Construction of a clinical decision support system for undergoing surgery based on domain ontology and rules reasoning

Telemed J E Health. 2014 May;20(5):460-72. doi: 10.1089/tmj.2013.0221. Epub 2014 Apr 14.

Abstract

Objective: To construct a clinical decision support system (CDSS) for undergoing surgery based on domain ontology and rules reasoning in the setting of hospitalized diabetic patients.

Materials and methods: The ontology was created with a modified ontology development method, including specification and conceptualization, formalization, implementation, and evaluation and maintenance. The Protégé-Web Ontology Language editor was used to implement the ontology. Embedded clinical knowledge was elicited to complement the domain ontology with formal concept analysis. The decision rules were translated into JENA format, which JENA can use to infer recommendations based on patient clinical situations.

Results: The ontology includes 31 classes and 13 properties, plus 38 JENA rules that were built to generate recommendations. The evaluation studies confirmed the correctness of the ontology, acceptance of recommendations, satisfaction with the system, and usefulness of the ontology for glycemic management of diabetic patients undergoing surgery, especially for domain experts.

Conclusions: The contribution of this research is to set up an evidence-based hybrid ontology and an evaluation method for CDSS. The system can help clinicians to achieve inpatient glycemic control in diabetic patients undergoing surgery while avoiding hypoglycemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biological Ontologies / organization & administration*
  • Decision Support Systems, Clinical / organization & administration*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / surgery*
  • Female
  • Humans
  • Insulin / administration & dosage*
  • Male
  • Monitoring, Intraoperative / methods
  • Monitoring, Physiologic / methods
  • Postoperative Complications / prevention & control
  • Program Development
  • Program Evaluation
  • Risk Assessment
  • Severity of Illness Index
  • Surgical Procedures, Operative / adverse effects
  • Surgical Procedures, Operative / methods*
  • Taiwan

Substances

  • Insulin