title: Design and Development of a Sharable Clinical Decision Support System Based on a Semantic Web Service Framework.
abstract: Clinical decision support (CDS) systems provide clinicians and other health care stakeholders with patient-specific assessments or recommendations to aid in the clinical decision-making process. Despite their demonstrated potential for improving health care quality, the widespread availability of CDS systems has been limited mainly by the difficulty and cost of sharing CDS knowledge among heterogeneous healthcare information systems. The purpose of this study was to design and develop a sharable clinical decision support (S-CDS) system that meets this challenge. The fundamental knowledge base consists of independent and reusable knowledge modules (KMs) to meet core CDS needs, wherein each KM is semantically well defined based on the standard information model, terminologies, and representation formalisms. A semantic web service framework was developed to identify, access, and leverage these KMs across diverse CDS applications and care settings. The S-CDS system has been validated in two distinct client CDS applications. Model-level evaluation results confirmed coherent knowledge representation. Application-level evaluation results reached an overall accuracy of 98.66 % and a completeness of 96.98 %. The evaluation results demonstrated the technical feasibility and application prospect of our approach. Compared with other CDS engineering efforts, our approach facilitates system development and implementation and improves system maintainability, scalability and efficiency, which contribute to the widespread adoption of effective CDS within the healthcare domain.
authors.affiliation: Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Gou
authors.affiliation: Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Heart Center, Navy General Hospital, Beijing, China.
authors.forename: Tian-Chang
authors.initials: TC
authors.lastname: Li
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China. ljs@zju.edu.cn.
authors.forename: Jing-Song
authors.initials: JS
authors.lastname: Li
mesh_terms: D040421:Cell Phone; D016494:Computer Security; D003219:Confidentiality; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D066275:Health Information Exchange; D006801:Humans; D007256:Information Systems / Q000458:organization & administration*; D051188:Knowledge Bases; D012660:Semantics
keywords: Clinical decision support; Knowledge base; Semantic web technologies; Service-oriented architecture