临床实践指南实施性促进研究之二:基于非肌层浸润性膀胱癌指南的知识图谱框架设计

Research on promotion of implementation of clinical practice guidelines(Ⅱ):framework design of knowledge graph construction based on guidelines for non-muscle invasive bladder cancer

指南的转化和应用是医学科技成果转化的关键环节。但是,目前指南在临床决策和实践可操作性方面仍存在较多不足。知识图谱技术的引入为指南智能化提供了坚实的基础,为解决指南实施问题提供了良好的手段。非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)是泌尿系统常见的恶性肿瘤,随着新的诊疗手段不断涌现,NMIBC临床指南存在查阅费时、更新频繁等问题。鉴于临床医生迫切需要学习和使用指南知识、梳理指南更新内容,本研究基于NMIBC疾病特征和临床指南特点,提出并构建NMIBC临床指南知识图谱框架,包括解析指南内容范围、梳理指南内容模块、归纳指南知识结构等,参考OMAHA Schema,根据二级概念层及概念实例设计概念结构表,设计并调整概念间的关系结构,改进并完善实体与实体间的关系,并请专家对知识图谱的科学性和方法有效性进行审核与评估。基于NMIBC指南的知识图谱框架设计为指南数字化、智能化提供了基础,有利于推动指南的实施与传播。

The transformation and application of the guidelines is a crucial link in the transformation of medical science achievements and technology.However,there are still many problems with the operability of the current guidelines in clinical decision-making and practice.The knowledge graph has provided a solid foundation for the intelligentization of the guidelines and a good method for solving the problems of the implementation of the guidelines.Non-muscle invasive bladder cancer(NMIBC)is a common malignant tumor of the urinary system,and new diagnosis and treatment methods for NMIBC are emerging.In view of the time-consuming and frequent update of clinical guidelines for NMIBC,as well as the urgent need for clinicians to learn,use,and sort out the updated content of the guidelines,this study is based on the disease characteristics of NMIBC and the clinical guidelines to propose and construct a knowledge graph framework for clinical guidelines of NMIBC,which mainly starts from analyzing the scope of the guideline,combing the guideline content modules,summarizing the guideline knowledge structure.Then,we referred to the OMAHA Schema,and designed the concept structure table according to the secondary concept layer and concept instances.Thereafter,we designed and adjusted the relationship structure between concepts,improved the relationship between entities,and finally reviewed and evaluated the scientific and method validity of the knowledge graph through experts.The design of the knowledge graph construction framework based on the guideline for NMIBC proposed in this paper provides a basis for the digitization and intelligence of the guideline,which is conducive to the implementation and dissemination of the guideline.