diagnosis*; D020000:Decision Support Systems, Clinical; D005103:Expert Systems; D006801:Humans; D011159:Population Surveillance / Q000379:methods*; D011381:Programming Languages