In many countries medical care is increasingly based on standardised clinical guidelines, many of which have been derived from prospective clinical trials. In addition to the problem of how to obtain appropriate evidence for these standards, a major problem is how to make practical use of them and assure that patients receive adequate treatment. Addressing the latter problem, it will become more and more important to provide computer-based tools that assist physicians and health care providers in guideline and protocol-based disease management.
The design of computer-based clinical guideline support systems, requires that the following three fundamental aspects be addressed. Guideline development is usually an interdisciplinary effort requiring many specialists from different fields a broad range of knowledge types must be acquired, represented and integrated, and finally we must be aware that analysis of disease management requires extensive documentation, necessitating the support of data acquisition and data dependent consulting procedures.
Since the development of the classical rule-based frame-oriented approaches, new technologies originating from the field of knowledge and ontology engineering, workflow management, data warehousing and data mining have been used to support guideline-and protocol-based care.
It was the objective of the First European Workshop on Computer-Based Support for Clinical Guidelines and Protocols (held in Leipzig, Germany on November 13th and 14th 2000) to bring together leading experts in the field and discuss the present state of development and future perspectives. An impressive range of topics was covered. Among them were:
• Knowledge acquisition tools, knowledge bases and problem solving methods
• Ontological engineering and formal concepts
• Design and implementation of data dictionaries
• Multi-dimensional organization and online analytical processing
• Data mining techniques
• Integration of workflow systems and CSCW for guideline - and protocol-based health care
• Telematics-based infrastructures and knowledge distribution
The workshop demonstrated clear that we are witnessing the beginning of a fascinating new field of interdisciplinary science, bridging innovative disciplines in computer science, medical practice and disease management. There is no doubt that integrating such disciplines will reap long term benefits. However, it will be crucial to design and integrate systems carefully and to accumulate experience on a step by step basis.
Essential questions include to what degree we need, and how we can design, knowledge-based data dictionaries to provide a basis for these systems. Related to this is the problem of providing efficient tools for data and knowledge acquisition and representation. Most importantly, however, will be the need to define the role of the physician and the patient. Here we need to make use of practical experience and develop ways to measure success.
This volume collects together the most interesting papers submitted to the workshop. These papers were selected by peer review from about 20 submissions. A full set of abstracts can be obtained from firstname.lastname@example.org.
The meeting was extremely encouraging and stimulated extensive discussions. It became apparent that it was the first meeting of its kind, and all participants agreed that it was a very timely subject to focus on. Indeed, plans for successor-workshops have already been discussed.
As the local convener of this meeting it is my privilege to thank all members of the local organizing staff who contributed with great enthusiasm to this meeting. These were Robert Müller, Kristin Lippoldt, Mónica Aguiar, Sebastian Dietzold, Michael Krüger and Roman Mishchenko. Jan Ramsch was very helpful in editing the manuscript of this issue. Particular merit goes to Barbara Heller, who initiated this meeting. Her ideas and her charm were infectious and left everybody enthused.
We hope the readers of this volume will find motivation for future work, and will be inspired to contribute to this field.
Leipzig, summer 2001
Institute of Medical Informatics, Statistics and Epidemiology