Temporal Conformance Analysis and Explanation of Clinical Guidelines Execution: An Answer Set Programming Approach

Abstract

Clinical Guidelines (CGs) provide general evidence-based recommendations and physicians often have to resort also to their Basic Medical Knowledge (BMK) to cope with specific patients. In this paper, we explore the interplay between CGs and BMK from the viewpoint of a-posteriori conformance analysis, intended as the adherence of a specific execution log to both the CG and the BMK. In this paper, we consider also the temporal dimension: the guideline may include temporal constraints for the execution of actions, and its adaptation to a specific patient and context may add or modify conditions and temporal constraints for actions. We propose an approach for analyzing execution traces in Answer Set Programming with respect to a guideline and BMK, pointing out discrepancies – including temporal discrepancies – with respect to the different knowledge sources, and providing explanations regarding how the applications of the CG and the BMK have interacted, especially in case strictly adhering to both is not possible.