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The InterMed Approach to Sharable Computer-interpretable Guidelines: A Review

Affiliations of the authors: Stanford Medical Informatics, Stanford University, Stanford, CA (MP, ST); Decision Systems Group, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (AAB, QZ, OO, RAG); Department of Biomedical Informatics, Columbia University, New York, NY (DW, VLP, EHS). Dr. Peleg is currently at the Department of Management Information Systems, University of Haita, Israel.

Correspondence and reprints: Mor Peleg, PhD, Stanford University, MSOB x-206, 251 Campus Drive, Stanford, CA 94305-5479; e-mail: peleg{at}smi.stanford.edu.

Received for publication: 05/21/03; accepted for publication: 08/05/03.

InterMed is a collaboration among research groups from Stanford, Harvard, and Columbia Universities. The primary goal of InterMed has been to develop a sharable language that could serve as a standard for modeling computer-interpretable guidelines (CIGs). This language, called GuideLine Interchange Format (GLIF), has been developed in a collaborative manner and in an open process that has welcomed input from the larger community. The goals and experiences of the InterMed project and lessons that the authors have learned may contribute to the work of other researchers who are developing medical knowledge-based tools. The lessons described include (1) a work process for multi-institutional research and development that considers different viewpoints, (2) an evolutionary lifecycle process for developing medical knowledge representation formats, (3) the role of cognitive methodology to evaluate and assist in the evolutionary development process, (4) development of an architecture and (5) design principles for sharable medical knowledge representation formats, and (6) a process for standardization of a CIG modeling language.