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Annette ten Teije

Publications and source records attributed to Annette ten Teije.

3 recordsLinked to original sources

Extraction and use of linguistic patterns for modelling medical guidelines.

OBJECTIVE: The quality of knowledge updates in evidence-based medical guidelines can be improved and the effort spent for updating can be reduced if the knowledge underlying the guideline text is explicitly modelled using the so-called linguistic guideline patterns, mappings between a text fragment and a formal representation of its corresponding medical knowledge. METHODS AND MATERIAL: Ontology-driven extraction of linguistic patterns is a method to automatically reconstruct the control knowledge captured in guidelines, which facilitates a more effective modelling and authoring of medical guidelines. We illustrate by examples the use of this method for generating and instantiating linguistic patterns in the text of a guideline for treatment of breast cancer, and evaluate the usefulness of these patterns in the modelling of this guideline. RESULTS: We developed a methodology for extracting and using linguistic patterns in guideline formalization, to aid the human modellers in guideline formalization and reduce the human modelling effort. Using automatic transformation rules for simple linguistic patterns, a good recall (between 72% and 80%) is obtained in selecting the procedural knowledge relevant for the guideline model, even though the precision of the guideline model generated automatically covers only between 20% and 35% of the human-generated guideline model. These results indicate the suitability of our method as a pre-processing step in medical guideline formalization. CONCLUSIONS: Modelling and authoring of medical texts can benefit from our proposed method. As pre-requisites for generating automatically a skeleton of the guideline model from the procedural part of the guideline text, to aid the human modeller, the medical terminology used by the guideline must have a good overlap with existing medical thesauri and its procedural knowledge must obey linguistic regularities that can be mapped into the control constructs of the target guideline modelling language.

Artificial Intelligence↗

Improving medical protocols by formal methods.

OBJECTIVES: During the last decade, evidence-based medicine has given rise to an increasing number of medical practice guidelines and protocols. However, the work done on developing and distributing protocols outweighs the efforts on guaranteeing their quality. Indeed, anomalies like ambiguity and incompleteness are frequent in medical protocols. Recent efforts have tried to address the problem of protocol improvement, but they are not sufficient since they rely on informal processes and notations. Our objective is to improve the quality of medical protocols. APPROACH: The solution we suggest to the problem of quality improvement of protocols consists in the utilisation of formal methods. It requires the definition of an adequate protocol representation language, the development of techniques for the formal analysis of protocols described in that language and, more importantly, the evaluation of the feasibility of the approach based on the formalisation and verification of real-life medical protocols. For the first two aspects we rely on earlier work from the fields of knowledge representation and formal methods. The third aspect, i.e. the evaluation of the use of formal methods in the quality improvement of protocols, constitutes our main objective. The steps with which we have carried out this evaluation are the following: (1) take two real-life reference protocols which cover a wide variety of protocol characteristics; (2) formalise these reference protocols; (3) check the formalisation for the verification of interesting protocol properties; and (4) determine how many errors can be uncovered in this way. RESULTS: Our main results are: a consolidated formal language to model medical practice protocols; two protocols, each both modelled and formalised; a list of properties that medical protocols should satisfy; verification proofs for these protocols and properties; and perspectives of the potentials of this approach. Our results have been evaluated by a panel of medical experts, who judged that the problems we detected in the protocols with the help of formal methods were serious and should be avoided. CONCLUSIONS: We have succeeded in demonstrating the feasibility of formal methods for improving medical protocols.

Artificial Intelligence↗

Protocure: supporting the development of medical protocols through formal methods.

Medical guidelines and protocols describe the optimal care for a specific group of patients and therefore, when properly applied, improve the quality of patient care. During the last decade, a large number of medical guidelines and protocols have been published. However, the work done on developing and disseminating them far outweighs the efforts on guaranteeing their quality. Indeed, anomalies like ambiguity and incompleteness are frequent in medical guidelines and protocols. An approach grounded on a formal representation, can answer these needs, as we have demonstrated in the Protocure project'. The Protocure II project will aim at integrating formal methods in the life cycle of guidelines.

Clinical Protocols↗