A History-Based Algebra for Quality-Checking Medical Guidelines

In this paper, we propose a formal theory to describe the development of medical guideline text in detail, but at a sufficiently high level abstraction, in such way that essential elements of the guidelines are highlighted. We argue that because of the fragmentary nature of medical guidelines, an approach where details in guideline text are omitted is justified. The different aspects of a guideline are illustrated and discussed by a number of examples from the Dutch breast cancer guideline. Furthermore, we discuss how the theory can be used to detect flaws in the guideline text at an early stage in the guideline development process and consequently can be used to improve the quality of medical guidelines.