Comparing computer-interpretable guideline models: A case-study approach
Comparing computer-interpretable guideline models: A case-study approach
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DOI：
10.1197/jamia.m1135
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发表时间：
2003-01-01
影响因子：
6.4
通讯作者：
Stefanelli, M
中科院分区：
文献类型：
--
作者：
Peleg, M;Tu, S;Stefanelli, M
目的：许多小组正在开发计算机可解释的临床指南（CIG），用于临床治疗。CIG使用“任务网络模型”进行表示，但在解决特定建模挑战的方法上有所不同。我们已经研究了CIG之间的相似性和差异，以确定必须解决的问题之前，可以制定一套共同的components.Design的共识：我们比较了六个模型：Asbru，EON，GLIF，GUIDE，PRODIGY和PROforma。来自创建这些模型的团体的合作者以他们自己的形式表示了两个指南的一部分：美国内科医师学会-美国内科学会管理慢性咳嗽的指南和国家联合委员会关于预防，检测，评估和治疗高血压的第六次报告。这些组件使建模者能够将指导方针编码为在网络中组织决策和行动任务的计划。他们还使编码的指导方针与患者数据的关键要求，使患者特定的决策support.Results：我们发现共识的许多组成部分，包括计划组织，表达语言，概念病历模型，医疗概念模型，和数据抽象。差异是最明显的基本决策模型，目标表示，使用的情况下，和结构化的医疗actions.Conclusion：我们确定了准则的组成部分，CIG社区可以采用的标准。一些参与者正在HL 7的主持下对这些组成部分进行标准化。
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.