title: Challenges in using the Arden Syntax for computer-based nosocomial infection surveillance.
abstract: 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.
authors.affiliation: Department of Medical Informatics, Columbia University, New York, NY, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Jenders
authors.forename: A
authors.initials: A
authors.lastname: Shah
mesh_terms: 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