Combining Decision Support System-Generated Recommendations with Interactive Guideline Visualization for Better Informed Decisions

The main task of decision support systems based on computer-interpretable guidelines (CIG) is to send recommendations to physicians, combining patients’ data with guideline knowledge. Another important task is providing physicians with explanations for such recommendations. For this purpose some systems may show, for every recommendation, the guideline path activated by the reasoner. However the fact that the physician does not have a global view of the guideline may represent a limitation. Indeed, there are instances (e.g. when the clinical presentation does not perfectly fit the guideline) in which the analysis of alternatives that were not activated by the system becomes warranted. Furthermore possibly valid alternatives could not be activated due to lack of data or wrong knowledge representation. This paper illustrates a CIG implementation that complements the two functionalities, i.e., sending punctual recommendations and allowing a meaningful navigation of the entire guideline. The training example concerns atrial fibrillation management.