Computers in biology and medicine
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In implementing a clinical event monitor (CEM), a decision-support system, we worked with an existing repository of clinical data (Keystone), fed from ancillary systems using HL7. The rules are written in the Arden Syntax, an ASTM standard for expressing medical knowledge as medical logic modules (MLMs). ⋯ Overall, less than a quarter of the development effort has gone into the Arden compiler and interpreter; the rest has focused on accessing the data and integrating with other systems. We feel that the Arden Syntax has proved its worth in writing rules; effort should now be focused on medical vocabularies and data models.
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The Arden Syntax for Medical Logic Modules is a language for encoding medical knowledge bases that consist of independent modules. The Arden Syntax has been used to generate clinical alerts, diagnostic interpretations, management messages, and screening for research studies and quality assurance. ⋯ Most MLMs are triggered by clinical events, evaluate medical criteria, and, if appropriate, perform an action such as sending a message to a health care provider. This paper provides a detailed tutorial on how to write MLMs.
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We are developing a clinical workstation which integrates access to health maintenance guidelines with access to a computer-based medical record. In order to enhance the portability of such a system, we emphasize the use of open standards which can be used in diverse clinical environments. We discuss the use of relational database and expert system technology to provide both patient-specific and patient-independent access to clinical guidelines. We use the Arden Syntax as the format for a textual library which facilitates the storage of structured medical knowledge.
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When developing a clinical decision support system that uses knowledge expressed in Arden Syntax, the availability of a robust means of translating Arden Syntax into an executable module becomes critical. This paper describes an approach where Arden Syntax is translated into an intermediate pseudo-Arden language that is in turn compiled and linked to create the executable module. The pseudo-Arden language is defined in C++ using specialized class libraries and preprocessor macros. This approach provides an alternative means of developing the code generator for an Arden Syntax compiler.