Computer Science Question

CDSS Programming Project(15 points)

We are continuing our foray into the worlds of programming and clinical decision support systems. This week you will build upon your initial knowledge discovery and put your newly acquired programming skills to work on a “real” clinical scenario. Prior to working on this assignment, be sure to clear your CLIPS rules and facts from the prior assignment, by using the (clear) command. Instructions for this assignment are as follows:

1. Research or use work experience to identify a clinical workflow of your choice, which can be a triage similar to the example provided in the classroom (but not the same as the example) or something entirely different. You should have multiple decision points in your scenario though, as to produce no less than 8-10 rules when your CLIPS program is built. Describe this scenario in detail and specify the source of it, whether from literature (need a reference) or work experience. 2 points.

2. Diagram this scenario in an application of your choice. MS Power Point is fine, but feel free to explore other software, i.e. MS Visio, Open Office, LucidChart, OmniGraffle, and more. Please do not get yourself into a high expense situation to acquire the software, and many vendors have academic pricing that would literally cost you a few dollars to try their software for a limited time. 3 points.

3. Write a CLIPS program to fully reflect your proposed scenario and diagram, to the point that there is an exact match between provided documentation for the program and the program itself. Again, your CLIPS program must have a minimum of 8-10 rules (more are permitted, your choice), and it must accept user input from the keyboard, as well as be fully functional and execute without errors. Save your program as .CLP file that includes your name in the file name, and upload to the learning management system in fulfillment of the requirements for this assignment, along with your diagram and write-up introducing the clinical scenario. 10 points.

While programming may seem like a daunting task of formidable technical challenge, the key to success is in crafting a plausible logical clinical scenario from start to finish. If you have your scenario figured out, building a program is about having a good command of the language and following the logical trail you have already established. This is why I recommend that you fully develop and chart your scenario, as well as produce rules on paper before moving to programming tasks.

In the provided Basic CDSS Clinical Workflow document/scenario, a patient with breathing problems arrives to emergency department, and clinician’s goal is to triage and perform basic diagnostic routines. Four orders are placed as follows: (1) chest x-ray, (2) labs, (3) check patient history, and (4) physical examination. Based on outcomes of these four procedures, the following outcomes are possible (among others):

IF AND

THEN

IF AND

THEN

IF AND

THEN

IF AND

THEN

IF AND

THEN

Remember that you need to offer users to select ‘Other’ condition that may not appear on your chart, as array of possibilities is almost always wide and/or limitless, so there needs to be an option in case none of the predefined conditions are applicable. Also make sure that you cover a mix of conditions that are defined, but not in the exact order you have on the chart/diagram, i.e. what happens if a chest x-ray shows Infiltrate and labs show ‘Other’, or what happens if chest x-ray shows ‘Infiltrate’ and labs show ‘Elevated BNP’? You may need to suggest a possible consultation with an attending physician in the former case (although it might still be pneumonia) and definite consultation with attending physician in the latter case (to avoid medical error). Overall, you need to think through your logic to cover as many possible conditions as you can come up with and program a suggestion for each one.

In reality, physician’s job is more complex than this basic algorithm, and we are not here to discuss outcomes of this basic clinical workflow. But it represents the basic concept behind clinical decision support system, except that thousands of possible situations and nuances are programmed by hundreds of qualified software developers, with participation of many clinicians representing various fields of practice. This is how CDSS software from major vendors is created. We will practice the very basics in this exercise in order to understand how CDSS are created and utilized in the healthcare settings.

Have fun!