title: Does GEM-encoding clinical practice guidelines improve the quality of knowledge bases? A study with the rule-based formalism.
abstract: The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to standardize the terms used to characterize clinical situations, we created the GEM-encoded instance of the guideline. We developed a module for the automatic derivation of a rule base, BR-GEM, from the instance. BR-GEM was then compared to the rule base, BR-ASTI, embedded within the critic mode of ASTI, and manually built by two physicians from the same Canadian guideline. As compared to BR-ASTI, BR-GEM is more specific and covers more clinical situations. When evaluated on 10 patient cases, the GEM-based approach led to promising results.
authors.affiliation: Mission Recherche en Sciences et Technologies de l'Information Médicale, DPA / DSI / AP-HP & INSERM ERM 202, UFR Broussais - Hôtel-Dieu, Paris, France.
authors.forename: Georg
authors.initials: G
authors.lastname: Georg
authors.forename: Brigitte
authors.initials: B
authors.lastname: Séroussi
authors.forename: Jacques
authors.initials: J
authors.lastname: Bouaud
mesh_terms: D001185:Artificial Intelligence; D020000:Decision Support Systems, Clinical; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011381:Programming Languages; D018875:Vocabulary, Controlled