title: An ontology-driven, diagnostic modeling system.
abstract: OBJECTIVE
  To present a system that uses knowledge stored in a medical ontology to automate the development of diagnostic decision support systems. To illustrate its function through an example focused on the development of a tool for diagnosing pneumonia.
  
  
  METHODS
  We developed a system that automates the creation of diagnostic decision-support applications. It relies on a medical ontology to direct the acquisition of clinic data from a clinical data warehouse and uses an automated analytic system to apply a sequence of machine learning algorithms that create applications for diagnostic screening. We refer to this system as the ontology-driven diagnostic modeling system (ODMS). We tested this system using samples of patient data collected in Salt Lake City emergency rooms and stored in Intermountain Healthcare's enterprise data warehouse.
  
  
  RESULTS
  The system was used in the preliminary development steps of a tool to identify patients with pneumonia in the emergency department. This tool was compared with a manually created diagnostic tool derived from a curated dataset. The manually created tool is currently in clinical use. The automatically created tool had an area under the receiver operating characteristic curve of 0.920 (95% CI 0.916 to 0.924), compared with 0.944 (95% CI 0.942 to 0.947) for the manually created tool.
  
  
  CONCLUSIONS
  Initial testing of the ODMS demonstrates promising accuracy for the highly automated results and illustrates the route to model improvement.
  
  
  CONCLUSIONS
  The use of medical knowledge, embedded in ontologies, to direct the initial development of diagnostic computing systems appears feasible.
authors.affiliation: Medical Informatics Department, Intermountain Healthcare, Salt Lake City, Utah, USA. Peter.Haug@imail.org
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Haug
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Ferraro
authors.forename: John
authors.initials: J
authors.lastname: Holmen
authors.forename: Xinzi
authors.initials: X
authors.lastname: Wu
authors.forename: Kumar
authors.initials: K
authors.lastname: Mynam
authors.forename: Matthew
authors.initials: M
authors.lastname: Ebert
authors.forename: Nathan
authors.initials: N
authors.lastname: Dean
authors.forename: Jason
authors.initials: J
authors.lastname: Jones
mesh_terms: D000465:Algorithms; D001185:Artificial Intelligence; D020000:Decision Support Systems, Clinical; D004636:Emergency Service, Hospital; D006801:Humans; D038801:International Classification of Diseases; D011014:Pneumonia / Q000175:diagnosis*; D012372:ROC Curve; D018875:Vocabulary, Controlled
keywords: Data Mining; Diagnostic System; Ontology; Pneumonia