Using first-order logic to represent clinical practice guidelines and to mitigate adverse interactions

Abstract

Clinical practice guidelines (CPGs) were originally designed to help with evidence-based management of a single disease and such single disease focus has impacted research on CPG computerization. This computerization is mostly concerned with supporting different representation formats and identifying potential inconsistencies in the definitions of CPGs. However, one of the biggest challenges facing physicians is the application of multiple CPGs to comorbid patients. While various research initiatives propose ways of mitigating adverse interactions in concurrently applied CPGs, there are no attempts to develop a generalized framework for mitigation that captures generic characteristics of the problem, while handling nuances such as precedence relationships. In this paper we present our research towards developing a mitigation framework that relies on a first-order logic-based representation and related theorem proving and model finding techniques. The application of the proposed framework is illustrated with a simple clinical example.