Development of a guideline authoring tool with PROTÉGÉ II, based on the DILEMMA Generic Protocol and Guideline Model

Clinical guidelines are now commonly available, and their benefits have been demonstrated. However, they will not be widely used until they can be freely disseminated in a form that can be applied in the care process to assist the care provider. To do this effectively, guidelines must be authored to a common standard, in a form executable by a computer, such that the guideline takes into account findings already present in the medical record and then offers appropriate guideline-based advice. The Generic Protocol and Guideline Model (GPGM) was developed during the DILEMMA project and aims to solve these problems. However, work in DILEMMA and subsequently on asthma guidelines raises the question as to whether one formal model can adequately represent every piece of knowledge about all guidelines. PROTÉGÉ -II is a suite of programs to aid the development of such knowledge-based systems, which we have used to formally reimplement the GPGM to produce a guideline-editing tool, allowing a clinician to express a guideline as a sharable knowledge base. This process made clear that one model is an over simplification, and a family of related models is required to achieve the goals of the DILEMMA project.