Managing revisions of rules and guidelines used in clinical information systems : exploring a hierarchical knowledge representation model

One important purpose for creating clinical practice guidelines is to improve quality of care by reducing variations in practice. In the current healthcare environment, guidelines are being advocated as a means to disseminate research findings, standardize care, improve quality of care, and increase the cost-effectiveness of health care services. Unfortunately, compliance with text-based clinical practice guidelines is unsatisfactory. On the other hand, adherence to guideline recommendations is increased when providers receive patient-specific recommendations during the patient-provider consultation. Guideline-based point of care decision support systems have been shown to increase provider consultation. Guideline-based point of care decision support systems have been shown to increase provider adherence to guideline recommendations. Computer-interpretable formats for clinical practice guidelines are a prerequisite for decision support systems. The development process of a text-based clinical practice guideline is long and arduous and in most cases this process is repeated when text-based guidelines are revised to include new medical knowledge. Clearly, once text-based guideline knowledge is translated into a computer-interpretable format, the computer-interpretable guideline would also require periodic revisions to maintain the integrity of its evidence-base. Therefore, representation formalisms for encoding guideline knowledge into computer-interpretable formats should enable easy revisions of the encoded guidelines. This thesis describes a study I conducted to demonstrate that modular knowledge representation of clinical practice guidelines facilitates easy guideline revisions. To test the hypothesis

Department dc:contributor.department

Harvard University--MIT Division of Health Sciences and Technology.

Grantor dc:publisher

Massachusetts Institute of Technology

Year dc:date.issued

2004

Author dc:creator

• Scott-Wright, Alicia, 1949-

Advisor dc:contributor.advisor

• Aziz A. Boxwala.

• Harvard University--MIT Division of Health Sciences and Technology.

Statement dc:rights

• M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission.

Licence dc:rights.uri

• http://dspace.mit.edu/handle/1721.1/7582

Language dc:language.iso

en_US

Handle dc:identifier.uri

http://hdl.handle.net/1721.1/28589

OAI identifier oai:identifier

oai:dspace.mit.edu:1721.1/28589