EON: a component-based approach to automation of protocol-directed therapy

J Am Med Inform Assoc. 1996 Nov-Dec;3(6):367-88. doi: 10.1136/jamia.1996.97084511.

Abstract

Provision of automated support for planning protocol-directed therapy requires a computer program to take as input clinical data stored in an electronic patient-record system and to generate as output recommendations for therapeutic interventions and laboratory testing that are defined by applicable protocols. This paper presents a synthesis of research carried out at Stanford University to model the therapy-planning task and to demonstrate a component-based architecture for building protocol-based decision-support systems. We have constructed general-purpose software components that (1) interpret abstract protocol specifications to construct appropriate patient-specific treatment plans; (2) infer from time-stamped patient data higher-level, interval-based, abstract concepts; (3) perform time-oriented queries on a time-oriented patient database; and (4) allow acquisition and maintenance of protocol knowledge in a manner that facilitates efficient processing both by humans and by computers. We have implemented these components in a computer system known as EON. Each of the components has been developed, evaluated, and reported independently. We have evaluated the integration of the components as a composite architecture by implementing T-HELPER, a computer-based patient-record system that uses EON to offer advice regarding the management of patients who are following clinical trial protocols for AIDS or HIV infection. A test of the reuse of the software components in a different clinical domain demonstrated rapid development of a prototype application to support protocol-based care of patients who have breast cancer.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Algorithms
  • Artificial Intelligence*
  • Breast Neoplasms / therapy
  • Case Management
  • Clinical Protocols*
  • Computer Communication Networks
  • Female
  • HIV Infections / therapy
  • Humans
  • Models, Theoretical
  • Problem Solving
  • Software Design
  • Systems Integration*
  • Therapy, Computer-Assisted*
  • Time Factors
  • User-Computer Interface