Integrating a PICO Clinical Questioning to the QL4POMR Framework for Building Evidence-Based Clinical Case Reports

Practicing evidence based medicine requires establishing relevant and focused clinical questions that allow physicians to seek appropriate answers from rigor of the research and medical practice. These researchable question is not only important for diagnosis, prognosis, treatment and therapy but also for compiling clinical case reports when clinician encounters unanswered issues in current clinical practice. However, clinicians face multiple challenges in formulating the questions manually, searching medical literature as well as summarizing the methods and outcome from the finding of the most relevant articles. This paper extends our QL4POMR to provide a PICO clinical questioning wrapper as well as literature finding summarizers based on two pre-trained models like the BART and Bio-BERT. We also managed to integrate a clinical case report generator that can synthesis information on the clinical case based on its SOAP(s) description as well as the PICO questions and the clinical finding literature summary related to these PICO questions. Compiling the variations of the PICO questions and the integration harmonization with the SOAP cases has been done using the GraphQL API and the flexibility of the Neo4J graph-based representations for both the SOAP cases and the PubMed literature objects.