title: Expanding a First-Order Logic Mitigation Framework to Handle Multimorbid Patient Preferences.
abstract: The increasing prevalence of multimorbidity is a challenge for physicians who have to manage a constantly growing number of patients with simultaneous diseases. Adding to this challenge is the need to incorporate patient preferences as key components of the care process, thanks in part to the emergence of personalized and participatory medicine. In our previous work we proposed a framework employing first order logic to represent clinical practice guidelines (CPGs) and to mitigate possible adverse interactions when concurrently applying multiple CPGs to a multimorbid patient. In this paper, we describe extensions to our methodological framework that (1) broaden our definition of revision operators to support required and desired types of revisions defined in secondary knowledge sources, and (2) expand the mitigation algorithm to apply revisions based on their type. We illustrate the capabilities of the expanded framework using a clinical case study of a multimorbid patient with stable cardiac artery disease who suffers a sudden onset of deep vein thrombosis.
authors.affiliation: Adventium Labs, Minneapolis, MN, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Michalowski
authors.affiliation: Poznan University of Technology, Poland.
authors.forename: Szymon
authors.initials: S
authors.lastname: Wilk
authors.affiliation: University of Ottawa, Canada.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rosu
authors.affiliation: University of Ottawa, Canada.
authors.forename: Mounira
authors.initials: M
authors.lastname: Kezadri
authors.affiliation: University of Ottawa, Canada.
authors.forename: Wojtek
authors.initials: W
authors.lastname: Michalowski
authors.affiliation: Ottawa Hospital Research Institute, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Carrier
mesh_terms: D000465:Algorithms; D006331:Heart Diseases; D006801:Humans; D008128:Logic; D000076322:Multimorbidity; D057240:Patient Preference; D017410:Practice Guidelines as Topic; D020246:Venous Thrombosis