Development of an Expert System Knowledge Base: A Novel Approach to Promote Guideline Congruent Asthma Care

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Abstract
Existing guidelines for the clinical management of asthma provide a good framework for such tasks as diagnosing asthma, determining severity, and prescribing pharmacological treatment. Guidance is less explicit, however, about establishing a patient‐provider partnership and overcoming barriers to asthma management by patients in a way that can be easily adopted in clinical practice. We report herein the first developmental phase of the “Stop Asthma” expert system. We describe the establishment of a knowledge base related to both the clinical management of asthma and the enhancement of patient and family self‐management (including environmental management). The resultant knowledge base comprises 142 multilayered decision rules that describe clinical and behavioral management in three domains: 1) determination of asthma severity and control; 2) pharmacotherapy, including prescription of medicine for chronic maintenance, acute exacerbation, exercise pretreatment, and rhinitis relief; and 3) patient self‐management, including the process of intervening to facilitate the patient's asthma medication management, environmental control, and well‐visit scheduling. The knowledge base provides a systematic and accessible approach for intervening with family asthma‐related behaviors.