Step-by-step mark-up of medical guideline documents

Abstract

Summary.Approaches to formalisation of medical guidelines can be divided into model-centric and document-centric. While model-centric approaches dominate in the development of clinical decision support applications, document-centric, mark-up-based formalisation is suitable for application tasks requiring the 'literal' content of the document to be transferred into the formal model. Examples of such tasks are logical verification of the document or compliance analysis of health records.The quality and efficiency of document-centric formalisation can be improved using a decomposition of the whole process into several explicit steps. We present a methodology and software tool supporting the step-by-step formalisation process. The knowledge elements can be marked up in the source text, refined to a tree structure with increasing level of detail, rearranged into an XML knowledge base, and, finally, exported into the operational representation. User-definable transformation rules enable to automate a large part of the process.The approach is being tested in the domain of cardiology. For parts of the WHO/ISH Guidelines for Hypertension, the process has been carried out through all the stages, to the form of executable application, generated automatically from the XML knowledge base.

Supporting Physicians and Patients Through Recommendation: Guidelines and Beyond

“…Concerning acquisition, different issues have been addressed, ranging from the definition of suitable graphical interfaces to enhance the physician-system interaction, to the definition of set of tools supporting the progressive transformation from a textual CPG to its formal representation ( [8,11,14,16,17,20]). …”

Information requisition is the core of guideline‐based medical care: which information is needed for whom?

“…We have investigated various approaches [6,[23][24][25][26] to formalize a clinical practice guideline in a document-centric way. These approaches use different (and not always coherent) methods to do so.…”

From Clinical Practice Guidelines to Computer-interpretable Guidelines

“…The system is document-centric: it formalizes the initial text in multiple user-definable steps. They correspond to interactive XML transformations [37].…”