Stud Health Technol Inform
November 2024
We present a new methodological approach based on integrating Arden-Syntax-based clinical decision support (CDS) with an upstream ontology service. Incoming linguistic patient data, such as single reports about detected germs or viruses, shall be identified by the applied ontology at a low level. Then, higher-level concepts are activated by ontology-based bottom-up reasoning.
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November 2024
The Arden Syntax is a language designed for the encoding of medical knowledge into clinical decision support systems. Its evolution is overseen by Health Level 7. A significant enhancement in its new version 3.
View Article and Find Full Text PDFLeveraging the capabilities of a microbiological clinical analytics tool, this study delves into quantifying the public health impact of antibiotic-resistant bacteria. Focusing on eight predominant antibiotic-resistant bacteria, the study utilizes University Hospital Vienna's data to calculate the burden of antibiotic-resistant infections in disability-adjusted life years. The results highlight the potential of extended analytics tools in epidemiological research and underscore the pressing challenge of antimicrobial drug resistance.
View Article and Find Full Text PDFWe analyze five approaches to knowledge management in clinical decision support (CDS) systems: pattern recognition based on annotated imaging data, mining of stored structured medical data, text mining of published texts, computable knowledge design, and general or specific text corpora for large language models. Each method's strengths and limitations in automating clinical knowledge management while striving for a zero-error policy are evaluated, offering insights into their roles in enhancing healthcare through intelligent decision support. The study aims to inform decisions in the development of effective, transparent CDS systems in clinical and patient care settings.
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April 2024
Healthcare-associated infections (HAIs) may have grave consequences for patients. In the case of sepsis, the 30-day mortality rate is about 25%. HAIs cost EU member states an estimated 7 billion Euros annually.
View Article and Find Full Text PDFArden Syntax, a medical knowledge representation and processing language for clinical decision support tasks supervised by Health Level Seven International (HL7), was extended with HL7's Fast Healthcare Interoperability Resources (FHIR) constructs to allow standardized data access. The new version, Arden Syntax version 3.0, was successfully balloted as part of the audited, consensus-based, iterative HL7 standards development process.
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June 2023
Hospital wards need immediate information about multi-resistant pathogens and contagious viruses in their hospitalized patients. An alert service configurable with Arden-Syntax-based alert definitions passing through an ontology service to complement results from microbiology and virology with high-level terms was implemented as proof of concept. Integration into the University Hospital Vienna's IT landscape is ongoing.
View Article and Find Full Text PDFThis paper studies the feasibility of incorporating clinical decision support (CDS) into health digital twins (HDTs). A HDT is visualized in a web application, health data are stored in a FHIR-based electronic health record, and an Arden-Syntax-based CDS interpretation and alert service is connected. The prototype focuses on interoperability of these components.
View Article and Find Full Text PDFBackground: Intracranial hypertension is a serious complication accompanying the intensive care of children with traumatic brain injury. Intensive care of these patients is based on internationally accepted guidelines and their local editions.
Objective: The goal was to develop a software system for digital implementation of the clinical protocol for the treatment of intracranial hypertension in children, based on HL7 Arden Syntax clinical decision support.
Stud Health Technol Inform
June 2020
The expressiveness of a medical knowledge representation language has significant impact on the effectiveness of a knowledge-based clinical decision support system. We assess the expressiveness of two such languages, Arden Syntax and the Guideline Definition Language. Using data extracted from both languages' specifications, we quantify expressiveness by means of language syntax and the number of supported operators.
View Article and Find Full Text PDFBackground: Specifications for Arden Syntax lack provisions for the standardized access of clinical decision support (CDS) services. The CDS Hooks standard provides such access.
Objectives: To extend an ArdenSuite reference implementation of the Arden Syntax by providing a CDS-Hooks-compatible interface.
Background: Intracranial hypertension is a serious complication in the intensive care of children with severe traumatic brain injury (STBI).
Objective: The goal was to create a computer system for simultaneous neuromonitoring of cerebral parameters and Arden-Syntax-based clinical decision support (CDS) in children with STBI undergoing intensive care treatment.
Methods: Intensive care of these patients is based on internationally accepted guidelines.
Stud Health Technol Inform
August 2019
In the present study, we intended to solve identification problems in analyzing the results of microbiology by proactive man-machine interaction. We modified the analytics software MOMO so that it flags laboratory results containing textual elements unknown to the thesaurus, and a human expert assigns the elements to the respective existing thesaurus elements or creates new ones. In 773,309 laboratory results, roughly 2.
View Article and Find Full Text PDFStud Health Technol Inform
August 2019
Introduction: Arden Syntax is a Health Level Seven International standard for the development of clinical decision support (CDS) solutions. CDS Hooks is a specification for an interface to call CDS services from an electronic health record. Implementing the CDS Hooks interface into ArdenSuite, an Arden-Syntax-based CDS platform, will further enhance its interoperability with external systems.
View Article and Find Full Text PDFObjective: Daily assessment of the acid-base balance (ABB) in blood is one of the important elements of multi-parameter patient monitoring at intensive care units (ICUs). The present work aims to determine the effectiveness and validity of the integral homeostasis index IHx calculated from ABB blood test data for the assessment and prognosis of children with critical traumatic conditions.
Methods: 345 patients were studied.
Formal constructs for fuzzy sets and fuzzy logic are incorporated into Arden Syntax version 2.9 (Fuzzy Arden Syntax). With fuzzy sets, the relationships between measured or observed data and linguistic terms are expressed as degrees of compatibility that model the unsharpness of the boundaries of linguistic terms.
View Article and Find Full Text PDFBackground: Arden Syntax is an international standard for medical knowledge representation and processing. The openEHR Foundation publishes specifications for the creation of electronic health records based on interoperable data models.
Objectives: To perform a feasibility study showing how Arden Syntax medical logic modules (MLMs) can access openEHR data.
Background: Evidence-based clinical guidelines have a major positive effect on the physician's decision-making process. Computer-executable clinical guidelines allow for automated guideline marshalling during a clinical diagnostic process, thus improving the decision-making process.
Objectives: Implementation of a digital clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized workflow, thereby separating business logic from medical knowledge and decision-making.
Stud Health Technol Inform
June 2018
Evidence-based clinical guidelines positively effect physician decision-making. Actionable clinical guidelines that actively trigger alerts, reminders, and instructive texts will increase effectiveness. We applied Activiti, a Business Process Model and Notation language system to model a clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized clinical workflow.
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June 2018
An increasing body of raw patient data is generated on each day of a patient's stay at a hospital. It is of paramount importance that critical patient information be extracted from these large data volumes and presented to the patient's clinical caregivers as early as possible. Contemporary clinical alert systems attempt to provide this service with moderate success.
View Article and Find Full Text PDFIn times of steadily increasing numbers of administered drugs, the detection of adverse drug events (ADEs) is an important aspect of improving patient safety. At present only about 1-13% of detected ADEs are reported. Raising the number of reported ADEs will result in greater and more efficient support of pharmacovigilance.
View Article and Find Full Text PDFThe creation of clinical decision support systems has received a strong impulse over the last years, but their integration into a clinical routine has lagged behind, partly due to a lack of interoperability and trust by physicians. We report on the implementation of a clinical foundation framework in Arden Syntax, comprising knowledge units for (a) preprocessing raw clinical data, (b) the determination of single clinical concepts, and (c) more complex medical knowledge, which can be modeled through the composition and configuration of knowledge units in this framework. Thus, it can be tailored to clinical institutions or patients' caregivers.
View Article and Find Full Text PDFBackground: The diagnosis - and hence definitions - of healthcare-associated infections (HAIs) rely on microbiological laboratory test results in specific constellations.
Objectives: To construct a library that provides interoperable building blocks for the analysis of microbiological laboratory test results.
Methods: We used Java for preprocessing raw microbiological laboratory test results and Arden Syntax for knowledge-based querying of data based on microbiology information elements used in European surveillance criteria for HAIs.
Introduction: Clinical decision support systems (CDSSs) are being developed to assist physicians in processing extensive data and new knowledge based on recent scientific advances. Structured medical knowledge in the form of clinical alerts or reminder rules, decision trees or tables, clinical protocols or practice guidelines, score algorithms, and others, constitute the core of CDSSs. Several medical knowledge representation and guideline languages have been developed for the formal computerized definition of such knowledge.
View Article and Find Full Text PDFStud Health Technol Inform
March 2016
This study's objective is to develop and use a scalable genuine technology platform for clinical decision support based on Arden Syntax, which was extended by fuzzy set theory and fuzzy logic. Arden Syntax is a widely recognized formal language for representing clinical and scientific knowledge in an executable format, and is maintained by Health Level Seven (HL7) International and approved by the American National Standards Institute (ANSI). Fuzzy set theory and logic permit the representation of knowledge and automated reasoning under linguistic and propositional uncertainty.
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