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A framework for automated conflict detection and resolution in medical guidelines

机译：医疗指南中自动检测和解决冲突的框架

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Common chronic conditions are routinely treated following standardised procedures known as clinical guidelines. For patients suffering from two or more chronic conditions, known as multimorbidity, several guidelines have to be applied simultaneously, which may lead to severe adverse effects when the combined recommendations and prescribed medications are inconsistent or incomplete. This paper presents an automated formal framework to detect, highlight and resolve conflicts in the treatments used for patients with multimorbidities focusing on medications. The presented extended framework has a front-end which takes guidelines captured in a standard modelling language and returns the visualisation of the detected conflicts as well as suggested alternative treatments. Internally, the guidelines are transformed into formal models capturing the possible unfoldings of the guidelines. The back-end takes the formal models associated with multiple guidelines and checks their correctness with a theorem prover, and inherent inconsistencies with a constraint solver. Key to our approach is the use of an optimising constraint solver which enables us to search for the best solution that resolves/minimises conflicts according to medication efficacy and the degree of severity in case of harmful combinations, also taking into account their temporal overlapping. The approach is illustrated throughout with a real medical example. (C) 2019 Elsevier B.V. All rights reserved.
机译：常见的慢性病通常按照称为临床指南的标准化程序进行常规治疗。对于患有两种或多种慢性病（称为多发病）的患者，必须同时应用几项指南，当联合推荐的药物和处方药不一致或不完整时，可能导致严重的不良反应。本文提供了一个自动的正式框架，用于检测，突出显示和解决针对以药物为主的多病患者的治疗中的冲突。提出的扩展框架具有前端，该前端采用以标准建模语言捕获的准则，并返回检测到的冲突的可视化结果以及建议的替代处理方法。在内部，准则被转换为形式化的模型，以捕获准则可能的展开。后端采用与多个准则相关联的形式模型，并通过定理证明者检查其正确性，并通过约束求解器检查其固有的不一致性。我们方法的关键是使用优化约束求解器，该求解器使我们能够根据药物功效和严重性（在有害组合的情况下）并同时考虑到它们的时间重叠来寻找/消除冲突的最佳解决方案。整个过程以一个实际的医学示例进行了说明。 （C）2019 Elsevier B.V.保留所有权利。

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