title: With good intentions.
abstract: OBJECTIVE
  To develop a framework for clinical practice guidelines that not only allows the representation of best practices, but also facilitates reasoning about acceptable alternatives for those best practices.
  
  
  METHODS
  Design of an explicit representation formalism of intentions of guidelines and guideline steps. Implementation of this representation and reasoning mechanisms in GASTON, a tool for representing and executing computerized clinical guidelines.
  
  
  RESULTS
  The developed formalism is used to represent a heart failure clinical guideline. It is demonstrated that the representation of intentions provides the needed flexibility to avoid unnecessary errors and warnings.
  
  
  CONCLUSIONS
  By using an explicit representation of the intentions of guidelines and guideline steps, a flexible decision support system can be built that does not check only the adherence to the formal guideline but evaluates clinical activities in light of the intention of the guidelines.
authors.affiliation: Medical Informatics, University Maastricht, Maastricht, The Netherlands. aa.berendsen@mi.unimaas.nl
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Latoszek-Berendsen
authors.forename: Jan
authors.initials: J
authors.lastname: Talmon
authors.forename: Paul
authors.initials: P
authors.lastname: de Clercq
authors.forename: Arie
authors.initials: A
authors.lastname: Hasman
mesh_terms: D020000:Decision Support Systems, Clinical; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D033182:Intention; D017410:Practice Guidelines as Topic; D011340:Problem Solving; D012985:Software Design; D009626:Terminology as Topic