Ontology Driven CPG Authoring and Execution via a Semantic Web Framework

Abstract

Clinical practice guidelines (CPG) are used by healthcare practitioners to standardize clinical practice and to provide evidence mediated health-care. Currently, there have been considerable efforts to computerize CPG so as to operationalize them within clinical decision support systems (CDSS) and to deploy them at the point of care. In our work, we take a semantic Web approach - employing a domain ontology, a patient ontology, decision rules and a rule execution engine - towards the computerization and execution of CPG for CDSS. We present an ontology-driven approach for computerizing CPG and executing them based on individual patient instances. In our work we extend the guideline element model (GEM) for computerizing CPG. We have (i) defined a CPG ontology based on the document type definition (DTD) of GEM for ontologically representing a GEM encoded CPG, (ii) developed CPG decision logic definition tool and defined CPG rule syntax that allows practitioners to abstract and define decision logic rules based on the CPGs decision-variables inherent within the CPG, (iii) developed a forward-chaining CPG execution engine that executes the set of CPG execution logic rules using the JENA reasoning system, and (iv) implemented an automated justification tree generation module that provides the inference trace for the solution in order to assist practitioners in understanding the rationale for the proposed recommendations. In practice, given a patient instance our CDSS is able to derive CPG based clinical recommendations. We would present a working prototype of our CPG-based CDSS for the EU radiation protection 118 referral guideline for imaging (RPG)