Ten years of knowledge representation for health care (2009–2018): Topics, trends, and challenges

David Riaño, Mor Peleg, Annette ten Teije

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Background: In the last ten years, the international workshop on knowledge representation for health care (KR4HC) has hosted outstanding contributions of the artificial intelligence in medicine community pertaining to the formalization and representation of medical knowledge for supporting clinical care. Contributions regarding modeling languages, technologies and methodologies to produce these models, their incorporation into medical decision support systems, and practical applications in concrete medical settings have been the main contributions and the basis to define the evolution of this field across Europe and worldwide. Objectives: Carry out a review of the papers accepted in KR4HC in the 2009–2018 decade, analyze and characterize the topics and trends within this field, and identify challenges for the evolution of the area in the near future. Methods: We reviewed the title, the abstract, and the keywords of the 112 papers that were accepted to the workshop, identified the medical and technological topics involved in these works, provided a classification of these papers in medical and technological perspectives and obtained the timeline of these topics in order to determine interest growths and declines. The experience of the authors in the field and the evidences after the review were the basis to propose a list of challenges of knowledge representation in health care for the future. Results: The most generic knowledge representation methods are ontologies (31%), semantic web related formalisms (26%), decision tables and rules (19%), logic (14%), and probabilistic models (10%). From a medical informatics perspective, knowledge is mainly represented as computer interpretable clinical guidelines (43%), medical domain ontologies (26%), and electronic health care records (22%). Within the knowledge lifecycle, contributions are found in knowledge generation (38%), knowledge specification (24%), exception detection and management (12%), knowledge enactment (8%), temporal knowledge and reasoning (7%), and knowledge sharing and maintenance (7%). The clinical emphasis of knowledge is mainly related to clinical treatments (27%), diagnosis (13%), clinical quality indicators (13%), and guideline integration for multimorbid patients (12%). According to the level of development of the works presented, we distinguished four maturity levels: formal (22%), implementation (52%), testing (13%), and deployment (2%) levels. Some papers described technologies for specific clinical issues or diseases, mainly cancer (22%) and diseases of the circulatory system (20%). Chronicity and comorbidity were present in 10% and 8% of the papers, respectively. Conclusions: KR4HC is a stable community, still active after ten years. A persistent focus has been knowledge representation, with an emphasis on semantic-web ontologies and on clinical-guideline based decision-support. Among others, two topics receive growing attention: integration of computer-interpretable guideline knowledge for the management of multimorbidity patients, and patient empowerment and patient-centric care.

Original languageEnglish
Article number101713
Pages (from-to)1-12
Number of pages12
JournalArtificial Intelligence in Medicine
Volume100
Early online date7 Sep 2019
DOIs
Publication statusPublished - Sep 2019

Fingerprint

Knowledge representation
Health care
Guidelines
Delivery of Health Care
Ontology
Knowledge Management
Semantic Web
Semantics
Comorbidity
Technology
Decision tables
Education
Patient Participation
Medical Informatics
Electronic Health Records
Artificial Intelligence
Statistical Models
Knowledge management
Cardiovascular System
Decision support systems

Keywords

  • Knowledge representation for health care
  • Literature review
  • Medical informatics

Cite this

@article{9f17246034db485d8ca46b313695bc77,
title = "Ten years of knowledge representation for health care (2009–2018): Topics, trends, and challenges",
abstract = "Background: In the last ten years, the international workshop on knowledge representation for health care (KR4HC) has hosted outstanding contributions of the artificial intelligence in medicine community pertaining to the formalization and representation of medical knowledge for supporting clinical care. Contributions regarding modeling languages, technologies and methodologies to produce these models, their incorporation into medical decision support systems, and practical applications in concrete medical settings have been the main contributions and the basis to define the evolution of this field across Europe and worldwide. Objectives: Carry out a review of the papers accepted in KR4HC in the 2009–2018 decade, analyze and characterize the topics and trends within this field, and identify challenges for the evolution of the area in the near future. Methods: We reviewed the title, the abstract, and the keywords of the 112 papers that were accepted to the workshop, identified the medical and technological topics involved in these works, provided a classification of these papers in medical and technological perspectives and obtained the timeline of these topics in order to determine interest growths and declines. The experience of the authors in the field and the evidences after the review were the basis to propose a list of challenges of knowledge representation in health care for the future. Results: The most generic knowledge representation methods are ontologies (31{\%}), semantic web related formalisms (26{\%}), decision tables and rules (19{\%}), logic (14{\%}), and probabilistic models (10{\%}). From a medical informatics perspective, knowledge is mainly represented as computer interpretable clinical guidelines (43{\%}), medical domain ontologies (26{\%}), and electronic health care records (22{\%}). Within the knowledge lifecycle, contributions are found in knowledge generation (38{\%}), knowledge specification (24{\%}), exception detection and management (12{\%}), knowledge enactment (8{\%}), temporal knowledge and reasoning (7{\%}), and knowledge sharing and maintenance (7{\%}). The clinical emphasis of knowledge is mainly related to clinical treatments (27{\%}), diagnosis (13{\%}), clinical quality indicators (13{\%}), and guideline integration for multimorbid patients (12{\%}). According to the level of development of the works presented, we distinguished four maturity levels: formal (22{\%}), implementation (52{\%}), testing (13{\%}), and deployment (2{\%}) levels. Some papers described technologies for specific clinical issues or diseases, mainly cancer (22{\%}) and diseases of the circulatory system (20{\%}). Chronicity and comorbidity were present in 10{\%} and 8{\%} of the papers, respectively. Conclusions: KR4HC is a stable community, still active after ten years. A persistent focus has been knowledge representation, with an emphasis on semantic-web ontologies and on clinical-guideline based decision-support. Among others, two topics receive growing attention: integration of computer-interpretable guideline knowledge for the management of multimorbidity patients, and patient empowerment and patient-centric care.",
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}

Ten years of knowledge representation for health care (2009–2018) : Topics, trends, and challenges. / Riaño, David; Peleg, Mor; ten Teije, Annette.

In: Artificial Intelligence in Medicine, Vol. 100, 101713, 09.2019, p. 1-12.

Research output: Contribution to JournalReview articleAcademicpeer-review

TY - JOUR

T1 - Ten years of knowledge representation for health care (2009–2018)

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AU - Riaño, David

AU - Peleg, Mor

AU - ten Teije, Annette

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N2 - Background: In the last ten years, the international workshop on knowledge representation for health care (KR4HC) has hosted outstanding contributions of the artificial intelligence in medicine community pertaining to the formalization and representation of medical knowledge for supporting clinical care. Contributions regarding modeling languages, technologies and methodologies to produce these models, their incorporation into medical decision support systems, and practical applications in concrete medical settings have been the main contributions and the basis to define the evolution of this field across Europe and worldwide. Objectives: Carry out a review of the papers accepted in KR4HC in the 2009–2018 decade, analyze and characterize the topics and trends within this field, and identify challenges for the evolution of the area in the near future. Methods: We reviewed the title, the abstract, and the keywords of the 112 papers that were accepted to the workshop, identified the medical and technological topics involved in these works, provided a classification of these papers in medical and technological perspectives and obtained the timeline of these topics in order to determine interest growths and declines. The experience of the authors in the field and the evidences after the review were the basis to propose a list of challenges of knowledge representation in health care for the future. Results: The most generic knowledge representation methods are ontologies (31%), semantic web related formalisms (26%), decision tables and rules (19%), logic (14%), and probabilistic models (10%). From a medical informatics perspective, knowledge is mainly represented as computer interpretable clinical guidelines (43%), medical domain ontologies (26%), and electronic health care records (22%). Within the knowledge lifecycle, contributions are found in knowledge generation (38%), knowledge specification (24%), exception detection and management (12%), knowledge enactment (8%), temporal knowledge and reasoning (7%), and knowledge sharing and maintenance (7%). The clinical emphasis of knowledge is mainly related to clinical treatments (27%), diagnosis (13%), clinical quality indicators (13%), and guideline integration for multimorbid patients (12%). According to the level of development of the works presented, we distinguished four maturity levels: formal (22%), implementation (52%), testing (13%), and deployment (2%) levels. Some papers described technologies for specific clinical issues or diseases, mainly cancer (22%) and diseases of the circulatory system (20%). Chronicity and comorbidity were present in 10% and 8% of the papers, respectively. Conclusions: KR4HC is a stable community, still active after ten years. A persistent focus has been knowledge representation, with an emphasis on semantic-web ontologies and on clinical-guideline based decision-support. Among others, two topics receive growing attention: integration of computer-interpretable guideline knowledge for the management of multimorbidity patients, and patient empowerment and patient-centric care.

AB - Background: In the last ten years, the international workshop on knowledge representation for health care (KR4HC) has hosted outstanding contributions of the artificial intelligence in medicine community pertaining to the formalization and representation of medical knowledge for supporting clinical care. Contributions regarding modeling languages, technologies and methodologies to produce these models, their incorporation into medical decision support systems, and practical applications in concrete medical settings have been the main contributions and the basis to define the evolution of this field across Europe and worldwide. Objectives: Carry out a review of the papers accepted in KR4HC in the 2009–2018 decade, analyze and characterize the topics and trends within this field, and identify challenges for the evolution of the area in the near future. Methods: We reviewed the title, the abstract, and the keywords of the 112 papers that were accepted to the workshop, identified the medical and technological topics involved in these works, provided a classification of these papers in medical and technological perspectives and obtained the timeline of these topics in order to determine interest growths and declines. The experience of the authors in the field and the evidences after the review were the basis to propose a list of challenges of knowledge representation in health care for the future. Results: The most generic knowledge representation methods are ontologies (31%), semantic web related formalisms (26%), decision tables and rules (19%), logic (14%), and probabilistic models (10%). From a medical informatics perspective, knowledge is mainly represented as computer interpretable clinical guidelines (43%), medical domain ontologies (26%), and electronic health care records (22%). Within the knowledge lifecycle, contributions are found in knowledge generation (38%), knowledge specification (24%), exception detection and management (12%), knowledge enactment (8%), temporal knowledge and reasoning (7%), and knowledge sharing and maintenance (7%). The clinical emphasis of knowledge is mainly related to clinical treatments (27%), diagnosis (13%), clinical quality indicators (13%), and guideline integration for multimorbid patients (12%). According to the level of development of the works presented, we distinguished four maturity levels: formal (22%), implementation (52%), testing (13%), and deployment (2%) levels. Some papers described technologies for specific clinical issues or diseases, mainly cancer (22%) and diseases of the circulatory system (20%). Chronicity and comorbidity were present in 10% and 8% of the papers, respectively. Conclusions: KR4HC is a stable community, still active after ten years. A persistent focus has been knowledge representation, with an emphasis on semantic-web ontologies and on clinical-guideline based decision-support. Among others, two topics receive growing attention: integration of computer-interpretable guideline knowledge for the management of multimorbidity patients, and patient empowerment and patient-centric care.

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