GASTON: an architecture for the acquisition and execution of clinical guideline-application tasks

Learning points from paper

Critique of paper

Other comments

Citation and Abstract

Med Inform Internet Med. 2000 Oct-Dec;25(4):247-63. GASTON: an architecture for the acquisition and execution of clinical guideline-application tasks. De Clercq PA, Blom JA, Hasman A, Korsten HH.

Department of Medical Informatics, University of Maastricht, The Netherlands. P.A.d.Clercq@tue.nl

Recently, studies have shown the benefits of using clinical guidelines in the practice of medicine. There have been numerous efforts to develop clinical decision support systems that support guideline-based care in an automated fashion, covering a wide range of clinical settings and tasks. Despite these efforts, only a few systems progressed beyond the prototype stage and the research laboratory. For guideline-based clinical decision support systems to be successful, a balance must be made between intuitive but imprecise representations usually encountered by most of today's systems and representations that support a strong underlying clinical performance model. The project described in this paper tries to achieve such a balance. It presents the GASTON architecture that contains a set of reusable software components for the application of guidelines, including design-time components to facilitate the guideline authoring process based on guideline representation models along with execution-time components for building decision support systems that incorporate these guidelines. This architecture was used to develop several guideline representation models such as a rule-based representation to model rule-based guidelines and guideline representation models that address more complex tasks. Also, decision support systems that incorporate these models were developed with the architecture. For the representation and application of various classes of guidelines, rules were also viewed as instances of more complex tasks. By identifying similar characteristics of sets of rules, we developed several tasks such as a drug intera ction and drug contraindication task. Based on these models, we have developed and validated guidelines and decision support systems for use in several application domains such as intensive care, family physicians and psychiatry. In order to be able to represent more complex time-oriented plans, new guideline representation models are being developed.

PMID: 11198187 [PubMed - indexed for MEDLINE]

Related Links

• Design and implementation of a framework to support the development of clinical guidelines. [Int J Med Inform. 2001]
• ReviewApproaches for creating computer-interpretable guidelines that facilitate decision support. [Artif Intell Med. 2004]
• From guideline modeling to guideline execution: defining guideline-based decision-support services. [Proc AMIA Symp. 2000]
• ReviewRepresentation primitives, process models and patient data in computer-interpretable clinical practice guidelines: a literature review of guideline representation models. [Int J Med Inform. 2002]
• Sharable computer-based clinical practice guidelines: rationale, obstacles, approaches, and prospects. [Stud Health Technol Inform. 2001]