Methods Inf Med 1997; 36(02): 108-114
DOI: 10.1055/s-0038-1634697
Original Article
Schattauer GmbH

Extended Telemedical Consultation using Arden Syntax Based Decision Support, Hypertext and WWW Technique

D. Karlsson
1   Dept. of Medical Informatics, Linköping University, Sweden
,
C. Ekdahl
2   Dept. of Infectious Diseases, The University Hospital, Linköping, Sweden
,
O. Wigertz
1   Dept. of Medical Informatics, Linköping University, Sweden
,
N. Shahsavar
1   Dept. of Medical Informatics, Linköping University, Sweden
,
H. Gill
1   Dept. of Medical Informatics, Linköping University, Sweden
,
U. Forsum
3   Dept. of Clinical Microbiology, The University Hospital, Linköping, Sweden
› Author Affiliations
Further Information

Publication History

Publication Date:
20 February 2018 (online)

Abstract:

There is an obvious need for geographic distribution of expert knowledge among several health care units without increasing the cost of on-site expertise in locations where health care is provided. This paper describes the design of a knowledge-based decision-support system for extended consultation in clinical medicine. The system is based on Arden Syntax for Medical Logic Modules and hypertext using World Wide Web technology. It provides advice and explanations regarding the given advice. The explanations are presented in a hypertext format allowing the user to browse related information and to verify the relevance of the given advice. The system is intended to be used in a closed local network. With special precautions regarding issues of safety and patient security, the system can be used over wider areas such as in rural medicine. A prototype has been developed in the field of clinical microbiology and infectious diseases regarding infective endocarditis.

 
  • References

  • 1 Covell DG, Uman GC, Manning PR. Information needs in office practice: are they being met?. Ann Intern Med 1985; 4: 596-599.
  • 2 Manning PR, DeBakey L. Medicine: Preserving the Passion. New York: Springer-Verlag; 1987
  • 3 Shortliffe EH. Problems in Implementing the Computer for Continuing Education. Mobius 1983; 3: 52-55.
  • 4 Barahona P. et al. Knowledge processing for decision support in the health sector. In: Barahona P, Cristensen JP. eds. Knowledge and Decisions in Health Telematics. Amsterdam: IOS Press; 1994
  • 5 Timpka T. Introducing hypertext in primary health care: A study on the feasibility of decision support for practitioners. Comp Meth Progr Biomed 1989; 1: 1-13.
  • 6 Conklin J. Hypertext: an introduction and survey. IEEE Computer 1987; 17: 17-41.
  • 7 Hripcsak G. ed. Special Issue: The Arden Syntax. Computers in Biology and Medicine 1994; 5.
  • 8 Cimino JJ, Socratous SA, Clayton PD. Internet as clinical information system: application development using the World Wide Web. JAMIA 1995; 2: 273-84.
  • 9 Willard KE, Hallgren IH, Sielaff B, Connelly DP. The deployment of a World Wide Web (W3) based medical information system. In: SCAMC 95. Philadelphia: Hanley & Belfus, Inc.; 1995: 771-5.
  • 10 Erdman HP. The impact of an explanation capability for a computer consultation system. Meth Inform Med 1985; 24: 181-91.
  • 11 Scheld WM, Sande MA. Endocarditis and Intravascular Infections. In: Mandell GL, Bennet IE, Dolin R. Principles and Practice of Infective Diseases. 4th ed.. New York: Churchill Livingstone Inc; 1995: 741.
  • 12 Rada R. HYPER TEXT: from Text to Expertext. London: McGraw-Hill; 1991
  • 13 Cimino JJ, Elkin OL, Barnett GO. As we may think: the concept space and medical hypertext. Computers Biomed Res 1992; 3: 238-63.
  • 14 Standard Specification for Defining and Sharing Modular Health Knowledge Bases (Arden Syntax for Medical Logic Modules). In: Annual Book of ASTM Standards Vol 14: 01.
  • 15 Clayton PD, Pryor TA, Wigertz OB, Hripcsak G. Issues and structures for sharing medical knowledge among decision-making systems. The 1989 Arden Homestead Retreat. In: SCAMC 89. Washington DC: IEEE Com Soc Press; 1989: 116-21.
  • 16 Fielding R, Frystyk H, Berners-Lee T. Hypertext Transfer Protocol-HTTP/1.1. Internet-Draft. 1995
  • 17 Berners-Lee T, Connolly D. HyperText Markup Language – 2.0. Internet-Draft. 1995
  • 18 Gosling J, McGilton H. The Java Language Environment: A White Paper. Sun Microsystems Inc.; 1995
  • 19 Gennari JH, Oliver DE, Pratt W, Rice J, Musen MA. A Web-Based Architecture for a Medical Vocabulary Server. In: SCAMC 95. Philadelphia: Hanley & Belfus, Inc.; 1995: 275-9.
  • 20 Detmer WM, Shortliffe EH. A Model of Clinical Query Management that Supports Integration of Biomedical Information Over the World Wide Web. In: SCAMC 95. Philadelphia: Hanley & Belfus, Inc.; 1995: 898-902.
  • 21 Gao X. Realizing Medical Decision Support using the Arden Syntax as Knowledge Representation. Lic. thesis no. 399. Linköping University; 1993
  • 22 Johansson B, Wigertz OB. An Object Oriented Approach to Interpret Medical Knowledge Based on the Arden Syntax. In: SCAMC 92. New York: McGraw-Hill; 1995: 52-6.
  • 23 Johansson B, Shahsavar N, Åühlfeldt H. Data mapping method for Arden Syntax knowledge modules. Methods of Information in Medicine. Submitted.
  • 24 de Dombal FT. Background and current state-of-the-art. Technology and Health Care 1993; 1: 77-83.
  • 25 Shahsavar N. Implementation and Evaluation of a Knowledge-Based System to Support Ventilator Therapy Management. Dissertation no. 317 Linköping University; 1993
  • 26 Collste G. Expert Systems in Medicine and Moral Responsibility. Journal of Systems Software 1992; 17: 15-22.
  • 27 Bigsby DJ, Moehr JR. Internet for Teaching and Learning Introductory Health Informatics. In: SCAMC 95. Philadelphia: Hanley & Beifus, Inc.; 1995: 532-6.
  • 28 Rivest RL, Shamir A, Adleman L. A method for obtaining digital signatures and publickey cryptosystems. Communications of the ACM 1978; 2: 120-6.
  • 29 Gao X, Shahsavar N, Arkad K, Åhlfeldt H, Hripcsak G, Wigertz OB. Design and Functions of Medical Knowledge Editors for Arden Syntax. In: MEDINFO 92. Amsterdam: North-Holland; 1992: 472-7.
  • 30 Båenholm P, Anderskär K, Gill H, Jönsson KÅ, Wigertz OB. Adding decision support to a clinical information system. Technology I and Health Care 1994; 1: 245-51.