Guideline Development & Implementation - XML-Based Tools

一个长期的信息学挑战是开发有效和高效的机制，使有效的医学知识可以在计算机系统中应用，以支持临床医生的决策。指南元素模型(GEM)是指南知识的通用层次表示，它利用了用于表示和操作电子文档的强大技术--XML。拟议的活动大体上是为了促进基于准则的决策支持系统的知识获取和表达。具体目标包括：1)创建工具，促进将已公布的指南转化为以计算机为媒介的指南执行系统。将开发一个通用的流程和软件工具，将以创业板编码的指南转化为可改进护理流程的系统。2)确定影响实践指南可实施性的因素，并创建评估这一结构的工具。准则执行问题国际专家小组将帮助确定可实施性的各个方面，并参与文书的验证。3)提高国家专业学会制定的循证指南的质量和可实施性。在美国儿科学会和美国家庭实践学会制定急性中耳炎管理指南的过程中，将提供有关质量和可实施性的反馈。4)扩展和提炼GEM模型，以作为指导方针相关概念的精确、全面和一致应用的本体。

A longstanding informatics challenge has been to develop effective and efficient mechanisms whereby valid medical knowledge can be applied in computer systems to support decision making by clinicians. The Guideline Elements Model (GEM) is a generic hierarchical representation of guideline knowledge that makes use of XML, a powerful technology for representing and manipulating electronic documents. The proposed activities are designed broadly to facilitate knowledge acquisition and representation for guideline-based decision support systems. Specific aims include: 1) To create tools that will facilitate transformation of published guidelines into computer-mediated guideline implementation systems. A generic process and software tools will be developed to translate GEM-encoded guidelines into systems that can improve the process of care. 2) To define the factors that influence the implementability of practice guidelines and to create an instrument that evaluates this construct. An international panel of experts on guideline implementation will help to define dimensions of implementability and participate in validation of the instrument. 3) To improve the quality and implementability of an evidence- based guideline produced by national specialty societies. Feedback regarding quality and implementability will be provided during the development of a guideline on management of acute otitis media by the American Academy of Pediatrics and the American Academy of Family Practice. 4) To extend and refine the GEM model to serve as a precise, comprehensive, and consistently applied ontology of guideline- related concepts.