Routine Use of Integrated Knowledge Based Functions
- Some Prerequisites and Results
Tafazzoli AG, Altmann U, Katz FR, Wächter
W, Hölzer S, Dudeck J
Institut für Medizinische Informatik, Justus-Liebig-Universität
Gießen,
ali.g.tafazzoli@informatik.med.uni-giessen.de
Introduction
In the context of clinical cancer registries, there are a lot of useful
ways to help staff with relatively unsophisticated knowledge based functions.
The objectives have been the developement of an Arden-Syntax based
shell for integrated knowledge based functions, and its clinical use in
the setting of the "Gießener Tumordokumentationssystem" (GTDS). First
domain of application has been helping the documentation personell in recognizing
data inconsistencies and incompleteness by confronting them with appropriate
messages timely to the documentation process. This is intended to reduce
the time needed for data correction, because the documentation personell
is still involved in the potentially incorrect case.
Methods and Results
The ARDEN-Syntax permits the definition of Medical Logic Modules (MLM)
via a framelike mechanism. Due to the content types of an MLM, it can be
used for integrated knowledge based functions (IKBF). Specifics of these
IKBSs are the automated triggering, the reusing of existing data for reasoning
and the automated presentation of messages. A typical phenomenon of IKBF
is the emergence of "unjustified messages" caused by the automated triggering
in conjunction with an asynchronous presentation of eventually generated
messages. An analogous phenomenon has been observed in the Brigham Integrated
Computing System [Kuperman 1997]. This phenomenon has to be addressed by
retract methods.
Since mid 1998 the shell is in routine at now three settings. In a
6 months monitoring period in one setting almost 250 messages were presented
to the documentating staff. Due to the implemented retract method half
of the generated messages were recognized as "unjustified messages". About
70% of the judged messages were considered as correct by them. Other settings
using the GTDS have requested for the IKBFs.
Conclusion
IKBF combined with a retract method promises user-accepted knowledge based
functions. Additionnally, restricting to relatively unsophisticated IKBFs,
knowledge-engineer acceptance can be obtained by structuring the knowledge
base in strictly independent modules. Further potential domains are study
management, and if documentation moves closer to the process of patient
treatment the circulation of clinical guidelines. Finally we hope that
- via useful IKBF - the clinical acceptance for structured documentation
can be improved.
References
Kuperman GJ, Hiltz FL, Teich JM: Advanced Alerting Features : Displaying
New Relevant Data and Retracting Alerts. Proc AMIA 1997, S247-249