Rules can lead to a lot of redundant alerts or even inappropriate alerts. It is hard to tailor the alert appropriately to a specific user. For example, a cardiologist may wish to have a different set of alerts than a general practitioner. And a pediatric cardiologist may wish to have different alerts than a general cardiologist – so it quickly becomes complicated and difficult to scale. An alternative is to include models of the end users themselves in the knowledge graph and fine- tune decision support that is relevant to them – in essence both patient and provider-centric decision support. Updating can also be a challenge in rules-based systems. Every time the evidence changes, it needs to be analyzed and potentially incorporated into a range of rules. And because rules are specific, every time one part of the evidence changes, the rules need to be reviewed to see if they need to change as well. The same may occur with changes to codes for controlled medical terminologies. However, knowledge graphs can be updated continuously – and BMJ has a team of expert clinical academics and consultants from around the world (the majority are US-based) to survey the literature and guidelines and to apprise the BMJ when new practice- changing evidence needs to be incorporated into its clinical information and then translated into computable evidence by the clinical informatics team.
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Why the BMJ Knowledge Graph
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