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<h1><a id="title" name="title" />Desirable Features of Rule Based Systems for Medical Knowledge</h1>
<h2><a id="w3c-doctype" name="w3c-doctype" />Agfa Note 15 March 2005</h2><dl><dt>This version:</dt><dd>
      <a href="http://www.agfa.com/w3c/Notes/rules.xml">http://www.agfa.com/w3c/Notes/rules.xml</a>
    </dd><dt>Latest version:</dt><dd>
      <a href="http://www.agfa.com/w3c/Notes/rules.xml">http://www.agfa.com/w3c/Notes/rules.xml</a>
    </dd><dt>Editors:</dt><dd>Stan Devitt</dd><dd>Jos DeRoo</dd><dd>Helen Chen, Agfa HealthCare Inc.</dd></dl><p>This document is also available in these non-normative formats: <a href="http://www.agfa.com/w3c/Notes/rules.html">html version</a>.</p>Copyright 2005, Agfa Healthcare </div><hr /><div>
<h2><a id="abstract" name="abstract" />Abstract</h2><p>This note summarizes selected aspects of our investigations into the use
      of proof-based technologies to validate and manage medical knowledge. 
      In the course of our investigations we have found great
      benefit in being able to validate, restructure, and extend the data
      using a variety of tools and proof based engines. As our experience
      grows in this area, a number of key requirements are emerging. This
      paper discusses some specific use cases and then re-casts them in
      terms of requirements on the underlying rule based systems. </p></div><div>
<h2><a id="status" name="status" />Status of this Document</h2><p>
        <em> This section describes the status of this document at
        the time of its publication. Other documents may supersede this 
	document. This document is maintained at Agfa Healthcare. </em>
      </p><p>This document has been prepared as a position paper for 
      the W3C Workshop on Rule based systems.</p><p>A list of all current W3C related Agfa
      Healthcare Technical Reports can be found at 
      <a href="http://www.agfa.com/w3c/Notes/Overview.html">http://www.agfa.com/w3c/Notes/Overview.html</a>.</p></div><div class="toc">
<h2><a id="contents" name="contents" />Table of Contents</h2><p class="toc">1 <a href="#rules_intro">Introduction</a><br />
2 <a href="#details">Details</a><br />
    2.1 <a href="#refactoring">Refactoring</a><br />
    2.2 <a href="#N1009A">Expressiveness.</a><br />
    2.3 <a href="#N1009F">Rapid  Authoring</a><br />
    2.4 <a href="#N100A6">Validation.</a><br />
    2.5 <a href="#N100AB">Named Formal Definitions.</a><br />
    2.6 <a href="#N100B4">Extendability.</a><br />
    2.7 <a href="#N100BB">Interoperability.</a><br />
    2.8 <a href="#N100C2">Re-Use of Knowledge.</a><br />
3 <a href="#conclusions">Conclusions</a><br />
</p>
<h3><a id="appendices" name="appendices" />Appendix</h3><p class="toc">A <a href="#N100D3">Bibliography</a><br />
</p></div><hr /><div class="body"><div class="div1">
<h2><a id="rules_intro" name="rules_intro" />1 Introduction</h2><p>
The past decade has seen amazing advances in our ability to acquire
medical facts.  These facts range from new clinical or theoretical
discoveries  (see <a href="#WIHIR">[WIHIR]</a>) to our ability to 
collect and utilize large volumes of patient diagnostic and treatment data.  
This information has the potential to drastically
affect peoples medical treatment and lives in both a positive and
negative manner.  Proper usage of medical knowledge  can literally mean life. 
Errors of ommission or outright mistakes can mean death or injury.</p><p>Our investigations so far have shown that the semantic web is an
effective mechanism for representing a wide range of medical knowledge.
For example, we have been successful in recasting published clinical
guidelines  (see  <a href="#TRIP">[TRIP]</a>)
in a usable form using n3 and have been able to  use a variety
of proof engines to validate clinical contexts against such guidelines.</p><p>The sheer volume of largely unstructured, constantly changing
facts, procedures and guidelines together with the very human need for
assurances of correctness and validation against established procedures
make this subject area an ideal area for applications of semantic web
technologies.</p><p>Our experiments to this point made use of  <a href="#N3">[N3]</a> and rules together with
systems such as Euler <a href="#EULER">[EULER]</a>, CWM <a href="#CWM">[CWM]</a>
and Jena <a href="#JENA">[JENA]</a> to model situations requiring both
forward and backward reasoning and take into account some experience
with describing the semantics for content MathML <a href="#MATHML">[MATHML]</a>.</p><p>In the course of these investigations we have been able to make several
observations concerning the rules, the data, and their interaction.
</p></div><div class="div1">
<h2><a id="details" name="details" />2 Details</h2><p>The key items that we wish to take into consideration when reviewing the
infrastructure of rules are outlined below.</p><div class="div2">
<h3><a id="refactoring" name="refactoring" />2.1 Refactoring</h3><p>We have had a continual need to refactor our rules as we 
discover new factors that come into play and struggle with finding the right combination
of facts and meta-like rules such as transitivity versus collections of expanded rules</p></div><div class="div2">
<h3><a id="N1009A" name="N1009A" />2.2 Expressiveness.</h3><p>  There has been a continual tradeoff between
expressiveness and the decidability of the resulting queries.</p></div><div class="div2">
<h3><a id="N1009F" name="N1009F" />2.3 Rapid  Authoring</h3><p>In the early stages of development (at least until visual editing tools mature) 
the ability to quickly write down meaningful facts and statements
in a human readable form has been essential.</p><p>The ability to easily author rules in a human understandable format is
essential to developments in this area. History has shown that this
was essential to early development of the Web.  This only becomes less
important after usable editors become widely available.  Another  case in point
is MathML.  Given the complexity of writing advanced semantic constructs
in MathML the successful authoring of MathML is closely tied to the use
of tools.</p></div><div class="div2">
<h3><a id="N100A6" name="N100A6" />2.4 Validation.</h3><p>There is a need for easy methods of validation of both syntax and against a chosen
structure.  In the long term, this may be addressed by authoring tools, but quick 
convenient validation is essential to successful authoring.</p></div><div class="div2">
<h3><a id="N100AB" name="N100AB" />2.5 Named Formal Definitions.</h3><p> 
As we work with different implementations we have developed a library of Rules. 
There would appear to be a need include rules by name.
</p><p>It is important to allow for systems that support different logical
models.  How do we advertise the capabilities of a system?  How do we
behave when desired functionality is not supported? </p><p>
We need to at least consider mechanisms for naming individual rules.  
This can have considerable impact on our ability to quickly author and experiment.  
Conventions such as name spaces in order to be clear when a named rule is really 
the same rule is essential.  
</p></div><div class="div2">
<h3><a id="N100B4" name="N100B4" />2.6 Extendability.</h3><p>  
As the collection of proof based technologies matures and different balances 
between expressivness and decidability are explored, the need to plan for 
extendability becomes important. 
</p><p>
We should not have to re-design the language to add new functionality. 
There are potential lessons to be learned in the design of content MathML and 
in its appendices providing more formal mathematical definiions.
</p></div><div class="div2">
<h3><a id="N100BB" name="N100BB" />2.7 Interoperability.</h3><p>We have needed to consult a variety of
proof engines and tools during our investigations.  while a diversity of features
has been benificial, the notions of discoverability and interoperability
emerge, and might even benefit from the notion of a compatibilty layer.</p><p>During the course of our investigations we have had the constant need to 
feed results from one system into another.  One of the key outcomes of 
this activity must be to establish that interoperability.</p></div><div class="div2">
<h3><a id="N100C2" name="N100C2" />2.8 Re-Use of Knowledge.</h3><p>Througout, it has proved helpful to be able to separate the core "re-usable" knowledge from 
temporal or state specific knowledge and to use meta-structure whereever possible.</p><p>The actual data that is produced by a proof must also be valid input to the 
next proof, or for direct addition to our knowledge pool.</p></div></div><div class="div1">
<h2><a id="conclusions" name="conclusions" />3 Conclusions</h2><p>We do not presume to have absolute answers to the questions raised
here.  Nor do we presume that such a list is complete. An effective
design will be the result of balancing these needs and most of all
through buy-in by the stake-holders.  A satisfactory outcome of such a
workshop would be some consensus of where to draw the line and an
explanations of how the emerging design addresses each of these questions.  
We look forward to working with participants to move forward in an organized fashion. </p></div></div><div class="back"><div class="div1">
<h2><a id="N100D3" name="N100D3" />A Bibliography</h2><dl><dt class="label"><a id="CWM" name="CWM" />CWM</dt><dd><em>CWM, </em>, a general-purpose data processor for the semantic web, W3C. <a href="http://www.w3.org/2000/10/swap/doc/cwm.html">http://www.w3.org/2000/10/swap/doc/cwm.html</a></dd><dt class="label"><a id="EULER" name="EULER" />EULER</dt><dd><em>Euler, </em>, a backward-chaining reasoner enhanced with Euler path detection. <a href="http://sourceforge.net/projects/eulersharp">http://sourceforge.net/projects/eulersharp</a> </dd><dt class="label"><a id="JENA" name="JENA" />JENA</dt><dd><em>Jena - A Semantic Web Framework for Jena</em>, an opensource project grown out of work with the HP Labs Semantic Web Programme.  <a href="http://jena.sourceforge.net/index.html">http://jena.sourceforge.net/index.html</a></dd><dt class="label"><a id="N3" name="N3" />N3</dt><dd><em>Semantic Web Tutorial Using N3</em>, W3C.  <a href="http://www.w3.org/2000/10/swap/doc/">http://www.w3.org/2000/10/swap/doc/</a></dd><dt class="label"><a id="MATHML" name="MATHML" />MATHML</dt><dd>David Carlisle, Patrick Ion, Robert Miner, Nico Poppelier, <em>Mathematical Markup Language 
(MathML) Version 2.0 (2nd Edition)</em> World Wide Web Consortium, 2003 
(<a href="http://www.w3.org/TR/2003/REC-MathML2-20031021/">http://www.w3.org/TR/2003/REC-MathML2-20031021/</a>)
</dd><dt class="label"><a id="TRIP" name="TRIP" />TRIP</dt><dd>John S. Devitt , Ph.D,  Helen H. Chen , Ph.D,  Jos De Roo , ir., <em>Using the Semantic Web and Proof Technologies to Reduce Errors in Radiological Procedure Errors, </em>  , TRIP Conference &amp; Workshop Poster Abstracts, January 31, 2005</dd><dt class="label"><a id="WIHIR" name="WIHIR" />WIHIR</dt><dd><em>Futures Symposium</em>, Futures Symposium Archive, January 11, 2005. <a href="http://hi.uwaterloo.ca/hi/Futures%20Archive%202005.htm">http://hi.uwaterloo.ca/hi/Futures%20Archive%202005.htm</a></dd></dl></div></div></body></html>