Development of an expert system knowledge base: a novel approach to promote guideline congruent asthma care.
Existing guidelines for the clinical management of asthma provide a good framework for such tasks as diagnosing asthma, determining severity, and prescribing pharmacological treatment. Guidance is less explicit, however, about establishing a patient-provider partnership and overcoming barriers to asthma management by patients in a way that can be easily adopted in clinical practice. We report herein the first developmental phase of the "Stop Asthma" expert system. We describe the establishment of a knowledge base related to both the clinical management of asthma and the enhancement of patient and family self-management (including environmental management). The resultant knowledge base comprises 142 multilayered decision rules that describe clinical and behavioral management in three domains: 1) determination of asthma severity and control; 2) pharmacotherapy, including prescription of medicine for chronic maintenance, acute exacerbation, exercise pretreatment, and rhinitis relief; and 3) patient self-management, including the process of intervening to facilitate the patient's asthma medication management, environmental control, and well-visit scheduling. The knowledge base provides a systematic and accessible approach for intervening with family asthma-related behaviors.
Shegog
R
R
University of Texas, Houston, Texas 77225, USA. ross.shegog@uth.tmc.edu
Bartholomew
L K
LK
Czyzewski
D I
DI
Sockrider
M M
MM
Craver
J
J
Pilney
S
S
Mullen
P D
PD
Koeppl
P
P
Gold
R S
RS
Fernandez
M
M
Abramson
S L
SL
D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D020000:Decision Support Systems, Clinical; D005103:Expert Systems; D019983:Guideline Adherence; D015438:Health Behavior; D006801:Humans; D019359:Knowledge; D017410:Practice Guidelines as Topic; D012648:Self Care; D012720:Severity of Illness Index