Report Number: CS-TR-97-1599
Institution: Stanford University, Department of Computer Science
Title: Trial Banks: An Informatics Foundation for Evidence-Based Medicine
Author: PhD, Ida Sim, MD,
Date: December 1997
Abstract: Randomized clinical trials constitute one of our main sources of medical knowledge, yet trial reports are difficult to find, read, and apply to clinical care. I propose that authors report trials both as entries into electronic knowledge bases - or trial banks - and as text articles in traditional journals. Trial banks should be interoperable, and we thus require a shared ontology of clinical-trial concepts. My thesis work is the design, implementation, and evaluation of such an ontology. Using a new approach called competency decomposition, I show that my ontology design is reasonable, and that the ontology is competent for three of the four core tasks of clinical-trials interpretation for a broad range of trial types. Using this ontology, I implemented a frame-based trial bank that can be queried dynamically over the World Wide Web. Clinical researchers successfully used this system to critique trials in the trial bank. With the advent of digital publication, we have a window of opportunity to design our publication systems such that they support the transfer of evidence from the research world to the clinic. This dissertation presents foundational work for an interoperating trial-bank system that will help us achieve the day-to-day practice of evidence-based medicine.