title: Handling expressiveness and comprehensibility requirements in GLIF3.
abstract: Clinical guidelines are aimed at standardizing patient care and improving its quality and cost effectiveness. Guidelines represented in a computer-interpretable (CI) format can be used to provide automatic decision support applied to individual patients during the clinical encounter. The process of creating computer-interpretable guidelines (CIG) re-moves ambiguities contained in paper-based guidelines, thus making the guideline more comprehensible. For these reasons, CIGs may have a larger impact on clinician behavior than paper-based guidelines. Since much effort goes into creating guidelines in a CI format, it is desirable that different institutions and software systems share them. In a guideline representation workshop hosted by the InterMed Collaboratory in March 2000, the need for a standard representation format for sharable CIGs was recognized. As a first step towards achieving this goal, we proposed a set of functional requirements for sharable CIGs. The requirements encompass the entire life cycle of a CIG: development, implementation, use and maintenance. In this paper we discuss requirements that are important during the development stage of a CIG. We have abstracted the requirements into two groups: expressiveness--the ability to ex-press the knowledge content of different types of guidelines--and comprehensibility--the ability to manage complexity, facilitate coherence, and visualize a guideline model to aid in human comprehension. The Guideline Interchange For-mat version 3 (GLIF3) is a language for structured representation of CIGs. It is under development to facilitate sharing CIGs among different institutions and systems. We illustrate how GLIF3 meets the specified development requirements.
authors.affiliation: Stanford Medical Informatics, Stanford University School of Medicine, Stanford, California 94305-5479, USA. peleg@smi.stanford.edu
authors.forename: M
authors.initials: M
authors.lastname: Peleg
authors.forename: A A
authors.initials: AA
authors.lastname: Boxwala
authors.forename: S
authors.initials: S
authors.lastname: Tu
authors.forename: R A
authors.initials: RA
authors.lastname: Greenes
authors.forename: E H
authors.initials: EH
authors.lastname: Shortliffe
authors.forename: V L
authors.initials: VL
authors.lastname: Patel
mesh_terms: D003658:Decision Making, Computer-Assisted; D017410:Practice Guidelines as Topic / Q000592:standards*; D011381:Programming Languages