Improving

Clinical

Guideline I

mplementation through

Prototypical

Design

Patterns

Monika Moser, Silvia

Miksch{moser,

silvia}@ifs.tuwien.ac.at

Institute of Software Technology & Interactive SystemsVienna University of Technology

2 MOSER & MIKSCH

AimFormal RepresentationRaw Clinical

Guidelines & Protocols

Knowledge Engineers

Domain Experts

Finding Prototypical

Design Patterns

Implementing Prototypical

Design Patterns

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Approach

GuidelineBasis

Guideline PoolNational Guideline

Clearinghouse www.guideline.gov

Guideline PoolNational Guideline

Clearinghouse www.guideline.gov

1. Definition of Relevant Criteria for Guidelines: medical & technical criteria

2. Selection Process

4. Development of Macros with Asbru and DELT/A

Macro File Preview: plain source

<macro name="xor_structure"><element-ref name="plan-group">

<element-ref name="plan"><attribute-ref name="name"value="%INPUT%guideline_plan"/><element-ref name="plan-body">

<element-ref name="subplans"><attribute-ref name="type"value="any-order"/><element-ref name="wait-for">

<element-ref name="all"/></element-ref><element-refname="plan-activation">

<element-refname="plan-schema">

<attribute-refname="name"value="$plan1$"/>

</element-ref></element-ref><element-refname="plan-activation">

<element-refname="plan-schema">

<attribute-refname="name"value="$plan2$"/>

</element-ref></element-ref>

</element-ref></element-ref>

</element-ref></macro>

Macro: xor_structure_macro<plan-group> <plan name="%INPUT%guideline_plan"> <plan-body> <subplans type="any-order"> <wait-for> <all/> </wait-for> <plan-activation> <plan-schema

name="$plan1$"/> </plan-activation> <plan-activation> <plan-schema

name="$plan2$"/> </plan-activation> </subplans> </plan-body> </plan>

Preview: tree view

3. Analysis and Definition of Pattern

Structure Pattern Temporal Pattern Element Pattern

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ResultsSoftware Pattern Approach: failed!

Text Linguistics Approach: successful!

Clinical Guidelines were not as qualified for the work done as it had been expected before

Reasons

Very high level of abstraction

Evidence-based character

Consequences

Few temporal dimensions

Few intentions

No algorithms

Clinical Protocols would be more appropriate !

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Thank you for your attention!