Linked Open Data for Medical Guidelines Interactions
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An increasing number of patients suffer from multiple diseases at the same time. This makes their treatment much more complex, and the standard medical treatment guidelines no longer apply (they are typically written for patients with just a single disease). We present computer-based techniques for analysing medical guidelines to detect how multiple guidelines may interact in unexpected ways, and how Linked Open Data can be used to recognise and avoid such adverse effects.
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Linked Open Data for Medical Guidelines Interactions
- 1. @AIME, Pavia, 19th June 2015 Linked Open Data for Medical Guidelines Interactions Veruska Zamborlini, Marcos da Silveira, Cedric Pruski, Annette ten Teije and Frank van Harmelen, Rinke Hoekstra
- 2. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study (2012) Karen Barnett, Stewart W Mercer, Michael Norbury, Prof Graham Watt, Prof Sally Wyke, Bruce Guthrie Project Smart Ward Expectation: multi-morbidity holds for psychiatric patients as well
- 3. In practice: ✤ Paper-based Clinical Guideline (CG) ✤ One guideline per disease ✤ Common co-morbidities (2) are addressed during CG development ✤ Not suitable for detecting interactions
- 4. What about… ✤ Computer-interpretable Clinical Guideline (CIG) ✤ How to combine CIGs? ✤ CIG Languages: ✤ mainly designed for execution ✤ not suitable for detecting interactions
- 5. What do we propose? ✤ Address multimobidity at CG level: ✤ scalable in number of guidelines ✤ reusable rules designed for diverse types of interactions ✤ binary cumulative rules - allows for combination of n recommendations ✤ represent recommendations based on transitions promoted by actions ✤ do give aspirin x don’t give aspirin => different recommendations about the same action ✤ hierarchy of actions ✤ causation beliefs ✤ reuse of existent background knowledge available online (LOD)
- 6. Case Study
- 7. Case Study
- 8. Case Study
- 9. Case Study
- 10. Case Study
- 11. Case Study
- 12. Case Study
- 13. Case Study
- 14. Reusable Rules IF Positive recommendation R1 to action A1 & Negative recommendation R2 to action A2 & Actions A1 and A2 are the same or subsuming one another THEN R1 and R2 might contradict each other
- 15. FOL Rules
- 18. Case Study
- 19. Conclusion so far ✤ Address multimobidity at CG level: ✤ reusable/domain-independent rules for detecting types of interactions ✤ scalable in number of guidelines Next step ✤ Re-use of existent background knowledge available online (LOD)
- 29. 36Ibuprofen High Blood Pressure Side-EffectSide-Effect Sider Thiazide High Blood Sugar Level Side-Effect Side-Effect
- 30. Using LOD 37
- 31. Using LOD 38
- 32. Using LOD 39
- 33. Using LOD 40
- 34. Using LOD 41
- 35. Using LOD 42
- 36. Using LOD 43
- 37. Using LOD 44
- 38. Our guideline model in LOD using NanoPublications standard 45
- 39. Nanopublication 46 Provenance about the publication: When, by whom, how this publication was produced… “Atomic” piece of information: E.g. causation beliefs, recommendations. Provenance about the assertion: Who/where it was originally asserted; In case the source is a text, the specific piece od text can also be pointed out.
- 42. Conclusion 49 ✤Guideline model: represent recommendations based on transitions promoted by actions (hierarchy of actions & causation beliefs) ✤ Address multimobidity at guideline level ✤ scalable in number of guidelines ✤ reusable rules designed for diverse types of interactions ✤Semantic web technology ✤ reuse of existent background knowledge available online (LOD) ✤ use nano publications for guideline model Smart Ward: use of guidelines Smart Ward: interactions detection independent of specific diseases Relevant technology
Hinweis der Redaktion
- Should administer NSAID to reduce blood coagulation
- guideline Diabetes (DB) should administer Tramadol to reduce blood coagulation should administer Insulin to reduce blood sugar level
- guideline Osteoarthritis (OA) should NOT administer Aspirin to avoid increasing risk of gastro intestinal bleeding Notice: DB.1 and DB.2 are alternative recommendations meant for promoting the same effect. Interactions: DB1 en DB2 alternatives
- Osteoarthritis (OA): should administer Ibuprofen to reduce pain
- DB1 and OA1 are contradictory recommendations DB1 might lead to the prescription of Aspirin Aspirin is not recommended by OA1.
- third guideline: Hypertension Should administer Thiziade to reduce the blood pressure OA3 and HT1 interact: OA3 has interaction via high blood sugar levels.
- dotted lines: beliefs
- Alternative drug is Ibuprofen.
- Norm —> until now only mentioned recommendation