Description
In
every aspect of patient treatment, questions arise for which a search
of the published medical evidence is appropriate, as it is very likely
that the answer has already been found from the work of other clinicians.
For example:
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Q: In a child with asthma, do increased
doses of inhaled corticosteroids lead to a decrease in growth?
A: Growth was significantly slower in the group
receiving higher dose inhaled steroids (3.6 cm, 95%CI 3.0 to 4.2
with double dose beclometasone v 5.1 cm, 95% CI 4.5 to 5.7 with
salmeterol v 4.5 cm, 95% CI 3.8 to 5.2 with placebo).
(Stuart Barton, Clinical Evidence, BMJ Publishing Group, London 2002.) |
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Studies
have shown that searching in the literature can help clinicians in
answering questions generated in patient treatment. It
has also been found that if high-quality evidence is available in
this way at
the point of care -- for example, the patient's bedside -- clinicians
will
use it in their decision-making, and it frequently results in additional
or changed
decisions. The practice of using the current best evidence
to help clinicians in making decisions on the treatment of patients
is called
Evidence-Based Medicine (EBM).
The EPoCare project aims to provide fast access for clinicians to
EBM resources at the point of care, that is, while seeing a patient
either
in an office or on clinical rounds in a hospital. Clinicians will be
able to query resources that summarize and appraise evidence about
the diagnosis, treatment, prognosis, etiology and prevalence of medical
conditions. In order to make it available at the point of care, the
question-answering system is accessible using hand-held computers.
Questions are answered based on the semantics of the domain,
evidence-based medicine. Both the questions and the EBM sources from
which the answers are drawn are understood in terms of a lightweight
ontology of evidence-based medicine. This ontology constitutes a model
of the sorts of things that exist in the domain and the sorts of
relationships that can hold among them. The fact that the system has
such a common understanding of the queries and information sources
is the key to providing accurate answers.
The EPoCare project is an interdisciplinary collaboration that involves
research in several disciplines. Project members in Industrial
Engineering and Cognitive Psychology are investigating the design of
the system through a user-centred design process, in which requirements
are
elicited from end users who are also involved in the evaluation of
prototypes. Project members in Knowledge Management and Natural Language
Processing aim to ensure that the answers to queries are accurate and
complete. Project members in Database Management provide support in
dealing with data sources in XML format. And project members in Health
Informatics will test the influence of the system on clinical
decision-making and clinical outcomes.
| Funding Agency: |
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| Principle Investigators: |
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The
Knowledge Management Lab - Depoartment
of Computer Science - University
of Toronto 