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CGP-2004 (Computerized Guidelines and Protocols Symposium, Prague, April 2004)
was the fourth international meeting on formalising clinical
guidelines since the initial InterMed workshop in Boston in 1999.
A number of proposals for logical formalisms and "task-based"
representations have appeared since Arden Syntax became a de facto standard
for rule-based medical logic representation in the early 1990s.
One argument made at the
Boston workshop is that this diversity is healthy because different
representations have different strengths and weaknesses. Any attempt to
develop a standard guideline model or format at this time would be
premature. On this argument the priority should be to evaluate the different
approaches in real-world clinical applications and learn from these what is
needed. An opposing view, from industry perhaps, is that standards are
vital. Standards make it possible to develop interoperable applications and
reusable components for example. This could have the further benefit of
supporting the creation of public repositories of executable guidelines and
reusable guideline components. Standards would also facilitate the
introduction of an open source content model for publication and sharing of
evidence-based practice.
The panel was asked to address the issue of diversity versus standardisation.
Should we continue to encourage diversity or seek a standard model? Or adopt an
approach - if one exists - that will preserve the advantages of both?
OpenClinical will continue to be involved in disseminating developments in the field.
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DeGeL (Digital electronic Guideline Library) [OC]