A longstanding informatics challenge has been to develop effective and efficient mechanisms whereby valid medical knowledge can be applied in computer systems to support decision making by clinicians. The Guideline Elements Model (GEM) is a generic hierarchical representation of guideline knowledge that makes use of XML, a powerful technology for representing and manipulating electronic documents. The proposed activities are designed broadly to facilitate knowledge acquisition and representation for guideline-based decision support systems.
Specific aims i nclude: 1) To create tools that will facilitate transformation of published guidelines into computer-mediated guideline implementation systems. A generic process and software tools will be developed to translate GEM-encoded guidelines into systems that can improve the process of care. 2) To define the factors that influence the implementability of practice guidelines and to create an instrument that evaluates this construct. An international panel of experts on guideline implementation will help to define dimensions of implementability and participate in validation of the instrument. 3) To improve the quality and implementability of an evidence- based guideline produced by national specialty societies. Feedback regarding quality and implementability will be provided during the development of a guideline on management of acute otitis media by the American Academy of Pediatrics and the American Academy of Family Practice. 4) To extend and refine the GEM model to serve as a precise, comprehensive, and consistently applied ontology of guideline- related concepts.

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
1R01LM007199-01
Application #
6359739
Study Section
Biomedical Library and Informatics Review Committee (BLR)
Program Officer
Sim, Hua-Chuan
Project Start
2002-03-01
Project End
2005-02-28
Budget Start
2002-03-01
Budget End
2003-02-28
Support Year
1
Fiscal Year
2002
Total Cost
$338,445
Indirect Cost
Name
Yale University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Shiffman, Richard N; Michel, George; Rosenfeld, Richard M et al. (2012) Building better guidelines with BRIDGE-Wiz: development and evaluation of a software assistant to promote clarity, transparency, and implementability. J Am Med Inform Assoc 19:94-101
Hajizadeh, Negin; Kashyap, Nitu; Michel, George et al. (2011) GEM at 10: a decade's experience with the Guideline Elements Model. AMIA Annu Symp Proc 2011:520-8
Lomotan, E A; Michel, G; Lin, Z et al. (2010) How ""should"" we write guideline recommendations? Interpretation of deontic terminology in clinical practice guidelines: survey of the health services community. Qual Saf Health Care 19:509-13
Scotch, Matthew; Duggal, Mona; Brandt, Cynthia et al. (2010) Use of statistical analysis in the biomedical informatics literature. J Am Med Inform Assoc 17:3-5
Hussain, Tamseela; Bell, Brian; Brandt, Cynthia et al. (2010) Using VistA electronic medical record data extracts to calculate the waiting time for total knee arthroplasty. J Arthroplasty 25:213-5
Rosenfeld, Richard M; Shiffman, Richard N (2009) Clinical practice guideline development manual: a quality-driven approach for translating evidence into action. Otolaryngol Head Neck Surg 140:S1-43
Hsiao, Allen L; Shiffman, Richard N (2009) Dropping the baton during the handoff from emergency department to primary care: pediatric asthma continuity errors. Jt Comm J Qual Patient Saf 35:467-74
Tran, Nam; Michel, George; Krauthammer, Michael et al. (2009) Embedding the guideline elements model in web ontology language. AMIA Annu Symp Proc 2009:645-9
Hussain, Tamseela; Michel, George; Shiffman, Richard N (2009) The Yale Guideline Recommendation Corpus: a representative sample of the knowledge content of guidelines. Int J Med Inform 78:354-63
Michel, George; Marcy, Theodore; Shiffman, Richard N (2005) A wireless, handheld decision support system to promote smoking cessation in primary care. AMIA Annu Symp Proc :530-4

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