Literature DB >> 8563259

Medical decision support: experience with implementing the Arden Syntax at the Columbia-Presbyterian Medical Center.

R A Jenders1, G Hripcsak, R V Sideli, W DuMouchel, H Zhang, J J Cimino, S B Johnson, E H Sherman, P D Clayton.   

Abstract

We began implementation of a medical decision support system (MDSS) at the Columbia-Presbyterian Medical Center (CPMC) using the Arden Syntax in 1992. The Clinical Event Monitor which executes the Medical Logic Modules (MLMs) runs on a mainframe computer. Data are stored in a relational database and accessed via PL/I programs known as Data Access Modules (DAMs). Currently we have 18 clinical, 12 research and 10 administrative MLMs. On average, the clinical MLMs generate 50357 simple interpretations of laboratory data and 1080 alerts each month. The number of alerts actually read varies by subject of the MLM from 32.4% to 73.5%. Most simple interpretations are not read at all. A significant problem of MLMs is maintenance, and changes in laboratory testing and message output can impair MLM execution significantly. We are now using relational database technology and coded MLM output to study the process outcome of our MDSS.

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Mesh:

Year:  1995        PMID: 8563259      PMCID: PMC2579077     

Source DB:  PubMed          Journal:  Proc Annu Symp Comput Appl Med Care        ISSN: 0195-4210


  2 in total

1.  Use of open standards to implement health maintenance guidelines in a clinical workstation.

Authors:  R A Jenders; M Morgan; G O Barnett
Journal:  Comput Biol Med       Date:  1994-09       Impact factor: 4.589

2.  Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research.

Authors:  M E Johnston; K B Langton; R B Haynes; A Mathieu
Journal:  Ann Intern Med       Date:  1994-01-15       Impact factor: 25.391

  2 in total
  27 in total

1.  Translating national childhood immunization guidelines to a computer-based reminder recall system within an immunization registry.

Authors:  D Wang; R A Jenders; B Dasgupta
Journal:  Proc AMIA Symp       Date:  1999

2.  The use of an explanation algorithm in a clinical event monitor.

Authors:  W R Hogan; M M Wagner
Journal:  Proc AMIA Symp       Date:  1999

3.  A UMLS-based knowledge acquisition tool for rule-based clinical decision support system development.

Authors:  S L Achour; M Dojat; C Rieux; P Bierling; E Lepage
Journal:  J Am Med Inform Assoc       Date:  2001 Jul-Aug       Impact factor: 4.497

4.  Challenges in implementing a knowledge editor for the Arden Syntax: knowledge base maintenance and standardization of database linkages.

Authors:  Robert A Jenders; Balendu Dasgupta
Journal:  Proc AMIA Symp       Date:  2002

5.  Arden/J: an architecture for MLM execution on the Java platform.

Authors:  Harry C Karadimas; Christophe Chailloleau; François Hemery; Julien Simonnet; Eric Lepage
Journal:  J Am Med Inform Assoc       Date:  2002 Jul-Aug       Impact factor: 4.497

6.  Making the standard more standard: a data and query model for knowledge representation in the Arden syntax.

Authors:  Robert A Jenders; Roger Corman; Balendu Dasgupta
Journal:  AMIA Annu Symp Proc       Date:  2003

7.  Improving adherence to research protocol drug exclusions using a clinical alerting system.

Authors:  James J Cimino; Lincoln Farnum; Gary E DiPatrizio; Barry R Goldspiel
Journal:  AMIA Annu Symp Proc       Date:  2011-10-22

8.  A four-phase model of the evolution of clinical decision support architectures.

Authors:  Adam Wright; Dean F Sittig
Journal:  Int J Med Inform       Date:  2008-03-19       Impact factor: 4.046

9.  Evolution of a knowledge base for a clinical decision support system encoded in the Arden Syntax.

Authors:  R A Jenders; H Huang; G Hripcsak; P D Clayton
Journal:  Proc AMIA Symp       Date:  1998

10.  Towards improved knowledge sharing: assessment of the HL7 Reference Information Model to support medical logic module queries.

Authors:  R A Jenders; W Sujansky; C A Broverman; M Chadwick
Journal:  Proc AMIA Annu Fall Symp       Date:  1997
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