Step II A: GEM Cutter II

GEM Cutter II (general information)

The GEM Cutter II is an XML document editor and it is part of the Guideline Elements Model (GEM) developed by the Yale Center for Medical Informatics at Yale University School of Medicine. The GEM Cutter II is able to transform textual clinical guideline information into GEM II formatted XML. 

To be able to explain the GEM Cutter II better, I will first elaborate on the Guideline Elements Model (GEM).

GEM is a model developed by Yale to assist the translation of clinical guidelines into a lay out computers can process. If we want technology to assist e.g. medical practitioners with clinical guidelines, then a translation is needed. This means clinical guidelines written in natural language are to be translated into a format that computers can process.

GEM is a model that “can store and organise the heterogeneous information contained in clinical guidelines”. This indicates that the model can be used to get a good overview of the knowledge provided by stakeholders in different articles. Each stakeholder will put emphasis on his/her orientation and therefore a good overview is useful (Shiffman et al (2000)). E.g. implementers of guidelines will put emphasis on the practical implications of a clinical guideline and less on the scientific concept/validity; while the developers of guidelines will provide the theoretical validity of the guideline and less conceptual recommendations. GEM can organise and represent this heterogeneous information.

In 2000, the first article about GEM was published. Now, in 2012, the second version, GEM II, is in use. The improved GEM II has, for example, more branches to contain the elements. These branches are, for instance, “purpose”, “intended audience” and “method of development”. Each branch contains several elements, which can be filled with information from the original document.

(GEM Hierarchy - Source: GEM website by Yale Center for Medical Informatics) 

This is where the GEM Cutter II comes in as a tool. The XML document editor can be used to mark up the wanted parts of the clinical guideline and categorize them under the right element. In this way the textual clinical guidelines are transformed into GEM II formatted XML. The user does not even need programming knowledge for this transformation. There is a user guide available, so I will investigate how easy it really is...

Sources:

• Official GEM website by Yale Center for Medical Informatics
• Shiffman et al (2000) – GEM: A proposal for a more comprehensive guideline document model using XML