An ontology-based mediator of clinical information for decision support systems: a prototype of a clinical alert system for prescription.
OBJECTIVE
We have been developing a decision support system that uses electronic clinical data and provides alerts to clinicians. However, the inference rules for such a system are difficult to write in terms of representing domain concepts and temporal reasoning. To address this problem, we have developed an ontology-based mediator of clinical information for the decision support system.


METHODS
Our approach consists of three steps: 1) development of an ontology-based mediator that represents domain concepts and temporal information; 2) mapping of clinical data to corresponding concepts in the mediator; 3) temporal abstraction that creates high-level, interval-based concepts from time-stamped clinical data. As a result, we can write a concept-based rule expression that is available for use in domain concepts and interval-based temporal information. The proposed approach was applied to a prototype of clinical alert system, and the rules for adverse drug events were executed on data gathered over a 3-month period.


RESULTS
The system generated 615 alerts. 346 cases (56%) were considered appropriate and 269 cases (44%) were inappropriate. Of the false alerts, 192 cases were due to data inaccuracy and 77 cases were due to insufficiency of the temporal abstraction.


CONCLUSIONS
Our approach enabled to represent a concept-based rule expression that was available for the prototype of a clinical alert system. We believe our approach will contribute to narrow the gaps of information model between domain concepts and clinical data repositories.
Kawazoe
Y
Y
Department of Planning, Information and Management, University of Tokyo Hospital, Bunkyo, Tokyo, Japan. kawazoe-tky@umin.ac.jp
Ohe
K
K
D022126:Access to Information; D003210:Concept Formation; D003628:Database Management Systems; D019992:Databases as Topic; D016208:Databases, Factual; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D003661:Decision Support Techniques; D006801:Humans; D020407:Internet; D007564:Japan; D008490:Medical Informatics / Q000458:organization & administration*; D008962:Models, Theoretical; D004364:Pharmaceutical Preparations; D010865:Pilot Projects; D012985:Software Design; D009626:Terminology as Topic
D004364:Pharmaceutical Preparations