A Knowledge-Based Clinical Decision Support System For Headache Disorders Management

Headache is one of the most common neurological problems faced by General Practitioners (GPs) and neurologists. Most of GPs find the diagnosis of headache rather difficult: paper-based guidelines are long and the diagnostic criteria are complex. Thus, many headache patients do not have an early accurate diagnosis of headaches' type and an appropriate treatment. In order to overcome this burden, we present a knowledge-based Clinical Decision Support System (CDSS) specifically devoted to support GPs in the headache diagnosis and in the appropriate selection of the diagnostic-therapeutic path. The proposed CDSS has been designed and developed based on internationally validated guidelines and clinical protocols. The knowledge base contains the medical-clinical knowledge appropriately formalized in several set of rules. Communication interfaces compliant with HL7 DSS (Health Level Seven Decision Support Service) international standard were developed enabling interoperation with other healthcare applications. The CDSS has been tested and assessed in the GPs' daily practice of the Calabria Cephalalgic Network. During the evaluation period, a reduced number of requests for neurological visits and unnecessary and expensive instrumental examinations was registered. The results obtained from the evaluation period demonstrate that the CDSS turns out to be effective in the management of headache patients.