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Basis of the study: extracts of two guidelines were modelled
in each of six formalisms (Asbru, EON, GLIF, GUIDE, PRODIGY
and PROforma) for analysis and comparison. The guidelines
were:
- The American College of Physicians - American Society
of Internal Medicine's guideline for managing chronic cough;
- The Sixth Report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure.
Eight aspects of the resulting models were analysed - four
that capture the structure of a guideline:
- organisation of guideline plans
- representation of goals/intentions
- representation of guideline actions
- models of decision-making
and four that are prerequisites for linking a guideline model
with patient data (a key requirement for enabling patient-specific
decision support):
- expression language
- data interpretation
- medical concept model
- patient information model.
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| Peleg M, Tu S, Bury J, Ciccarese
P, Fox J, Greenes RA, Hall R, Johnson PD, Jones N, Kumar A,
Miksch S, Quaglini S, Seyfang A, Shortliffe EH, Stefanelli
M. Comparing computer-interpretable guideline models:
a case-study approach. J Am Med Inform Assoc. 2003
Jan-Feb;10(1):52-68.
[PubMed]
[PubMed
Central]
[SMI
technical report: Part 1 of 2]
[SMI
technical report: Part 2 of 2]
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"OBJECTIVES: Many groups
are developing computer-interpretable clinical guidelines
(CIGs) for use during clinical encounters. CIGs use "Task-Network
Models" for representation but differ in their approaches
to addressing particular modeling challenges. We have studied
similarities and differences between CIGs in order to identify
issues that must be resolved before a consensus on a set of
common components can be developed. DESIGN: We compared six
models: Asbru, EON, GLIF, GUIDE, PRODIGY, and PROforma.
Collaborators from groups that created these models represented,
in their own formalisms, portions of two guidelines: the American
College of Physicians-American Society of Internal Medicine's
guideline for managing chronic cough and the Sixth Report
of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure. MEASUREMENTS:
We compared the models according to eight components that
capture the structure of CIGs. The components enable modelers
to encode guidelines as plans that organize decision and action
tasks in networks. They also enable the encoded guidelines
to be linked with patient data-a key requirement for enabling
patient-specific decision support. RESULTS: We found consensus
on many components, including plan organization, expression
language, conceptual medical record model, medical concept
model, and data abstractions. Differences were most apparent
in underlying decision models, goal representation, use of
scenarios, and structured medical actions. CONCLUSION: We
identified guideline components that the CIG community could
adopt as standards. Some of the participants are pursuing
standardization of these components under the auspices of
HL7. "
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