contents    Preamble, aims and scope    Presentations    Links

This workshop was organised by Cancer Research UK and sponsored by OpenClinical.

Preamble, aims and scope
In March 2000, the InterMed Project (Harvard Medical School, McGill University, Stanford University School of Medicine) and the American College of Physicians - American Society of Internal Medicine hosted an invited workshop in Boston entitled Towards a Shareable Guideline Representation. Main goals of this meeting were: To bring together different stakeholders intereted in the development, dissemination and use of clinical practice guidelines; To discuss the development of a standard robust, shareable guideline representation model. The Boston workshop also highlighted the number and variety of efforts underway in the modelling of clinical processes and contributed to the establishment of an international community of researchers with a shared interest in formalising medical knowledge for use in computer-based decision support and guideline systems. During 2001, a team led by Stanford University initiated a comparative study of six different approaches to guideline modelling (Asbru, EON, GLIF, GUIDE, PRODIGY and PROforma). Each method development group was invited to model two published guidelines and to submit the results to the study team for analysis. Mor Peleg (then at Stanford, now at Haifa University, Israel) took the lead role in preparing a consensus overview of the different methods, identifying common and contrasting features of the methods in a non-evaluative way. The study was published by JAMIA in January 2002. This OpenClinical workshop, held in London in September 2001 allowed a large number of OpenClinical members to learn about the guideline representation methods under discussion. It also enabled the development groups to present updates on their work and discuss an interim report on the results of the comparative study. OpenClinical has published material not included in the final paper.
Abstracts and Presentations
Asbru Silvia Miksch Department of Computer Science, Vienna University of Technology    Presentation Asbru tools Yuval Shahar Department of Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel    Presentation EON Samson Tu Stanford Medical Informatics, Stanford University School of Medicine    Presentation GLIF Mor Peleg Stanford Medical Informatics, Stanford University School of Medicine (now Haifa Unviersity)    Presentation GUIDE Silvana Quaglini Medical Informatics Laboratory, University of Pavia, Italy    Presentation PRODIGY Neill Jones the Sowerby Centre for Health Informatics at Newcastle (SCHIN), (then a Newcastle University research centre)    Presentation PROforma John Fox Advanced Computation Laboratory, Cancer Research UK, London    Presentation
reference
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]   [OpenClinical - unpublished material] " 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. "
Links: Related work
Previous related meetings    Towards a Shareable Guideline Representation, Invitational workshop, Boston, Massachusetts, March 2000     A set of short position papers on guideline representation issues - material from the above workshop on glif.org.    Sharing Knowledge for Clinical Practice Guidelines: Are We There Yet? - A panel discussion at the 1999 AMIA Annual Symposium	Subsequent related meetings    Symposium on Computerized Guidelines and Protocols, Prague, 2004 (CPG 2004) [OC]
links
Peleg et al [2003], Comparative study of six different approaches to guideline modelling [OC]	Summaries of 14 methods for representing clinical guidelines [OC]
acknowledgements
Silvia Miksch, Yuval Shahar, Samson Tu, Mor Peleg, Silvana Quaglini, Neill Jones, John Fox
page history
Entry on OpenClinical: 2001 Redesigned and last main update: 17 April 2005