Arden Syntax is a markup language that is used in an executable format by
CDSS (Clinical Decision Support System). It is playing a crucial role in the healthcare industry and is helping professionals in making better decisions for patients. It is significantly improving the efficiency and quality of healthcare services.
Arden Syntax is used for representing knowledge associated with a medical field. This executable format by decision support system is used to generate alerts and to share messages to clinicians. It is used across many health services institutions.
Initially, it was a standard under ASTM (American Society for Testing and Materials) and is now a part of
HL7. It refers to the data format and is used at healthcare organizations to share medical data. The first version of Arden syntax 2.0 was published in 1999. Currently, the 2.10 Arden syntax version is in use.
History of Arden Syntax
The old version of Arden syntax was created to show the medical logic in a form that could be interpreted by medical experts to facilitate CDSS. Over the years, Arden Syntax evolved and then included features of programming languages and integration into a clinical information system architecture.
The name Arden Syntax got its name from Arden House, which is situated around 90 minutes north of Manhattan in Orange County. This syntax name was chosen in recognition of milestones achieved at Arden house in refinement and development of the syntax and its implementation.
The version 2.1 was released in 2002 and included new string operators. Another version 2.5 was released in 2005 and featured major changes like XML representations of MLMs. The newer version, i.e., 2.6, included UNICODE encoding and additional resources category to define text resources for particular languages.
The 2.7 version of Arden Syntax launched in 2008 featured enhanced assignment statements and new operators that allowed flexible object instantiation. The newer version that was released in 2008 focused on operators to manipulate parts of the given date and time values. The 2.9 version adjusted all the operators to handle fuzzy data types. The current version 2.10 is an XML representation of the whole XMLs.
Structure of Arden Syntax
A Medical Logic Module consists of 4 major categories, i.e., maintenance, knowledge, library, and resources.
1. Maintenance Category
It contains metadata about MLM. It includes several slots that help to maintain information associated with the medical field. The first slot in the maintenance category shares an overview of the module, followed by a file name and a distinct identifier. The third slot specifies the version that is currently in use.
Plus, it also keeps an eye on the updates about MLM. The slot is always left blank when information is transferred from one block to another. The validation set is specified by the specialists and is used for the knowledge base and change control.
2. Knowledge Category
It contains the medical knowledge of MLM and also includes data, priority, logic, and action slots. It aims to separate several specific parts of MLM from other common parts. The way how MLM is used is decided according to the priority, which ranges from 1 to 99.
The module set at 99 has the highest priority, and then it decreases with the number. It can be activated by a direct call from an MLM, or through a particular application program. The action then sends a message to the healthcare provider and sends an alert to the destination by returning values.
3. Library Category
It includes other slots, namely links, keywords, explanation, purpose, and more. This explains what MLM is about and illustrates how it works.
4. Resources Category
Not much information is available about the resources category.
How HL7 Arden Syntax Functions?
HL7 Arden Syntax is offering several features to the healthcare services. For instance, the syntax gives a warning message when a clinical situation shows dangerous laboratory results.
It also sends a message to the clinical research team when the patient meets certain characteristics. Furthermore, it sends management messages that are used for administrative purposes like same-day admissions and discharge history.
Advantages of HL7 Arden Syntax
It allows the encoding of important medical concepts and is a part of Health Level Seven International Standards Organizations.
The code written in this syntax is user-friendly and has flexible list handling that can be filtered. Developers annotate MLMs for producing metadata, which is crucial for making large collections of MLMs manageable.
Uses and Applications of HL7 Arden Syntax
It is used in computerized care plans for managing patients. It recommends clinicians about the patient’s treatment based on the clinical appointment and data stored in the system.
Arden Syntax and its applications were developed as the primary deliverables of a j aoint research and development program between CPMC in New York and IBM Health Industry Marketing in Atlanta.
At Columbian medical center, around 40 Arden Syntax MLMs are implemented in which nearly 18 are Clinical MLMs. It has 14 alerts and four interpretations. For instance, a user is warned by three MLMs in the presence of digoxin that might lead to cardiac dysrhythmia.
Medical support in Sweden consists of a clinical database and a knowledge base component. Samwald et al. group developed several CDSS using Arden Syntax that ranges from a few to dozens of MLMs. It includes systems like Hepaxert, Toxopert, RHEUxpert.
Thyrexpert system helps in interpreting thyroid hormone test results, whereas, Hepaexert allows to interpret Hepatitis A, B, and C Serology test results. To meet user’s expectations: several features are incorporated in Arden Syntax. These features are classified into several classes of change. These changes include a formalism for structured output, user-defined objects, and additional control features.
Final Words
It is a popularly recognized standard for sharing scientific knowledge in an executable format. Arden Syntax is currently managed by the HL7 organization. The Arden Syntax for Medical Logic Systems Version 2.10 is the latest version that healthcare services are using.
It is used by clinicians, administrators, and others who are implementing CDS solutions to improve patient’s safety. It targets HIS vendors, CDSS Vendors, Quality Reporting Agencies, and healthcare institutions.
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