| Summary: | Objective:
Access to, and reliance upon, high quality data is an enabling cornerstone of modern health delivery systems. Sadly, health systems are often awash with poor quality data which contributes both to adverse outcomes and can compromise the search for new knowledge. Traditional approaches to purging poor data from health information systems often require manual, laborious and time-consuming procedures at the collection, sanitizing and processing stages of the information life cycle with results that often remain sub-optimal. A promising solution may lie with semantic technologies - a family of computational standards and algorithms capable of expressing and deriving the meaning of data elements. Semantic approaches purport to offer the ability to represent clinical knowledge in ways that can support complex searching and reasoning tasks. It is argued that this ability offers exciting promise as a novel approach to assessing and improving data quality. This study examines the effectiveness of semantic web technologies as a mechanism by which high quality data can be collected and assessed in health settings. To make this assessment, key study objectives include determining the ability to construct of valid semantic data model that sufficiently expresses the complexity present in the data as well as the development of a comprehensive set of validation rules that can be applied semantically to test the effectiveness of the proposed semantic framework.
Methods:
The Semantic Framework for Data Quality Assessment (SemDQ) was designed. A core component of the framework is an ontology representing data elements and their relationships in a given domain. In this study, the ontology was developed using openEHR standards with extensions to capture data elements used in for patient care and research purposes in a large organ transplant program. Data quality dimensions were defined and corresponding criteria for assessing data quality were developed for each dimension. These criteria were then applied using semantic technology to an anonymized research dataset containing medical data on transplant patients. Results were validated by clinical researchers. Another test was performed on a simulated dataset with the same attributes as the research dataset to confirm the computational accuracy and effectiveness of the framework.
Results:
A prototype of SemDQ was successfully implemented, consisting of an ontological model integrating the openEHR reference model, a vocabulary of transplant variables and a set of data quality dimensions. Thirteen criteria in three data quality dimensions were transformed into computational constructs using semantic web standards. Reasoning and logic inconsistency checking were first performed on the simulated dataset, which contains carefully constructed test cases to ensure the correctness and completeness of logical computation. The same quality checking algorithms were applied to an established research database. Data quality defects were successfully identified in the dataset which was manually cleansed and validated periodically. Among the 103,505 data entries, application of two criteria did not return any error, while eleven of the criteria detected erroneous or missing data, with the error rates ranging from 0.05% to 79.9%. Multiple review sessions were held with clinical researchers to verify the results. The SemDQ framework was refined to reflect the intricate clinical knowledge. Data corrections were implemented in the source dataset as well as in the clinical system used in the transplant program resulting in improved quality of data for both clinical and research purposes.
Implications:
This study demonstrates the feasibility and benefits of using semantic technologies in data quality assessment processes. SemDQ is based on semantic web standards which allows easy reuse of rules and leverages generic reasoning engines for computation purposes. This mechanism avoids the shortcomings that come with proprietary rule engines which often make ruleset and knowledge developed for one dataset difficult to reuse in different datasets, even in a similar clinical domain. SemDQ can implement rules that have shown to have a greater capacity of detect complex cross-reference logic inconsistencies. In addition, the framework allows easy extension of knowledge base to cooperate more data types and validation criteria. It has the potential to be incorporated into current workflow in clinical care setting to reduce data errors during the process of data capture.
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