A clinical practice guideline-based ontology driven clinical decision support system for breast cancer follow-up

Breast cancer is the most common cancer among women in Canada. The delivery of longterm follow-up care, has traditionally been provided at dedicated cancer clinics but places a strain on specialist resources. As a result there is an incentive to transfer breast cancer follow-up care to family physicians after primary treatment is completed by specialists. Cancer Care in Nova Scotia has developed a breast cancer follow-up clinical practice guideline (CPG) for use by family physicians. We have used this as the basis for developing a CPG-based interactive decision support system for use by family practitioners. The system has been achieved in three main steps: (i) Conversion of the breast cancer follow-up CPG into an electronic format using the Guideline Element Model (GEM); (ii) Use of the logic in the conditional statements of the CPG to develop a domain ontology using Protégé; (iii) Execution of the guideline using a GEM execution engine developed at Dalhousie University.