Section: Application Domains

Knowledge Management in Medicine

Participants : Nicolas Jay, Jean Lieber, Thomas Meilender, Amedeo Napoli.

Keywords:

knowledge representation, description logics, classification-based reasoning, case-based reasoning, formal concept analysis, semantic web

The Kasimir research project holds on decision support and knowledge management for the treatment of cancer  [103] . This is a multidisciplinary research project in which participate researchers in computer science (Orpailleur), experts in oncology (“Institut de Cancérologie de Lorraine Alexis Vautrin” in Vandœuvre-lès-Nancy), Oncolor (a healthcare network in Lorraine involved in oncology), and A2Zi (a company working in Web technologies and involved in several projects in the medical informatics domain, http://www.a2zi.fr/ ). For a given cancer localization, a treatment is based on a protocol similar to a medical guideline, and is built according to evidence-based medicine principles. For most of the cases (about $70\%$), a straightforward application of the protocol is sufficient and provides a solution, i.e. a treatment, that can be directly reused. A case out of the $30\%$ remaining cases is “out of the protocol”, meaning that either the protocol does not provide a treatment for this case, or the proposed solution raises difficulties, e.g. contraindication, treatment impossibility, etc. For a case “out of the protocol”, oncologists try to adapt the protocol. Actually, considering the complex case of breast cancer, oncologists discuss such a case during the so-called “breast cancer therapeutic decision meetings”, including experts of all specialties in breast oncology, e.g. chemotherapy, radiotherapy, and surgery.

The semantic Web technologies are used and adapted in the Kasimir project since several years [12] . A semantic wiki allowing the management of decision protocols was deployed as an operational system (http://www.oncologik.fr ). More precisely, the migration from the static HTML site of Oncolor to a semantic wiki (with limited editing rights and unlimited reading rights) was performed. As a consequence, the editorial chain of the published protocols is more collaborative. A decision tree editor was developed and integrated into this semantic wiki with an export facility to formalized protocols in OWL DL.