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## Elements of the Knowledge Base
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The Precision Feedback Knowledge Base is comprised of four elements. The four elements are causal pathways, message templates, quality measures, and vignettes. Each element is described in detail next.
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The Precision Feedback Knowledge Base is comprised of four elements. The four elements are causal pathways, message templates, quality measures, and vignettes. Each element is described in detail below.
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1. Causal Pathways
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## Causal Pathways
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Each causal pathway specifies the influence of "motivating information", such as performance comparisons, on its recipients. They are called causal pathways because there is published scientific evidence to suggest that when "motivating information" is incorported into precision feedback interventions it can change recipient behaviors. In this case, "motivating information" is the combination of a recipient's past performance record and added contextual information to support comparisons. As an element of the knoweldge base, causal pathways serve the dual purposes of 1) explaining why feedback interventions influence behavior (i.e. program theory), and 2) configuring a precision feedback intervention to generate messages that can be delivered to recipients in emails, reports, or by other means. The causal pathways are implemented semantically in a computer-processable format using a linked-data approach (JSON-LD), based on the Performance Summary Display Ontology (PSDO) and the Causal Pathway Ontology (CPO).
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2. Message Templates
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## Message Templates
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Each message template specifies an evidence-based text and display format for a performance feedback message corresponding to a causal pathway. (Note: A single causal pathway may have more than one message template.) The contents of each message template include links to concept definitions from relevant ontologies.
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3. Quality Measures
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## Quality Measures
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Each quality measure represents a standard for measuring the performance and improvement of people who do a given task, here providers of healthcare services.
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4. Vignettes
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## Vignettes
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Each vignette tells a narrative story about two personas. Each vignette is also associated with one casual pathway and its templates. Each vignette includes example performance data, a specific context for presenting the performance data as "motivating information", and example messages formatted according to relevant message templates. The purpose of each vignette is to bring together the core components of the knowledge base as they would be used to generate precision performance feedback. Overall, the vignettes illustrate how a causal pathway is used by a precision feedback system to deliver motivating information to one or more feedback recipients, based on their performance data, their preferences, and a collection of message templates that determine a minimal set of possible feedback interventions.
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## Overall View of the Knowledge Base
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![knowledgebase-map](https://github.com/Display-Lab/knowledge-base/assets/133153871/abcd7acf-ca74-4fcb-a904-bfe1a13a6c16)
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Taken together, all of the elements in the knowledge base can be used by a precision feedback system to prioritize motivating feedback messages. For example, if a person (the precision feedback message recipient) is performing below average but is improving, a precision feedback system could use information about the recipient's preferences and past performance to determine whether or not to prioritize and deliver one of the following messages: "You are not a top performer", "Your performance is improving", "Your performance is approaching the benchmark", or "You may have an opportunity to improve."
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This project is supported by funding from the NIH National Library of Medicine awards: "A knowledge-based message tailoring system" (1K01 LM012528-01) and "A scalable service to improve health care quality through precision audit and feedback" (5R01LM013894-01).

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