Medexter’s ArdenSuite Is Part of a Comprehensive Study of Rule Formalisms for the Representation of Clinical Guidelines

Medexter’s Arden-Syntax-based ArdenSuite is part of a “Comprehensive analysis of rule formalisms to represent clinical guidelines: Selection criteria and case study on antibiotic clinical guidelines”, by Natalia Iglesias, Jose M. Juarez, and Manuel Campos, published in Artificial Intelligence in Medicine 103 (2020) 1017H1. 
Through over-utilization of antibiotics in clinical domains an increase in bacterial resistances has been caused. To contain the over-use, the computerization of clinical guidelines (CGs) including rules on how to prescribe antibiotics correctly is crucial. This study addresses the challenges of this process and offers a framework of criteria that can help clinical institutions in selecting rule-based technology that suits the process of computerizing their specific CGs best. The analysis identified three main criteria: language, interoperability, and industrial aspects. Part of the extended comparison are HL7’s Arden Syntax, Drools, RIF/PRD, OWL + SWRL, OWL + SPIN. The research is based on existing literature, clinical guidelines, and the authors used the John Hopkins Hospital’s Clinical Guidelines on Urinary Tract Infection as a case study.  

The study revealed a number of highly beneficial properties of HL7’s Arden Syntax when it comes to the representation of CGs, such as its medical orientation—which leads to a higher compliance with medical standards and terminologies—and the fact that it provides a wide range of powerful temporal operators for temporal reasoning. This is an essential factor when working with antibiotic CGs. When it comes to interoperability, the Arden Syntax is known for the curly braces problem which means that references to local data stores have to be enclosed in the medical logic modules’ (MLMs) curly braces expression. This problem is being solved by integrating new technologies, which is done by Medexter. Medexter’s ArdenSuite is continuously and actively developed and supports the integration of new features such as the HL7 standard FHIR.

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