Verifying a medical protocol with temporal graphs: the case of a nosocomial disease.

OBJECTIVE Our contribution focuses on the implementation of a formal verification approach for medical protocols with graphical temporal reasoning paths to facilitate the understanding of verification steps. MATERIALS AND METHODS Formal medical guideline specifications and background knowledge are represented through conceptual graphs, and reasoning is based on graph homomorphism. These materials explain the underlying principles or rationale that guide the functioning of verifications. RESULTS An illustration of this proposal is made using a medical protocol defining guidelines for the monitoring and prevention of nosocomial infections. Such infections, which are acquired in the hospital, increase morbidity and mortality and add noticeably to economic burden. An evaluation of the use of the graphical verification found that this method aids in the improvement of both clinical knowledge and the quality of actions made. DISCUSSION As conceptual graphs, representations based on diagrams can be translated into computational tree logic. However, diagrams are much more natural and explicitly human, emphasizing a theoretical and practical consistency. CONCLUSION The proposed approach allows for the visual modeling of temporal reasoning and a formalization of knowledge that can assist in the diagnosis and treatment of nosocomial infections and some clinical problems. This is the first time that one emphasizes the temporal situation modeling in conceptual graphs. It will also deliver a formal verification method for clinical guideline analyses.