1. 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 Center Department of Information Systems Engineering Ben Gurion University, Beer Sheva, Israel

2. 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

3. 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 …

4. DeGeL – Digital electronic Guidelines Library Semantic Classification and Concept-Based Search In DeGeL there are seven semantic axes (or aspects) that can categorize CGPs (e.g., diagnosis type, therapy type)In DeGeL there are seven semantic axes (or aspects) that can categorize CGPs (e.g., diagnosis type, therapy type) Each axis is implemented as a treeEach axis is implemented as a tree Each Guideline can be classified under zero, one, or more indices from each semantic, conceptual axisEach Guideline can be classified under zero, one, or more indices from each semantic, conceptual axis

5. DeGeL – Digital electronic Guidelines Library The Vaidurya Query Interface Concepts Queried Concepts Ontology Elements Queried Ontology Elements

6. DeGeL – Digital electronic Guidelines Library Vaidurya Results Viewer Categorized Results Retrieved CPGs Ontology Elements

7. 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

8. DeGeL – Digital electronic Guidelines Library Simple Search Using the VCQI

9. DeGeL – Digital electronic Guidelines Library Advanced Full-Ontology Search in the VCQI

10. DeGeL – Digital electronic Guidelines Library A Customized VCQI example

11. 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

12. DeGeL – Digital electronic Guidelines Library The Vaidurya TBQI designer

13. DeGeL – Digital electronic Guidelines Library A COPD Domain Query in TBQI

14. 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

15. 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