A Domain-Independent Semantically Validated Authoring Tool for Formalizing Clinical Practice Guidelines

Clinical Practice Guidelines (CPGs) are promoted as a powerful tool for standardization of the medical care quality and improvement of patients’ outcomes. However,  CPGs  need  to  be  formalized  in  a  computer  interpretable  format  (i.e.  as  Computer  Interpretable  Guidelines  or  CIGs)  for  their  implementation  within  Clinical  Decision  Support  Systems  (CDSS).  But,  maintaining  the  reliability  of  these  guidelines  when  deploying  them  in  different  clinical  settings  is  still  a  challenge.  On  the  one  hand,  the  complexity  of  the  medical  language  complicates  the adoption of the guidelines in different clinical institutions. On the other hand, the  continuous  discovery  of  new  evidence  needs  to  be  included  within  CPGs,  updating their contents and providing tools for evidence assessment. Furthermore, although nowadays’ clinical decision-making tends towards a personalized process, guidelines  are  designed  for  a  general  population.  In  this  paper,  we  present  an  Authoring Tool (AT) that allows clinicians to take an active role in the process of CPG  formalization.  This  AT  enables  them  to  introduce  new  clinical  knowledge  and  create  personalized  CIGs  for  their  local  application,  which  best  fits  their  clinical needs. The proposed system also allows the use of ontologies to facilitate the  standardization  and  interoperability  of  the  created  guidelines.  Finally,  the  content included in the CIGs can be evaluated using standard systems for grading clinical evidence.