URUZ3: A formal-specification tool for acquisition and maintenance of clinical guidelines
Department of Information Systems EngineeringFaculty of Engineering
Ben-Gurion University of the Negev
Student :Erez ShalomAdvisor : Prof.Yuval Shachar
• The task of authoring the Knowledge will include a two-phase process:-first phase (typically performed by a medical expert) supports semantic mark-up and structuring of free-text guidelines-second phase (typically performed by a knowledge engineer)
converts the semi-structured guideline into a formal guideline-specification language , ASBRU.
• Current work on URUZ has graphical and other limitations , therefore, the structuring is performed until the semi-structured only, in cumbersome ,not intuitive way.
a
b
Semantic markup(semi-Structuring)
Adding a machine-comprihensible f ormat
Free-text guideline
Web-basedguideline library
-Eligibility & applicability determination-Runtime application-Retrospective Quality assessment
Context-sensitiveWeb-based Search,retrieval, andBrowsing interf ace
URUZ
Background
URUZ3 requirements
• Graphical and intuitive WinForm tool for guideline structuring
• Enable structuring for semi and formal language• every element in the formal-language will have
special graphical representation , emphasizing its special characteristics(e.g plan-body builder,condition builder)
• Support multi-ontology for mark-up• Part of DeGeL’s framework• the tool will also involve interaction with other
tools (IDAN’s frame work)
URUZ3 & IDAN framework
Physician Knowledgeengineer
URUZ3
DeGeL
IndexiGuide Vaidurya
Search for Gl,GlDoc to Edit
Index a SelectedGlDoc
IDAN
KnowledgeBase
QueryBuilder(IDAN Language)
Vocabularyserver
Define the term “Hypertension”in the KB
Search for standard term“hemoglobin” in ICD-9 anddefine it in the kb
Build the query“patients with Hypertension andhemoglobin less then 9.5 gr/dl” inIDAN language
Gudeline text example:“This guideline is forpatients withHypertension andhemoglobin less then9.5 gr/dl”
Starting URUZ3
When starting URUZ3 ,before creating a GLDoc ,one can choose the ontology to based on.
Current supported ontologies are Asbru,GEM
GL Source documentationand modules(e.g add source)
Open IndexiguideOpen the KB to Define
Knowledge
Current Ontologies tocreate GLDoc from
URUZ3 main interface:
About the Structure-level Views tree:There is view for each structure-level. Thus, when expert structure a GLDoc, she can choose a view of structuring level.the tree composed from relevant knowledge roles of the current structuring level(e.g. knowledge roles as “returns” and “arguments” will be shown just in Full-Asbru view –see slide 8).The expert push the button for each view. the most right button is hybrid view. See more explanation in the comments part
Here ,an expert dragged the “filter-precondition” knowledge role to the edit area.
because the current structuring level is “text”, an html editor tab control generated, enables drag& drop of text portions from the GL source ( “Diagnosis and management of hypertension”).
Free text and modifications can be done using the editor tool -bar
View area
Edit area
Text View(Default view)
SST View
Full structuredView
All levels -hybrid View
Tag for every sourceof the GL
Structure-levelsViews tree
Drop aknowledge role
here to edit
PB tree
Drag &Drop
Click to addComments
C
Specify here the structure of Sst-(filter condition)
Prompt the use every-time the plan proceeding the next step
Override the value of the condition in run-time by the user
...
Construct your condition(condition builder )
Specify a time for this condition to be hold
...
Drag &Drop
SST level of theknowledge role
SST viewselected
Control for “filter condition” isgenerated with SST semantics
Open the “conditionbuilder ” for furtherstructuring of thecondition
Open GUI for “time-annotation” structuring
Asbru semantics
Is the patientnot regnant?
And
Is thepatientadult?
SST view-”filter precondition” example :
Note that because the structure level view is SST,every knowledge role which belongs to this level (e.g not “arguments”) has an “SST” node (and icon) enabling further structuring in SST.Here ,an expert dragged the Text “filter-precondition” to the view area and the “SST” knowledge role to the edit area ; then he can open the condition builder for the semi-formal structuring.
Specify here the Full structure of -(filter condition)
Full structure level ofthe knowledge role
Full structureview selected
Drag &Drop
Construct your condition in IDAN language ...
Open the query builder ofIDAN language to Full-structure of the condition
Full structured view-”filter precondition” example :
In the Full structure view every knowledge role which is belong to this level (e.g “arguments”,”value def”) have “Full” node(and simbolic image) enabling further structuring in Full Asbru. Here ,an expert dragged the Text “filter-precondition” to the view area and the “Full” knowledge role to the edit area –then he can constarct the condition in IDAN language ,thus the condition is represented in his formal structure.
Drag &Drop
SST level of theknowledge role
SST viewselected
Specify here the Sst structure of -(Deafults)
...Select a plan to activate when current plan is suspended
Select a plan to activate when current plan is Aborted
Sepcify a deafult time this plan can be activated
Specify a typical duration for current plan
...
...
...
Asbrusemantics
SST view-”deafults” example :
The expert dragged the “SST” node of “deafults “ knowledge role to the editing area.Thus the generated tab is according to Asbru semantics in the context of that knowledge role. when pressing the buttons a different GUI is generated for each attribute, enable further structuring of the element .for example,a control for specifing time –annotation or duration can be generated according to the user action.
Specify here the Sst structure of -(Deafults)
...
Open the Plan-Body Builder for specify Medical tasks hierarchy
Open the PB builder ,forfurther structuring -seeslide 13
Drag &Drop
SST viewselected
SST view-”Plan-Body” example :
From the SST level of Plan-body ,the expert can open the Plan-body builder (explain in detail in slid 12-17).Thus, the expert can create hierarchy of plans for the current plan.
Drag &Drop
Full structureslevel of the
knowledge role
Hybrid viewselected
Sst level of theknowledge role
HL StateBP Level
Specify here the Sst structure of -(Obtain values)
The list of Obtain values from current plan
HL State1BP Level1Deagnosis
Specify here the Full structure of -(Returns)
The list of Return values from current plan
Hybrid view-”deafults” example :
Note that the tree includes all the knowledge roles from all the levels.
Here ,the SST level of the “obtain values” knowledge role used for structuring the FULL level of “Returns” knowledge role. By selecting a plan in the PB tree (we have plans specification after we used the PB builder), we can structure a knowledge role in context of the selected GL.
Plan-Body builder :Expressing the Procedural Knowledge
• This task will be perform in several steps, guiding the physician, step by step, to structure the guideline’s procedural knowledge
• In the beginning of the process ,the medical tasks hierarchy will be defined and afterwards the order between the them.
• Thus, when the general concept of the plan is discovered, the physician can continue with defining the less intuitive characteristics of the procedural knowledge.
• In this primary prototype the first two steps were implemented
Semantic Types
Reference Types
Control Types
Parent Text Child Text
Order Between Plans
Plans Tree
Plans Tab
Drag And Drop Plans
Root Text (Source in this case) Free Text for selected Plan
selected Plan
Generated Tree of plans
Check if mandatory plan
Parallel Order selected
Dragged text to child plan from Parent text
Renamed Plan
New tab for expanded plan
Every new level has at least 2 general plans
Condition Type
Previous Child Text become Parent text in this level
Generated tree
Convert to semantic type mechanism
Converted plan
Condition Property – Opne
Expression Builder
Condition Text
Expression Bulider open to specify a condition base (or not) on the text
Double Click Expand the (plan (has dash boredr
Convert the general into drug type
The Expression
Choises
Default
Drag a Choice
and add to the cases collection
Back to Parent Level
Reference Types