Computable Declarative Representation of Clinical Assessment Scales in EHRs

Clinical assessment scales, such as the Glasgow coma scale, are a core part of Electronic Health Records (EHRs). However, fully representing them in an OWL ontology is challenging: In particular, the determination of a score from patient's observations and clinical findings requires forms of aggregation and addition which are either tedious in OWL 2 or merely impractical due to combinatorial explosion. To solve this problem, we propose to separate the representation of the structure and content of an assessment scale from its enactment with the former being captured in OWL 2 and the latter being determined by a SPARQL query. The paper reports the results of a systematic review of 104 well-established clinical assessment scales along with the performance of the SPARQL queries proposed when executed with the query engine ARQ for Jena over HL7 CDA level three documents.