Declarative Guideline Conformance Checking of Clinical Treatments: A Case Study

TL;DR

This paper explores the use of declarative, rule-based conformance checking with HL7 Arden Syntax to verify medical treatment cases against clinical guidelines, addressing variability and complexity in medical processes.

Contribution

It demonstrates the practical application of declarative conformance checking and manually modeled alignments in a medical case study using HL7 Arden Syntax.

Findings

Successfully checked conformance of treatment cases

Created medically meaningful alignments for large guideline parts

Showed advantages of declarative approaches in medical context

Abstract

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.