Semantic Web for Adaptable Clinical Protocols and Pathways
There are currently at least two approaches to the programmatic specification of processes. The first is the prospective enumeration of sequential steps, with boolean branch points based upon axiomatic logic applied to state variables. The second specifies tasks, and the antecedent conditions necessary for their activation, and dynamically allocates tasks when the appropriate requisite conditions met.
Further, these technologies can be applied both to the sequence of logical steps in a decision sequence (often by a single individual), and to the sequence of process execution steps that occur during healthcare service provision (often by multiple individuals).
The ACPP Group is chartered to design a framework that consists of the following components:
- A descriptive mechanism that expresses the tasks involved in both approaches to protocol and process definition, including the instantiation, performance, and evaluation of these steps.
- A collection of core vocabulary that express pre-defined logical connections between steps, including conditionality, sequence, process branching and synchronization
- A set of generic mechanisms that govern the selection of clinical pathways and protocols in any given contexts
- A mechanism for specifying clinical indications and contra-indications for inferred pathway steps, sufficiently generic enough portable across different pathway invocations
- A mechanism that discerns and documents the possible adverse effects when merging clinical pathways or detecting inter process collisions.
- A mechanism that records and handles execution variances from clinical pathways
If feasible the group will try to differentiate between medical oriented concepts and generic workflow concepts, leaving open the possibility to connect with existing or emerging generic workflow ontologies.
The group plans to examine and wherever feasible, integrate with other standards for nomenclature, reference information models, workflow and rules specifications including the HL7 Reference Information Model.
Stroke management protocol
Stroke management diagram illustrates how a stroke episode is managed.
ACC/AHA Guidelines and Indications for Coronary Artery Bypass Graft Surgery
ACC/AHA Practice Guidelines for the management of patients with ST-Elevated myocardial infarction
This ACC/AHA Guidelineprovides a comprehensive list on managing stroke at every level. More test scenarios can be derived from this guideline.
Excerpt from ADA Guideline: " Lowering triglyceridees and increasing HDL choleserol with a fibrate are associated with a refuction in cardiovascular events in patients with clinical CVD, low HDL and near-normal levels of LDL (A) Lower triglycerides to < 150 mg/dL (1.7 mmol/L) and raise HDL cholesterol to > 40 mg/dL (1.15mmol/L). In women, an HDL goal 10 mg/dL higher may be appropriate (C). Patient has CVD, triglycerides > 150 and /or HDL< 40 (for women HDL < 50) and LDL levels are near normal. "
The expected duration of the ACPP Working Group is two years. The major deliverable is the ACPP Ontology 1.0, with test cases. A set of technical notes documenting important discussions, issues and group consensus are also considered as deliverables.
- 1st Deliverable
- use cases and major category of constructs for ACPP ontology
- 2nd Deliverable
- ACPP Ontology draft
- test workbench demo proposal
Our weekly teleconference occurs on Wednesdays, from 1500h-1600h US Eastern Time.
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Meeting Minites are here
The following HCLS members are actively involved in the activities of this task force. All HCLS participants are welcome to join in the activity of this task force.
- [firstname.lastname@example.org Sam Brandt]
- [THONGSERMEIER@PARTNERS.ORG Tonya Hongsermeier]
- [email@example.com Davide Zaccagnini]
- [firstname.lastname@example.org Chimezie Ogbuji]
- [email@example.com Helen Chen]
- [VKASHYAP1@PARTNERS.ORG Vipul Kashyap]
Before finding a place at W3C server to hold all working drafts including ontology, demo codes and notes for the group, we use this wiki to hold the materials experiemented or produced by this group
- ACPP Ontology Draft
- HL7 RIM Ontology
- ACPP Contructs Using RIM as reference ontology
- Rules in ACPP
- Using Rules with Ontologies in The Semantic Web
- Stroke Management knowledge represented in ACPP
- ADA Guideline Representation Ontology and Rules
- ACPP Ontology Explained
- Use Cases Containing Temperal Concepts
- Writing N3 Rules and Reasoning With "euler" and "cwm" Reasoners
- Proposed Rules (Logic Framework) to handle inclusion/exclusion
- Representing Clinical Goal in ACPP
- ACPP Ontology Presentation Feb. 6 2007
- Chimezie POMR Presentation Jan 2007
- ACPP Notes Feb. 7 2007
Feel free to add to the reference links
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