J Korean Soc Med Inform.  2009 Dec;15(4):445-453.

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

• Kim HY
• Kim JH
• Cho IS
• Kim Y

Abstract

OBJECTIVE
For the development of interoperable and sharable knowledge-based clinical decision support systems, it is important 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 provides more precise and useful knowledge model in the next.

Keyword

Clinical Interpretable Guideline; Knowledge Modeling; Evaluation; Hypertension Management

MeSH Terms

Decision Support Systems, Clinical
Hypertension

Figure

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  Figure 1 Process for evaluation of knowledge model

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  Figure 2 An Activity graph specifying hypertension management to decision-support opportunities in the main clinical workflow

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  Figure 3 An instance of a Evidence Statement encoded 'In the hypertension management, presence of angina is a compelling indication for beta blocking agent.'

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  Figure 4 An instance of a Presence_Criterion encoded presence of angina on EMR

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