Approaches for Guideline Versioning Using GLIF

Computer-interpretable clinical guidelines (CIGs) aim to eliminate clinician errors, reduce practice variation, and promote best medical practices by delivering patient-specific advice during patient encounters. Clinical guidelines are being regularly updated and revised to handle expanding clinical knowledge. When revising CIGs, much effort can be saved by specifying changes among versions instead of encoding revised guidelines from scratch. A representation of differences between versions could focus the process of re-implementing CIGs in a clinical environment and help users understand and embrace changes. Guideline versioning has not been adequately dealt with by existing CIG formalisms. We present three approaches for CIG versioning. Focusing on one approach, we developed a versioning tool based on version 3 of the GuideLine Interchange Format (GLIF3), and used it to represent two guideline versions for management of community-acquired pneumonia (CAP) and the changes between them.

[1]  Michael J Fine,et al.  Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  Fabio Casati,et al.  Workflow Evolution , 1996, ER.

[3]  Enrico Franconi,et al.  A Semantic Approach for Schema Evolution and Versioning in Object-Oriented Databases , 2000, Computational Logic.

[4]  Omolola Ogunyemi,et al.  GLIF3: the evolution of a guideline representation format , 2000, AMIA.

[5]  Robert A. Greenes,et al.  Support for guideline development through error classification and constraint checking , 2002, AMIA.

[6]  Otthein Herzog,et al.  Managing Evolving Workflow Specifications With Schema Versioning and Migration Rules , 1999 .

[7]  Mark A. Musen,et al.  Promptdiff: a fixed-point algorithm for comparing ontology versions , 2002, AAAI/IAAI.

[8]  Andreas Geppert,et al.  Dynamic workflow schema evolution based on workflow type versioning and workflow migration , 1999, Proceedings Fourth IFCIS International Conference on Cooperative Information Systems. CoopIS 99 (Cat. No.PR00384).

[9]  Natalya F. Noy,et al.  The evo-lution of Prot'eg'e: An environment for knowledge-based sys-tems development , 2002 .

[10]  John F. Roddick,et al.  A Taxonomy for Schema Versioning Based on the Relational and Entity Relationship Models , 1993, ER.

[11]  Y Shahar,et al.  Change Management of Shared and Local Versions of Health-Care Terminologies , 2000, Methods of Information in Medicine.

[12]  J J Cimino,et al.  Formal Descriptions and Adaptive Mechanisms for Changes in Controlled Medical Vocabularies , 1996, Methods of Information in Medicine.

[13]  Henrik Eriksson,et al.  The evolution of Protégé: an environment for knowledge-based systems development , 2003, Int. J. Hum. Comput. Stud..

[14]  J. Bartlett,et al.  GUIDELINES FROM THE INFECTIOUS DISEASES SOCIETY OF AMERICA Community-Acquired Pneumonia in Adults: Guidelines for Management , 1998 .

[15]  J. Marc Overhage,et al.  Research Paper: A Randomized Trial of "Corollary Orders" to Prevent Errors of Omission , 1997, J. Am. Medical Informatics Assoc..

[16]  Michel C. A. Klein,et al.  Ontology Evolution: Not the Same as Schema Evolution , 2004, Knowledge and Information Systems.