A generic execution model for sharing of computer-interpretable clinical practice guidelines

Sharing of computer-interpretable clinical practice guidelines is a critical requirement for guideline development and implementation. Considering that no existing guideline representation model is universally accepted, I propose the Guideline Execution by Semantic Decomposition of Representation (GESDOR) model to facilitate the execution of guidelines encoded in different formats and to realize guideline sharing at the execution level. The GESDOR guideline execution model consists of a generalized Guideline Execution Task Ontology (GETO), a set of guideline representation models, a set of mapping relationships that define the semantic links between specific guideline representation models and the GETO, and a generic task-scheduling model for guideline execution. To support guideline execution under the GESDOR model, I extracted the generalized guideline execution tasks by analyzing the existing guideline representation models. I then defined a model of ontology mapping that could be used to create the semantic links between the elements in a specific guideline representation model and the generalized guideline execution tasks in the GETO. Finally, I developed a generic task-scheduling model that harmonized the existing approaches to task scheduling in guideline execution. Evaluation has shown that the GESDOR model can be used to effectively execute guidelines that are encoded in different representation formats, comparing to guideline execution that is based on a specific representation model. The clinical validity of the recommendations generated by the GESDOR guideline execution engine has reached the level of the reference systems that were used in the evaluation. As the GESDOR model supports the execution of guidelines encoded in different formats, it thus can be used to realize guideline sharing at the execution level.