Representation of clinical practice guidelines in a computer-interpretable format is a critical issue for guideline development, implementation, and evaluation. We studied 11 types of guideline representation models that can be used to encode guidelines in computer-interpretable formats. We have consistently found in all reviewed models that primitives for representation of actions and decisions are necessary components of a guideline representation model. Patient states and execution states are important concepts that closely relate to each other. Scheduling constraints on representation primitives can be modeled as sequences, concurrences, alternatives, and loops in a guideline's application process. Nesting of guidelines provides multiple views to a guideline with different granularities. Integration of guidelines with electronic medical records can be facilitated by the introduction of a formal model for patient data. Data collection, decision, patient state, and intervention constitute four basic types of primitives in a guideline's logic flow. Decisions clarify our understanding on a patient's clinical state, while interventions lead to the change from one patient state to another.
Bibliographical noteFunding Information:
This work is supported by grant LM06594 to the InterMed Collaboratory from the National Library of Medicine, the Department of the Army, and the Agency for Healthcare Research and Quality.
- Clinical decision support systems
- Computer-assisted decision making
- Knowledge representation
- Practice guidelines
- Theoretical models
ASJC Scopus subject areas
- Health Informatics