The guideline interchange format: a model for representing guidelines.
OBJECTIVE
To allow exchange of clinical practice guidelines among institutions and computer-based applications.


METHODS
The GuideLine Interchange Format (GLIF) specification consists of GLIF model and the GLIF syntax. The GLIF model is an object-oriented representation that consists of a set of classes for guideline entities, attributes for those classes, and data types for the attribute values. The GLIF syntax specifies the format of the test file that contains the encoding.


METHODS
Researchers from the InterMed Collaboratory at Columbia University, Harvard University (Brigham and Women's Hospital and Massachusetts General Hospital), and Stanford University analyzed four existing guideline systems to derive a set of requirements for guideline representation. The GLIF specification is a consensus representation developed through a brainstorming process. Four clinical guidelines were encoded in GLIF to assess its expressivity and to study the variability that occurs when two people from different sites encode the same guideline.


RESULTS
The encoders reported that GLIF was adequately expressive. A comparison of the encodings revealed substantial variability.


CONCLUSIONS
GLIF was sufficient to model the guidelines for the four conditions that were examined. GLIF needs improvement in standard representation of medical concepts, criterion logic, temporal information, and uncertainty.
Decision Systems Group, Brigham and Women's Hospital, Boston, MA 02115, USA. machado@dsg.harvard.edu
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Ohno-Machado
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Gennari
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Murphy
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Jain
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Tu
D E
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Oliver
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Pattison-Gordon
R A
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Greenes
E H
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Shortliffe
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Barnett
D003658:Decision Making, Computer-Assisted; D007256:Information Systems / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards; D017010:Reminder Systems; D012984:Software; D012985:Software Design; D018511:Systems Integration