Ontology-based tools to expedite predictive model construction.

Large amounts of medical data are collected electronically during the course of caring for patients using modern medical information systems. This data presents an opportunity to develop clinically useful tools through data mining and observational research studies. However, the work necessary to make sense of this data and to integrate it into a research initiative can require substantial effort from medical experts as well as from experts in medical terminology, data extraction, and data analysis. This slows the process of medical research. To reduce the effort required for the construction of computable, diagnostic predictive models, we have developed a system that hybridizes a medical ontology with a large clinical data warehouse. Here we describe components of this system designed to automate the development of preliminary diagnostic models and to provide visual clues that can assist the researcher in planning for further analysis of the data behind these models.

An ontology-driven, diagnostic modeling system.

OBJECTIVES: To present a system that uses knowledge stored in a medical ontology to automate the development of diagnostic decision support systems. To illustrate its function through an example focused on the development of a tool for diagnosing pneumonia. MATERIALS AND METHODS: We developed a system that automates the creation of diagnostic decision-support applications. It relies on a medical ontology to direct the acquisition of clinic data from a clinical data warehouse and uses an automated analytic system to apply a sequence of machine learning algorithms that create applications for diagnostic screening. We refer to this system as the ontology-driven diagnostic modeling system (ODMS). We tested this system using samples of patient data collected in Salt Lake City emergency rooms and stored in Intermountain Healthcare's enterprise data warehouse. RESULTS: The system was used in the preliminary development steps of a tool to identify patients with pneumonia in the emergency department. This tool was compared with a manually created diagnostic tool derived from a curated dataset. The manually created tool is currently in clinical use. The automatically created tool had an area under the receiver operating characteristic curve of 0.920 (95% CI 0.916 to 0.924), compared with 0.944 (95% CI 0.942 to 0.947) for the manually created tool. DISCUSSION: Initial testing of the ODMS demonstrates promising accuracy for the highly automated results and illustrates the route to model improvement. CONCLUSIONS: The use of medical knowledge, embedded in ontologies, to direct the initial development of diagnostic computing systems appears feasible.