Using model checking for critiquing based on clinical guidelines

OBJECTIVE Medical critiquing systems compare clinical actions performed by a physician with a predefined set of actions. In order to provide useful feedback, an important task is to find differences between the actual actions and a set of 'ideal' actions as described by a clinical guideline. In case differences exist, the critiquing system provides insight into the extent to which they are compatible. METHODS AND MATERIAL We propose a computational method for such critiquing, where the ideal actions are given by a formal model of a clinical guideline, and where the actual actions are derived from real world patient data. We employ model checking to investigate whether a part of the actual treatment is consistent with the guideline. RESULTS We show how critiquing can be cast in terms of temporal logic, and what can be achieved by using model checking. Furthermore, a method is introduced for off-line computing relevant information which can be exploited during critiquing. The method has been applied to a clinical guideline of breast cancer in conjunction with breast cancer patient data.