Ghent University Academic Bibliography

Advanced

Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines

Femke Ongenae UGent, Femke De Backere UGent, Kristof Steurbaut UGent, KIRSTEN COLPAERT UGent, Wannes Kerckhove UGent, Johan Decruyenaere UGent and Filip De Turck UGent (2010) BMC MEDICAL INFORMATICS AND DECISION MAKING. 10.
abstract
Background: Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs. The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase. Methods: A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA). Results: The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows. Conclusions: The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
ONTOLOGY, EXAMPLE, REPRESENTATION, DECISION-SUPPORT-SYSTEMS, VENTILATOR-ASSOCIATED PNEUMONIA, UNIT, OUTCOMES, MODEL
journal title
BMC MEDICAL INFORMATICS AND DECISION MAKING
BMC Med. Inform. Decis. Mak.
volume
10
article_number
3
pages
22 pages
Web of Science type
Article
Web of Science id
000274680300001
JCR category
MEDICAL INFORMATICS
JCR impact factor
2.231 (2010)
JCR rank
6/22 (2010)
JCR quartile
2 (2010)
ISSN
1472-6947
DOI
10.1186/1472-6947-10-3
language
English
UGent publication?
yes
classification
A1
copyright statement
I have retained and own the full copyright for this publication
id
986862
handle
http://hdl.handle.net/1854/LU-986862
date created
2010-06-25 11:22:04
date last changed
2010-08-04 14:00:20
@article{986862,
  abstract     = {Background: Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs. The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase.
Methods: A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA).
Results: The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows.
Conclusions: The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline.},
  articleno    = {3},
  author       = {Ongenae, Femke and De Backere, Femke and Steurbaut, Kristof and COLPAERT, KIRSTEN and Kerckhove, Wannes and Decruyenaere, Johan and De Turck, Filip},
  issn         = {1472-6947},
  journal      = {BMC MEDICAL INFORMATICS AND DECISION MAKING},
  keyword      = {ONTOLOGY,EXAMPLE,REPRESENTATION,DECISION-SUPPORT-SYSTEMS,VENTILATOR-ASSOCIATED PNEUMONIA,UNIT,OUTCOMES,MODEL},
  language     = {eng},
  pages        = {22},
  title        = {Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines},
  url          = {http://dx.doi.org/10.1186/1472-6947-10-3},
  volume       = {10},
  year         = {2010},
}

Chicago
Ongenae, Femke, Femke De Backere, Kristof Steurbaut, KIRSTEN COLPAERT, Wannes Kerckhove, Johan Decruyenaere, and Filip De Turck. 2010. “Towards Computerizing Intensive Care Sedation Guidelines: Design of a Rule-based Architecture for Automated Execution of Clinical Guidelines.” Bmc Medical Informatics and Decision Making 10.
APA
Ongenae, F., De Backere, F., Steurbaut, K., COLPAERT, K., Kerckhove, W., Decruyenaere, J., & De Turck, F. (2010). Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines. BMC MEDICAL INFORMATICS AND DECISION MAKING, 10.
Vancouver
1.
Ongenae F, De Backere F, Steurbaut K, COLPAERT K, Kerckhove W, Decruyenaere J, et al. Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines. BMC MEDICAL INFORMATICS AND DECISION MAKING. 2010;10.
MLA
Ongenae, Femke, Femke De Backere, Kristof Steurbaut, et al. “Towards Computerizing Intensive Care Sedation Guidelines: Design of a Rule-based Architecture for Automated Execution of Clinical Guidelines.” BMC MEDICAL INFORMATICS AND DECISION MAKING 10 (2010): n. pag. Print.