Building an ontology for pressure ulcer risk assessment to allow data sharing and comparisons across hospitals

As a way to promote consistency and completeness of pressure ulcer risk assessment, as well as to establish a framework for data and knowledge sharing in this domain, we constructed an ontology that represents how the characteristics of the high risk patients defined by the Braden scale are operationalized at two different settings. We observed great similarity between the two study hospitals. Forty scenarios that portrayed patients at each site were added to the ontology and algorithmically assessed for pressure ulcer risk using the ontology reasoner FACT++. When validated by manual assessment by the nurses from each site, high consistency in the assessed risk level was observed with the average consistency score of 0.82 (SD= 0.06) out of 1.0. The results suggest that explicitly defining the site specific methods for assessing pressure ulcer risk that comply with the standard methods defined in the Braden scale can improve assessment consistency.