Related Experiment Video
Updated: May 27, 2026
Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
Published on: June 13, 2025
A multi-layered framework for disseminating knowledge for computer-based decision support
Aziz A Boxwala1, Beatriz H Rocha, Saverio Maviglia
1Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California 92093-0728, USA. aboxwala@ucsd.edu
Background:
There are several challenges in encoding guideline knowledge in a form that is portable to different clinical sites, including the heterogeneity of clinical decision support (CDS) tools, of patient data representations, and of workflows.
Methods:
We have developed a multi-layered knowledge representation framework for structuring guideline recommendations for implementation in a variety of CDS contexts. In this framework, guideline recommendations are increasingly structured through four layers, successively transforming a narrative text recommendation into input for a CDS system. We have used this framework to implement rules for a CDS service based on three guidelines. We also conducted a preliminary evaluation, where we asked CDS experts at four institutions to rate the implementability of six recommendations from the three guidelines.
Conclusion:
The experience in using the framework and the preliminary evaluation indicate that this approach has promise in creating structured knowledge, to implement in CDS systems, that is usable across organizations.
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