Representation primitives, process models and patient data in computer-interpretable clinical practice guidelines: a literature review of guideline representation models.

Full Abstract

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.

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Author information

Author/s: Wang, Dongwen (D); Peleg, Mor (M); Tu, Samson W (SW); Boxwala, Aziz A (AA); Greenes, Robert A (RA); Patel, Vimla L (VL); Shortliffe, Edward H (EH);

Affiliation: Department of Medical Informatics, Columbia University, VC5 622 West 168th Street, New York, NY 10032, USA. dongwen.wang@dmi.columbia.edu

Grants: LM06594 (Agency:United States NLM)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; Review

Journal: International journal of medical informatics (Int J Med Inform), published in Ireland. (Language: eng)

Reference: 2002-Dec; vol 68 (issue 1-3) : pp 59-70

Dates: Created 2002/12/06; Completed 2003/04/28; Revised 2007/11/15;

PMID: 12467791, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Medical Records Systems, Computerized
Models, Theoretical
Practice Guidelines as Topic
Programming Languages
Software

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