Subscribe to RSS
DOI: 10.1055/s-0038-1634387
Representation of Practice Guidelines with XML – Modeling with XML Schema
Publication History
Received
16 October 2001
Accepted
27 February 2002
Publication Date:
07 February 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035037/200204/lookinside/thumbnails/10-1055-s-0038-1634387-1.jpg)
Summary
Objectives: Data and information in medicine are mainly represented in slightly structured or even unstructured, narrative text documents. It is nearly impossible to detect and handle relationships between data elements within narrative documents or to retrieve parts of documents that contain specific information. But information access and retrieval are essential to serve the delivery and application of evidence-based medicine.
Methods: The eXtensible Markup Language (XML) provides a standard means to explicitly describe a document‘s structure and to identify meaningful elements inside textual narrations. Information about the state-of-the-art medical care can be delivered to the physician by different means and media. Clinical practice guidelines are thought to be one possible solution to summarize and present current medical evidence.
Results: The structuring of resources containing medical information with XML can facilitate the provision of problem-specific medical information at the point of care by improving content retrieval and presentation. In our project, the XML Schema is used for the electronic representation in order to structure guidelines (and other text-based resources) in a standardized way.
Conclusion: The transition from unstructured textual data towards structured and coded data will be a migration process. One of the premises of our approach is that the structure that is defined by the information model doesn‘t restrict the content of the documents. This approach may fill the gap between computerized, algorithmic guideline recommendations and text-based guideline distributions.
-
References
- 1 Bakken S. An Informatics Infrastructure is essential for evidence-based practice. J Am Med Inform Assoc 2001; 8 (Suppl. 03) 199-201.
- 2 Roberts A. Analysing XML health records. XML Europe Conference Proceedings. 2000: 377-80.
- 3 Schweiger R, Tafazzoli A, Dudeck J. Using XML for flexible data entry in healthcare, example use for pathology. XML Europe Conference Proceedings. 2000: 357-62.
- 4 Schweiger R, Hoelzer S, Altmann U. et al. Plug & play XML – A healthcare perspective. J Am Med Inform Assoc 2002; 9 (Suppl. 01) 37-48.
- 5 Eddy DM. Clinical decision making: from theory to practice. Practice policies – guidelines for methods. JAMA 1990; 263 (Suppl. 13) 1839-41.
- 6 Grimshaw JM, Russell IT. Achieving health gain through clinical guidelines II: Ensuring guidelines change medical practice. Qual Health Care 1994; 3 (Suppl. 01) 45-52.
- 7 Grol R, Grimshaw J. Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv 1999; 25 (Suppl. 10) 503-13.
- 8 Hunt DL, Haynes RB, Hanna SE. et al. Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review (see comments). JAMA 1998; 280 (Suppl. 15) 1339-46.
- 9 Shiffman RN, Liaw Y, Brandt CA. et al. Computer-based guideline implementation systems: a systematic review of functionality and effectiveness. J Am Med Inform Assoc 1999; 6 (Suppl. 02) 104-14.
- 10 Kuperman GJ, Teich JM, Bates DW. et al. Detecting alerts, notifying the physician, and offering action items: a comprehensive alerting system. Proc AMIA Annu Fall Symp. 1996: 704-8.
- 11 McDonald CJ, Wilson GA, McCabe Jr GP. Physician response to computer reminders. JAMA 1980; 244 (Suppl. 14) 1579-81.
- 12 Overhage JM, Tierney WM, McDonald CJ. Computer reminders to implement preventive care guidelines for hospitalized patients. Arch Intern Med 1996; 156 (Suppl. 14) 1551-6.
- 13 Hoelzer S, Hundahl SA, Stewart A. et al. Confronting actual practice with practice guidelines in oncology. Qual Assur 1999; 7 (Suppl. 03) 163-71.
- 14 Holzer S, Fremgen AM, Hundahl SA. et al. Analysis of medical-decision making and the use of standards of care in oncology. Proc AMIA Symp 2000; (20 Suppl): 364-8.
- 15 Cimino JJ. Data storage and knowledge representation for clinical workstations. Int J Biomed Comput 1994; 34: 185-94.
- 16 Karras BT, Nath SD, Shiffman RN. A preliminary evaluation of guideline content markup using GEM – An XML guideline elements model. Proc AMIA Symp 2000; (20 Suppl): 413-7.
- 17 Shiffman RN, Karras BT, Agrawal A. et al. GEM: a proposal for a more comprehensive guideline document model using XML. J Am Med Inform Assoc 2000; 7 (Suppl. 05) 488-98.
- 18 Patel VL, Allen VG, Arocha JF. et al. Representing clinical guidelines in GLIF: individual and collaborative expertise. J Am Med Inform Assoc 1998; 5 (Suppl. 05) 467-83.
- 19 Peleg M, Boxwala AA, Ogunyemi O. et al. GLIF3: the evolution of a guideline representation format. Proc AMIA Symp 2000; (20 Suppl): 645-9.
- 20 Hripcsak G. Arden Syntax for Medical Logic Modules. MD Comput 1991; 8 (Suppl. 02) 76-8.