Report Number: CS-TR-98-1609
Institution: Stanford University, Department of Computer Science
Title: Automated creation of clinical-practice guidelines from
Author: Sanders, Gillian D.
Date: July 1998
Abstract: I developed an approach that allows clinical-practice
guideline (CPG) developers to create, disseminate, and tailor
CPGs, using decision models (DMs). I propose that guideline
developers can use computer-based DMs that reflect global and
site-specific data to generate CPGs. Such CPGs are high
quality, can be tailored to specific settings, and can be
modified automatically as the DM or evidence evolves.
I defined conceptual models for representing CPGs and DMs,
and formalized a method for mapping between these two
representations. I designed a DM annotation editor that
queries the decision analyst for missing knowledge. I
implemented the ALCHEMIST system that encompasses the
conceptual models, mapping algorithm, and the resulting
I evaluated the design of both conceptual models, and the
accuracy of the mapping algorithm. To show that ALCHEMIST
produces high-quality CPGs, I had users rate the quality of
produced CPGs using a guideline-rating key, and evaluate
ALCHEMIST's tailoring abilities.
ALCHEMIST automates the DM-to-CPG process and distributes the
CPG over the web to allow local developers to apply, tailor,
and maintain a global CPG. I argue that my framework is a
method for guideline developers to create and maintain
automated CPGs, and it thus promotes high-quality and
cost-effective health care.