title: An integrated fuzzy logic and web-based framework for active protocol support.
abstract: OBJECTIVE
  To develop a general purpose web-based system for active support in using protocols.
  
  
  METHODS
  The conceptual model underlying the design of the overall decision support system is drawn from fuzzy set theory and fuzzy logic giving rise to a framework for both acquiring and representing descriptive and operational protocol knowledge. It has been conceived as a web application, designed and implemented according to the technological standards of Internet, in particular XML language and web services, to guarantee distributed functionalities for multicentric studies and the re-use of domain knowledge and problem solving strategies.
  
  
  RESULTS
  Solutions have been evaluated experimentally addressing the specific domain of Temporomandibular disorders (TMD) specializing the general purpose procedures to the dedicated "Research Diagnostic Criteria" (RDC)/TMD protocol. The accuracy of the system was correlated with a set of 50 clinically cases consecutively selected from the Gnatology Department. The results were consistent in 100% of cases. The systematic observation by physicians of both activated rules and diagnostic judgements identified and explicitly formalized additional diagnostic rules in the same context.
  
  
  CONCLUSIONS
  Active protocol support based on fuzzy diagnostic reasoning and advanced web-based technologies shows great potentialities for the renewed role DSSs are called to play in the increasingly wide scale context of evidence-based medicine.
authors.affiliation: Università degli Studi dell'Insubria, Via Ravasi 2, 21100 Varese, Italy. elisabeth.binaghi@uninsubria.it
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Binaghi
authors.forename: Ignazio
authors.initials: I
authors.lastname: Gallo
authors.forename: Cristina
authors.initials: C
authors.lastname: Ghiselli
authors.forename: Luca
authors.initials: L
authors.lastname: Levrini
authors.forename: Katia
authors.initials: K
authors.lastname: Biondi
mesh_terms: D002985:Clinical Protocols; D020000:Decision Support Systems, Clinical; D017143:Fuzzy Logic; D006801:Humans; D020407:Internet; D008490:Medical Informatics; D018511:Systems Integration; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000517:prevention & control