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Developing a knowledge base of interactive cases teaching prescribing in hospitals

Presentation Aims Project Aims Who’s Involved Use Cases Initial Position Technical Challenges Approach Achievements Demo Questions. Developing a knowledge base of interactive cases teaching prescribing in hospitals. Raise Awareness Educators

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Developing a knowledge base of interactive cases teaching prescribing in hospitals

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  1. Presentation Aims • Project Aims • Who’s Involved • Use Cases • Initial Position • Technical Challenges • Approach • Achievements • Demo • Questions Developing a knowledge base of interactive cases teaching prescribing in hospitals Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  2. Raise Awareness • Educators • Ease with which online content can be created • Potential use of knowledge bases in learning contexts • Technologists • Small, structured, interactive components can EASILY be incorporated into online content management systems • Large applications with suitable APIs have potential educational use and value Presentation Aims Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  3. Can it be, Ischomachus, that asking questions is teaching? I am just beginning to see what is behind all your questions. You lead me on by means of things I know, point to things that resemble them, and persuade me that I know things that I thought I had no knowledge of. — Socrates (Quoted in Xenophon's "Economics”) Education by QuestioningShockingly Old Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  4. Think back to your childhood • Pick a minor medical condition that you had then e.g. • Bad belly • Bumped elbow • Scraped knee • Bit of a cold • On your card write • Your name (optional) • The name of the condition • Something that made it feel better • Something that would have made it feel worse • We’ll be using the information on your card in a later exercise TASKMinor Childhood MedicalCondition Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  5. Interactive case studies • Medical students • Spot errors in prescriptions • Correct the errors • Get feedback • Realistic as possible Project Aims Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  6. Lots of forms • Lots of boxes on the forms • Different form designs in different hospitals • The completed forms need to be meaningful and correct • Need to give feedback on all forms in a case Project AimsChallenges Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  7. NHS • Bee Wee • Rhagib Ali • Diane Evans • MSD Teaching and Learning • Vivien Sieber • Andrew Stenhouse • Phil Rees Who’s Involved Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  8. Use Cases Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  9. QuestionMark Perception/TOIA • Questions with Feedback • Different question types • Questions don’t interact • Flash • Control of visual design • WebLearn • Central Navigation Initial Position Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  10. Forms • Look real • Capture data effectively • Change appearance without changing function • Feedback • Complex set of choices and interactions • Content Authoring • Easy and intuitive • No bottlenecks Technical Challenges Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  11. Forms • Visual Design • Data Handling • Marking and Feedback • Content Creation Approach Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  12. Screen versions look like paper versions • Basic validation of data can be handled in Flash ApproachFormsDesign in Flash Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  13. A Flash Version of a Standard Form Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  14. XML = Extensible Markup Language • Separates how something looks from what it means • Same XML can be used for two different designs of the same form • <readable> <by>humans</by> <by>machines</by></readable> ApproachFormsData in XML Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  15. <?xml version="1.0" encoding="utf-8"?> <WQN255> <Identification> <Name>Name</Name> <Address> <Line1>1</Line1> <Line2>2</Line2> <Line3>3</Line3> </Address> <Consultant>4</Consultant> <HospitalNumber>klj</HospitalNumber> <AreaCode>kljlkj</AreaCode> <Sex>lklkj</Sex> <DateOfBirth>lkjkjlk</DateOfBirth> <Weight>lkjlk</Weight> </Identification> <Medication> <Item> <Drug>lklklk</Drug> <Dose>jlkj</Dose> <Route>lkjlkj</Route> <Continue>lkjlk</Continue> <Pharmacy>lkjl</Pharmacy> </Item> A Sample of XML Generated by Flash Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  16. Children are dumb to say how hot the day is, How hot the scent is of the summer rose, How dreadful the black wastes of evening sky, How dreadful the tall soldiers drumming by. But we have speech, to chill the angry day, And speech, to dull the rose’s cruel scent. We spell away the overhanging night, We spell away the soldiers and the fright. … The Cool WebRobert Graves Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  17. Protégé • Ontology Editor • Knowledge Base Framework • National Library of Medicine • Stanford Medical Informatics ApproachCreating a Knowledge Base for Marking, Feedback and Questioning Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  18. An ontology is a specification of a conceptualization.Tom Gruber, Stanford • Contains • Classes (types of thing) • Instances (individual things) • Relationships • Constraints ApproachKnowledge BaseWhat do we mean by Ontology? Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  19. Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  20. People • Patient • Doctor • Pharmacist • Condition • Drug • Signs • Symptoms • Indication • Contra-Indication • Side Effect ApproachKnowledge BaseOntology Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  21. Patient have underlying Conditions • Conditions may be treatable by Drug therapies • Patients may exhibit signs • Patients may exhibit symptoms • Signs and symptoms may inform diagnoses • Diagnoses, signs and symptoms may indicate the appropriateness of particular drug therapies • Prescribing particular drugs may be contra-indicated by the prescription of other drugs or by the existence of signs, symptoms or additional diagnoses • Particular drugs may cause side effects etc. etc. etc. . . . . . . ApproachKnowledge BaseOntology Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  22. Magnolia • Content Management System • Page Templates • Paragraph Templates* • Custom Controls* • Standards Based (JSR-170) • Flash • WYSIWYG Form Editing • Magnolia + Flash • Easy Interface • Case Creation • Prescription Form Generation ApproachUser Interface for Content Creation Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  23. Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  24. Ontology – initial version • Flash XML libraries • Content Creation framework • Developed Case Content Achieved So Far Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  25. Quick tour of a small knowledge base • Group construction of a knowledge base (have your cards ready)http://www.cmaj.ca/cgi/content/full/169/12/1294 • Constraint Checking • Two visualisation tools DemoN.B. This is the backend. We’re seeing the model, not the final application. Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  26. You’ve prescribed Drug X which signs and symptoms led to you this choice? • What other drug could you prescribe for Condition Y? • What other conditions could Drug X be prescribed for? • Some of the drugs you’ve prescribed have interactions. Identify them. • Your patient is now showing Sign Y. Which of your drugs could be causing this? What alternatives are there? Potential Generating Follow-up QuestionsA return to the Socratic? Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  27. ProtégéOntology editorhttp://www.protege.stanford.edu • MagnoliaContent Management Systemhttp://www.magnolia.info • FlashGraphical Web Interactionshttp://www.macromedia.com • Flash XPath LibrariesManipulating XML in Flashhttp://www.xfactorstudio.com Links Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

  28. Who has the first question? Questions and Discussion Shock of the Old 2005 | Prescriptions | phillip.rees@medsci.ox.ac.uk

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