Care Pathway Records with Ontologies: Potential uses in Medical Research and Health Care

This is one of a series of papers arising in part out of the SHARE (Supporting and structuring Healthgrid Activities and Research in Europe) project; in previous work, we have examined the use of integrated care pathways (ICPs), a fine-grained form of medical guideline including the explicit recording of any deviation, or ‘variance’, for research purposes. In particular, we explored how feeding the results of the analysis of variance into the development of a pathway might be an effective way of capturing ‘evidence from practice’. Building on this concept, in our principal case study we propose an information system for extracting data from ICPs using ontologies and a method for inferring ICPs from other patient records, combining these with data collected for retrospective and prospective studies in preimplantation genetic diagnosis (PGD) and screening (PGS) for assisted reproduction. We also look at the problem of selecting alternatives when drug interactions occur when multiple pathways are used in parallel.