XML Data and Knowledge-Encoding Structure for a Web-Based and Mobile Antenatal Clinical Decision Support System:...

Area of Science:

• Medical Informatics
• Health Systems Engineering
• Computer Science

Background:

• Clinical decision support systems (CDSSs) face challenges in matching functionality with clinical workflows.
• Existing computer-interpretable guidelines (CIGs) require specific interpreters, hindering implementation and interoperability.
• A need exists for a CDSS representation that is expressive, has a small footprint, and aligns with clinical workflows.

Purpose of the Study:

• To describe a novel approach for representing clinical knowledge and data in CDSSs.
• To enhance clinician perception of CDSSs through improved expressivity and usability.
• To develop a minimal syntax for web and mobile CDSS applications, particularly for antenatal care guidelines.

Main Methods:

• Designed and implemented a CDSS architecture using the Model-View-Controller (MVC) pattern.
• Developed a knowledge engine within the MVC architecture based on XML.
• Utilized work ontology analysis of antenatal care clinical practice guidelines (CPGs) to align with clinical workflows.

Main Results:

• The XML-based approach facilitates electronic sharing of structured data, improving upon common CIGs.
• XML's flexibility allows for standardization of CIG structure design in a ubiquitous, efficient, and human-readable format.
• The system is integrable with web technologies and suitable for mobile applications.

Conclusions:

• The XML knowledge representation framework effectively encodes antenatal care CPGs and clinical workflows.
• The framework is generalizable to other CPGs in medicine and proves expressive for clinical systems.
• XML is suitable for mobile CDSS applications requiring small footprints and autonomous operation, integrating capabilities of specialized CIGs.