A goal-driven approach for clinical decision conflict detection and its application to the treatment of multimorbidity

Abstract

The treatment of patients with multimorbidity has always been a matter of importance. Due to the complexity of patients' conditions, physicians need to consider not only the cumbersome consultation process and complex care plans., but also potential clinical decision conflicts between different diseases. Currently, most clinical guidelines focus on a single medical condition, and the emergent and random nature of illness in patients with multiple conditions makes it difficult to take good account of the potential conflicts between various clinical decisions. Current clinical decision models on the treatment of complications are limited to specific types of complications and usually detect conflicts in a declarative method, which is difficult to cover various types of clinical decision conflicts and is not scalable. We model the treatment process of patients with multimorbidity as a goal forest and propose a goal-driven clinical support model for group decision making. This model is applicable to distributed settings and can integrate multiple clinical guidelines to concurrently treat patients with multimorbidity. A clinical decision conflict ontology is constructed that defines various decision conflict types for clinical decision conflict detection, and providing solutions for conflict resolution.