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An ontology driven clinical evidence service providing diagnostic decision support in family practice.

Corrigan D - AMIA Jt Summits Transl Sci Proc (2015)

Bottom Line: Formulation of a working diagnostic hypothesis in family practice requires consideration of many differential diagnoses associated with any presenting patient complaint.The solution implements ontology models of evidence accessible to consumers as a web service using open source components and standards.An implementation example is described that consumes the service to drive a diagnostic decision support tool developed for the TRANSFoRm project.

View Article: PubMed Central - PubMed

Affiliation: HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.

ABSTRACT
Formulation of a working diagnostic hypothesis in family practice requires consideration of many differential diagnoses associated with any presenting patient complaint. There follows a process of refinement of the differentials to consider, through ruling in or out each candidate differential based on the confirmed presence or absence of diagnostic cues elicited during patient consultation. The patient safety implications of diagnostic error are potentially severe for patient and clinician. This paper describes a clinical evidence service supporting this diagnostic process. It allows decision support consumers to provide coded evidence-based recommendations to assist with diagnostic hypothesis formulation, integrated with an EHR in primary care. The solution implements ontology models of evidence accessible to consumers as a web service using open source components and standards. An implementation example is described that consumes the service to drive a diagnostic decision support tool developed for the TRANSFoRm project.

No MeSH data available.


Related in: MedlinePlus

Core evidence ontology concepts.
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f1-2081312: Core evidence ontology concepts.

Mentions: The clinical concepts to support a diagnostic process have been modelled as an ontology of clinical evidence (figure 1). This allows representation of the relationships between a presenting patient reason for encounter and the associated candidate differential diagnoses to consider. The evidence relating to any particular diagnosis is captured as associated diagnostic cues, of which there are cue sub-concepts to represent clinician observed signs, patient reported symptoms, risk factors and clinical tests. The ontology design methodology used is based on the design practices advocated by the work of Gruninger and Fox (7). Semantic interoperability support is provided for by the ‘code binding’ concept, separate and independent of the clinical concepts. This is used to associate potentially many different clinical terminology codes for any single ontology RFE, cue or diagnosis.


An ontology driven clinical evidence service providing diagnostic decision support in family practice.

Corrigan D - AMIA Jt Summits Transl Sci Proc (2015)

Core evidence ontology concepts.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4525252&req=5

f1-2081312: Core evidence ontology concepts.
Mentions: The clinical concepts to support a diagnostic process have been modelled as an ontology of clinical evidence (figure 1). This allows representation of the relationships between a presenting patient reason for encounter and the associated candidate differential diagnoses to consider. The evidence relating to any particular diagnosis is captured as associated diagnostic cues, of which there are cue sub-concepts to represent clinician observed signs, patient reported symptoms, risk factors and clinical tests. The ontology design methodology used is based on the design practices advocated by the work of Gruninger and Fox (7). Semantic interoperability support is provided for by the ‘code binding’ concept, separate and independent of the clinical concepts. This is used to associate potentially many different clinical terminology codes for any single ontology RFE, cue or diagnosis.

Bottom Line: Formulation of a working diagnostic hypothesis in family practice requires consideration of many differential diagnoses associated with any presenting patient complaint.The solution implements ontology models of evidence accessible to consumers as a web service using open source components and standards.An implementation example is described that consumes the service to drive a diagnostic decision support tool developed for the TRANSFoRm project.

View Article: PubMed Central - PubMed

Affiliation: HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.

ABSTRACT
Formulation of a working diagnostic hypothesis in family practice requires consideration of many differential diagnoses associated with any presenting patient complaint. There follows a process of refinement of the differentials to consider, through ruling in or out each candidate differential based on the confirmed presence or absence of diagnostic cues elicited during patient consultation. The patient safety implications of diagnostic error are potentially severe for patient and clinician. This paper describes a clinical evidence service supporting this diagnostic process. It allows decision support consumers to provide coded evidence-based recommendations to assist with diagnostic hypothesis formulation, integrated with an EHR in primary care. The solution implements ontology models of evidence accessible to consumers as a web service using open source components and standards. An implementation example is described that consumes the service to drive a diagnostic decision support tool developed for the TRANSFoRm project.

No MeSH data available.


Related in: MedlinePlus