Evaluation of Knowledge Model for a Hypertension Management CDSS Using a Standard-based Knowledge Authoring Tool

Hyun Young Kim, Ji Hyun Kim, I. Cho, Y. Kim
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Abstract

Objective: For the development of interoperable and sharable knowledge-based clinical decision support systems, it is impor- tant to evaluate the appropriateness of knowledge in each phase. In this study, an evaluation of early phase's knowledge model for hypertension management was conducted to develop a more precise and useful knowledge model. Methods: The knowledge model for hypertension management based on JNC7 was modeled using a knowledge representation tool based on SAGE. Two physicians were involved in evaluating the process of the knowledge model. They reviewed 36 scenarios and made recommendations based on the knowledge model. These recommendations were compared with those derived from the model. Results: Eight algorithms and 223 evidence statements were included in the knowledge model. The concordance rate of the recommendations between the physicians and the model for the goal BP were 61% and 93% by the respective physicians. Six scenarios showed low proficiency and efficiency for drug recommendation. Two refinements of the knowledge model were made based on the results. Conclusion: The evaluation process of the knowledge model in the early phase pro- vides more precise and useful knowledge model in the next. (Journal of Korean Society of Medical Informatics 15-4, 445-453, 2009)
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基于标准的知识创作工具对高血压管理CDSS知识模型的评价
目的:为了开发可互操作和共享的基于知识的临床决策支持系统,评估每个阶段知识的适宜性是很重要的。本研究对高血压管理的早期知识模型进行评估,以建立一个更精确和有用的知识模型。方法:采用基于SAGE的知识表示工具,建立基于JNC7的高血压管理知识模型。两名医生参与了对知识模型过程的评估。他们回顾了36个场景,并根据知识模型提出了建议。将这些建议与从模型中得出的建议进行比较。结果:知识模型共包含8种算法和223条证据语句。医生对目标血压的建议与模型的符合率分别为61%和93%。6种情况下药物推荐的熟练度和效率较低。在此基础上,对知识模型进行了两次改进。结论:知识模型的早期评价过程为知识模型的后期评价提供了更为精确和实用的知识模型。(韩国医学信息学会杂志15- 4,445 -453,2009)
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