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Because clinical databases vary in structure, access methods and vocabulary used to represent data, the Arden Syntax does not define a standard model for querying databases. Consequently, database queries are encoded in ad hoc ways and enclosed in "curly braces" in Medical Logic Modules (MLMs). However, the nonstandard representation of queries impairs(More)
A standards-based, service-oriented architecture for clinical decision support (CDS) has the potential to significantly enhance CDS scalability and robustness. To enable such a CDS architecture, the Health Level 7 CDS Work Group reviewed the literature, hosted multi-stakeholder discussions, and consulted domain experts to identify and prioritize the(More)
Clinical coding and classification processes transform natural language descriptions in clinical text into data that can subsequently be used for clinical care, research, and other purposes. This systematic literature review examined studies that evaluated all types of automated coding and classification systems to determine the performance of such systems.(More)
CONTEXT Arden Syntax is a Health Level Seven (HL7) standard that can be used to encode computable knowledge. However, dissemination of knowledge is hampered by lack of standard database linkages in Arden knowledge bases (KB). Moreover, the HL7 Reference Information Model (RIM) is object-oriented and hence incompatible with the current Arden data model.(More)
Clinical decision support systems (CDSS) are being used increasingly in medical practice. Thus, long-term maintenance of the knowledge bases (KB) of such systems becomes important. To quantify changes that occur as a KB evolves, we studied the KB at the Columbia-Presbyterian Medical Center. This KB has a total of 229 Medical Logic Modules (MLMs) encoded in(More)
Background. Although coronary heart disease (CHD) continues to be a leading cause of morbidity and mortality among adults in the U.S., it is possible to prevent CHD through modification of risk factors. The major and independent risk factors are elevated blood pressure, cigarette smoking, elevated LDL-C and cholesterol (TC), low HDL-C, diabetes mellitus,(More)
Despite their potential to significantly improve health care, advanced clinical decision support (CDS) capabilities are not widely available in the clinical setting. An important reason for this limited availability of CDS capabilities is the application-specific and institution-specific nature of most current CDS implementations. Thus, a critical need for(More)
Computer-based clinical decision support systems (CDSSs) are often implemented at a cluster level, but standard statistical methods for sample estimation and analysis may not be appropriate for such studies. This review aims to determine whether the design and analysis methods of cluster-based studies were adequately addressed in reports of CDSS studies. We(More)