A quantitative assessment of a methodology for collaborative specification and evaluation of clinical guidelines

Erez Shalom, Yuval Shahar, Meirav Taieb-Maimon, Guy Bar, Avi Yarkoni, Ohad Young, Susana B. Martins, Laszlo Vaszar, Mary K. Goldstein, Yair Liel, Akiva Leibowitz, Tal Marom, Eitan Lunenfeld

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

We introduce a three-phase, nine-step methodology for specification of clinical guidelines (GLs) by expert physicians, clinical editors, and knowledge engineers and for quantitative evaluation of the specification's quality. We applied this methodology to a particular framework for incremental GL structuring (mark-up) and to GLs in three clinical domains. A gold-standard mark-up was created, including 196 plans and subplans, and 326 instances of ontological knowledge roles (KRs). A completeness measure of the acquired knowledge revealed that 97% of the plans and 91% of the KR instances of the GLs were recreated by the clinical editors. A correctness measure often revealed high variability within clinical editor pairs structuring each GL, but for all GLs and clinical editors the specification quality was significantly higher than random (p < 0.01). Procedural KRs were more difficult to mark-up than declarative KRs. We conclude that given an ontology-specific consensus, clinical editors with mark-up training can structure GL knowledge with high completeness, whereas the main demand for correct structuring is training in the ontology's semantics.

Original languageEnglish (US)
Pages (from-to)889-903
Number of pages15
JournalJournal of Biomedical Informatics
Volume41
Issue number6
DOIs
StatePublished - Dec 1 2008

Keywords

  • Clinical decision support systems
  • Clinical guidelines
  • Completeness
  • Correctness
  • Evaluation
  • Knowledge acquisition
  • Knowledge bases
  • Mark-up
  • Ontologies
  • Structuring

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics

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    Shalom, E., Shahar, Y., Taieb-Maimon, M., Bar, G., Yarkoni, A., Young, O., Martins, S. B., Vaszar, L., Goldstein, M. K., Liel, Y., Leibowitz, A., Marom, T., & Lunenfeld, E. (2008). A quantitative assessment of a methodology for collaborative specification and evaluation of clinical guidelines. Journal of Biomedical Informatics, 41(6), 889-903. https://doi.org/10.1016/j.jbi.2008.04.009