Declarative Guideline Conformance Checking of Clinical Treatments: A Case Study
This addresses the problem of adapting conformance checking to highly variable medical processes for healthcare practitioners, though it appears incremental as it builds on existing declarative approaches.
The study tackled the challenge of verifying clinical treatment conformance to guidelines by using the HL7 Arden Syntax for declarative, rule-based checking, enabling conformance assessment and medically meaningful alignments for large parts of a guideline.
Conformance checking is a process mining technique that allows verifying the conformance of process instances to a given model. Thus, this technique is predestined to be used in the medical context for the comparison of treatment cases with clinical guidelines. However, medical processes are highly variable, highly dynamic, and complex. This makes the use of imperative conformance checking approaches in the medical domain difficult. Studies show that declarative approaches can better address these characteristics. However, none of the approaches has yet gained practical acceptance. Another challenge are alignments, which usually do not add any value from a medical point of view. For this reason, we investigate in a case study the usability of the HL7 standard Arden Syntax for declarative, rule-based conformance checking and the use of manually modeled alignments. Using the approach, it was possible to check the conformance of treatment cases and create medically meaningful alignments for large parts of a medical guideline.