A Multiple-Ontology Template-Based Query Interface for a Clinical

Guidelines Search Engine

Robert Moskovitch, Talie Lavie, Akiva Leibowitz, Yaron Denekamp and Yuval Shahar

Medical Informatics Research CenterDepartment of Information Systems Engineering

Ben Gurion University, Beer Sheva, Israel

DeGeL – Digital electronic Guidelines Library

Vaidurya – a Search Engine For Multiple- Ontology Clinical

Practice Guidelines

• CPGs are indexed as Source Guidelines (SGLs) and as structured, Marked-Up Guidelines (MGLs)– MGLs may be represented in different ontologies ( Asbru,

GEM,. )

• CPGs are classified along seven semantic conceptual axes in the DeGeL digital guidelines library

DeGeL – Digital electronic Guidelines Library

Example: Markup of a Guideline’s Text Using a Guideline Ontology

Plan

…

Entry Conditions

Target Population

objectives

Outcome

Process

Pregnant women at high risk for gestational diabetes

The main goal is reduction of fasting blood glucose level…

The guideline uses mainly dietary measures…

If a need for insulin develops, use a guideline for using short-acting insulin…

DeGeL – Digital electronic Guidelines Library

Semantic Classification and Concept-Based Search

• In DeGeL there are seven semantic axes (or aspects) that can In DeGeL there are seven semantic axes (or aspects) that can

categorize CGPs (e.g., diagnosis type, therapy type)categorize CGPs (e.g., diagnosis type, therapy type)• Each axis is implemented as a tree Each axis is implemented as a tree • Each Guideline can be classified under zero, one, or more Each Guideline can be classified under zero, one, or more

indices from each semantic, conceptual axisindices from each semantic, conceptual axis

DeGeL – Digital electronic Guidelines Library

The Vaidurya Query Interface

ConceptsQueried

Concepts

Ontology Elements

Queried Ontology Elements

DeGeL – Digital electronic Guidelines Library

Vaidurya Results Viewer

Categorized Results

Retrieved CPGs

Ontology Elements

DeGeL – Digital electronic Guidelines Library

The Vaidurya Customizable Query Interface (VCQI)

• The current interface is overloaded• Different users have different information needs,

different familiarity with DeGeL and CPGs ontologies, and different levels of clinical knowledge.

• The VCQI offers a customizable interface, in which a super user specifies a sub collection of the requested ontology elements and semantic indices, to answer a general information need

• The user searching through a VCQI instantiates with particular terms a generic search frame

DeGeL – Digital electronic Guidelines Library

Simple Search Using the VCQI

DeGeL – Digital electronic Guidelines Library

Advanced Full-Ontology Search in the VCQI

DeGeL – Digital electronic Guidelines Library

A Customized VCQI example

DeGeL – Digital electronic Guidelines Library

The Vaidurya Template-Based Query Interface (TBQI)

• A preliminary VCQI evaluation was encouraging, but it pointed out that the user still needs to be familiar with CPG ontologies

• A more abstract interface is required.• The Vaidurya Template Based Query Interface (TBQI) offers an

approach that overcomes the need for familiarity with CPG ontologies

• The TBQI presents a template interface presented as a more clinical, task-oriented description of the information need, which has to be completed using combo boxes, text boxes, or check boxes.

• The searcher’s choices are converted into a series of formal Vaidurya queries in the background

DeGeL – Digital electronic Guidelines Library

The Vaidurya TBQI designer

DeGeL – Digital electronic Guidelines Library

A COPD Domain Query in TBQI

DeGeL – Digital electronic Guidelines Library

Summary

• Vaidurya offers concept-based & context-sensitive search methods shown in a rigorous evaluation to significantly outperform the Full Text search.

• The original DeGeL interface presents an overloaded interface, which requires familiarity with CPG ontologies and concept hierarchies.

• The VCQI presents a reduced-load query interface, including elements which are derived from the information need and the user level of clinical and CPG knowledge

DeGeL – Digital electronic Guidelines Library

Summary

• The TBQI suggests an interface, in a story format, which describes the information need in the user’s terms

• The user mostly needs to choose only from a combo box / text box / check box.

• Choosing from a set of given options is easier and overcomes the need for familiarity with CPG ontologies and with the concept hierarchies

• Preliminary reactions to the TBQI are favorable; we are planning to perform a more formal evaluation