The development of new paradigms for the electronic dissemination and consultation of clinical knowledge must be accompanied by new methods for ensuring the quality of the information available. This paper sets out a possible framework for ensuring the quality, reliability and safety of machine-enactable electronic guidelines. This addresses the quality of the clinical content and the integrity of the software platform, drawing on the quality assurance principles of conventional medical publishing and formal software engineering.
References
1.
Johnston M E, Langton K B, Haynes R B, Mathieu A.Effects of computer-based clinical decision support systems on clinician performance and patient outcome: a critical appraisal of research. Ann Intern Med1994; Jan 15; 120(2): 135-142.
2.
Hripcsak G, Ludemann P, Pyror T A, Wigertz O B, Clayton P D.Rationale for the Arden Syntax. Comput Biomed Res1994; 27: 291-324.
3.
Sherman EH, Hripcsak G, Strarren J, Jenders RA, Clayton P.Using intermediate stages to improve the ability of the Arden Syntax to implement care plans and reuse knowledge. Proc Annu Symp Comput Appl Med Care1995: 238-242.
4.
Ohno-Machado L, Gennari J H, Murphy S N, Jain N L, Tu S W, Oliver D E, Pattison-Gordon E, Greenes R A, Shortliffe E H, Barnett G O.The guideline interchange format: a model for representing guidelines. J Am Med Inform Assoc1998: Jul-Aug; 5(4): 357-372.
5.
Fox J, Johns N, Rahmanzadeh A, Thomson R.PROforma: a method and language specifying clinical guidelines and protocols. Proc. Medical Informatics Europe. Amsterdam: IOS Press, 1996.
6.
Fox J, Johns N, Lyons C, Rahmanzadeh A.Dissemination of medical knowledge: the PROforma approach. Artificial Intelligence in Medicine1998; 14: 157-181.
7.
Van Harmelen F, Balder J R.(ML)2: A formal language for KADS models of expertise. Knowledge Acquisition, 1992; 4(1): 127-161.
8.
Fox J, Das S.Safe and sound: artificial intelligence in hazardous applications. AAAI Press, Menlo Park, CA and MIT Press, Cambridge, Mass., 2000.
9.
Emery J, Walton R, Murphy M.Austoker J, Yudkin P, Chapman C, Coulson A, Glasspool D, Fox J.Computer support for interpreting family histories of breast and ovarian cancer in primary care: comparative study with simulated cases. BMJ2000; 321 (7252): 28-32.
10.
Emery Jet al. Computer support for recording and interpreting family histories of breast and ovarian cancer in primary care (RAGs): qualitative evaluation with simulated patients. BMJ1999; 319: 32-36.
11.
Fox J.On the soundness and safety of expert systems. Artificial Intelligence in Medicine1993; 5: 159-179.
12.
Das S and Fox J.A Logic for Reasoning about Safety in Decision Support Systems. In: Clarke Met al. (eds.) Symbolic and Quantitative Approaches to Reasoning and Uncertainty. Proceedings of European Conference ECSQARU93. Granada, Spain, November 1993. Lecture Notes in Computer Science 747. Springer-Verlag, 1993; 79-84.
13.
Hammond P, Harris A L, Das S K, Wyatt J C.Safety and decision support in oncology. Methods of Information in Medicine1994; 33(4): 371-381.
