Towards a Second Generation of Computer Interpretable Guidelines

Paolo Terenziani, Alessio Bottrighi, Laura Giordano, Giuliana Franceschinis, Stefania Montani, Luigi Portinale, Daniele Theseider Dupre


Computer Interpretable Guidelines (CIG) are an emerging area of research, to support medical decision making through evidence-based recommendations. However, new challenges in the data management field have to be faced, to integrate CIG management with a proper treatment of patient data, and of other forms of medical knowledge (e.g., causal and behavioral knowledge). In this position paper, we summarize a proposal for a research agenda that, in our opinion, can lead to a significant advancement in the field. The goal of the work is to provide suitable models and reasoning methodologies to cope with the aforementioned aspects, and to properly integrate them for medical decision support. Achieving such a goal requires advances in data management, and, in particular, in the treatment of indeterminate valid-time data in relational databases, of temporal abstraction on time series, of case retrieval on time series, of design-time and run-time model-based verification of guidelines, of case-based reasoning, of non-monotonic logics, of formal ontologies, of probabilistic graphical models (Bayesian Networks and Influence Diagrams).


  1. Aamodt, A., Plaza, E., 1994. Case-based reasoning: foundational issues, methodological variations and systems approaches. AI Communications 7, 39-59
  2. Montani, S., Bottrighi, A., 2006. Towards a Comprehensive Treatment of Repetitions, Periodicity and Temporal Constraints in Clinical Guidelines. AIIM 38, Elsevier, 171-195,
  3. Anselma, L., Terenziani, P., Snodgrass, R. T., 2012. Valid-Time Indeterminacy in Temporal Relational Databases: Semantics and Representations, IEEE TKDE, vol. 99, PrePrints.
  4. Baarir, S., Beccuti, M., Cerotti, D., De Pierro, M., Donatelli, S., Franceschinis, G., 2009. The GreatSPN tool: recent enhancements. ACM SIGMETRICS Performance Evaluation Review, Vol.36 Issue 4, 4-9
  5. Beccuti, M., Bottrighi, A., Franceschinis, G., Montani, S. , Terenziani, P. 2009. Modeling and verifying clinical guidelines through Petri Nets, Proc. AIME'09, LNAI 5651.
  6. Bellazzi, R., Larizza, C., Riva, A., 1998. Temporal abstractions for interpreting diabetic patients monitoring data. Intelligent Data Analysis 2, 97-122.
  7. Bellazzi, R., Montani, S., Portinale, L., Riva, A. 1999. Integrating Rule-Based and Case-Based Decision Making in Diabetic Patient Management, Proc. ICCBR'99, Munich, LNCS 1650, 386-400.
  8. Bonatti, P., Calimeri, F., Leone, N., Ricca, F. 2010. Answer Set Programming, chapter 5. LNCS Volume 6000 of Dovier and Pontelli,.
  9. Bottrighi, A., Chesani, F., Mello, P., Molino, G., Montali, M., Montani, M., Storari, S., Terenziani, P., Torchio, M., 2009. An Hybrid Approach to Clinical Guideline Conformance. Proc. AIME'09, LNAI 5651.
  10. Bottrighi, A., Giordano, L., Molino, G., Montani, S.. P.Terenziani, M.Torchio, 2010. Adopting model checking techniques for clinical guidelines verification, AIIM 48(1), 1-19.
  11. Brewka, G., 2004.: Complex Preferences for Answer Set Optimization, KR 2004, 213-223.
  12. Chesani, F., Mello, P., Montali, M., Torroni, P., 2009. Commitment tracking via the reactive event calculus. In Proc. IJCAI 2009, 91-96.
  13. Domingos P., Lowd, D. 2009. Markov Logic: an Interface Layer for Artificial Intelligence. Morgan & Claypool Publ.
  14. Dyreson, C.. 2009.Temporal Indeterminacy. In L. Liu and M. Tamer Özsu. Encyclopedia of Database Systems, Springer.
  15. Gelfond, M., 2007. Handbook of Knowledge Representation, chapter 7, Answer Sets. Elsevier.
  16. Getoor, L., Friedman, N., Koller, D., Pfeffer, A., Taskar, B., 2007. Probabilistic Relational Models. In L. Getoor and B. Taskar, editors, Introduction to Statistical Relational Learning.
  17. Giordano, L., Terenziani, P., Bottrighi, A., Montani, S., Donzella, L., 2006. Model Checking for Clinical Guidelines: an Agent-based Approach. in Proc. AMIA'06, Washington.
  18. Giordano, L., Gliozzi, V., Olivetti, N., Pozzato, G. L., 2009. ALC + T: a Preferential Extension of Description Logics. Fundam. Inform. 96(3): 341-372.
  19. Giordano, L., Martelli, A., Theseider Dupré, D., 2012. Reasoning about actions with Temporal Answer Sets. In Theory and Practice of Logic Programming. 2012, to appear. Available at
  20. Jensen, F.V., Nielsen, T.D., 2007. Bayesian Networks and Decision Graphs. Springer.
  21. Koller, D., Friedman, N., 2009. Probabilistic Graphical Models, MIT Press.
  22. Klinov, P., Parsia, B., 2008. Optimization and evaluation of reasoning in probabilistic description logic: Towards a systematic approach, in International Semantic Web Conference, LNCS 5318, 213-228. Springer.
  23. Leonardi, G. , Bottrighi, A., Galliani, G., Terenziani, P. Messina, A., Della Corte, F., 2012. Exceptions Handling within GLARE Clinical Guideline Framework, Proc. AMIA 2012, Distinguished Paper Award.
  24. Montani, S., Leonardi, G., Bottrighi, A., Portinale, L., Terenziani, P., 2013. Supporting Flexible, Efficient and User-Interpretable Retrieval of Similar Time Series. IEEE TKDE, ISSN: 1041-4347, doi: 10.1109/TKDE.2011.264
  25. Peleg, M., Tu, S., Bury, J., Ciccarese, P., Fox, J., Greenes, R.A., Hall, R., Johnson, P.D., Jones, N., Kumar, A., Miksch, S., Quaglini, S., Seyfang, A., Shortliffe, E.H., Stefanelli, M., 2004. Comparing computer interpretable GL models: a case-study approach, JAMIA 10, 52-68.
  26. Peleg, M., Rubin, D., Altman, R.B., 2005. Using petri nets tools to study properties and dynamics of biological systems. JAMIA 12:181-199.
  27. Poole, D., 1993. Probabilistic Horn Abduction and Bayesian Networks. Artificial Intelligence, 64(1): 81- 129.
  28. Poole, D., 1997. The Independent Choice Logic for modelling multiple agents under uncertainty, Artificial Intelligence, 94(1-2): 7-56.
  29. Quaglini, S., Stefanelli, M., Lanzola, G., Caporusso, V., Panzarasa, S., 2001. Flexible guideline-based patient careflow systems. AIIM 22:65-80.
  30. Schmidt, R., Montani, S., Bellazzi, R., Portinale, L., Gierl, L. 2001. Case-Based Reasoning for Medical Knowledge-based Systems, International Journal of Medical Informatics 64(2), 355-367.
  31. Shahar, Y., 1997. A framework for knowledge-based temporal abstractions. Artificial Intelligence 90, 79- 133.
  32. Snodgrass, R. T. (Editor), 1995: The TSQL2 Temporal Query Language, Kluwer Academic Publishers.
  33. Ten Teije, A., Miksch, S., Lucas, P., 2008Computer-based Medical Guidelines and Protocols: A Primer and Current Trends, Volume 139 Studies in Health Technology and Informatics, ISBN: 978-1-58603-873- 1.
  34. Terenziani, P., Molino, G., Torchio, M, 2001. A Modular Approach for Representing and Executing Clinical Guidelines. AIIM 23, 249-276.
  35. Terenziani, P. , Snodgrass, R.T., Bottrighi, A., Torchio, M., Molino, G., 2007. Extending temporal database to deal with telic/atelic medical data, AIIM 39(2) 113- 126.
  36. Terenziani, P., Montani, S., Bottrighi, A., Molino, G., Torchio, M., 2008. Applying Artificial Intelligence to Clinical Guidelines: the GLARE Approach, in (Tejie et al., 2008).

Paper Citation

in Harvard Style

Terenziani P., Bottrighi A., Giordano L., Franceschinis G., Montani S., Portinale L. and Theseider Dupre D. (2013). Towards a Second Generation of Computer Interpretable Guidelines . In Proceedings of the 2nd International Conference on Data Technologies and Applications - Volume 1: DATA, ISBN 978-989-8565-67-9, pages 199-205. DOI: 10.5220/0004585501990205

in Bibtex Style

author={Paolo Terenziani and Alessio Bottrighi and Laura Giordano and Giuliana Franceschinis and Stefania Montani and Luigi Portinale and Daniele Theseider Dupre},
title={Towards a Second Generation of Computer Interpretable Guidelines},
booktitle={Proceedings of the 2nd International Conference on Data Technologies and Applications - Volume 1: DATA,},

in EndNote Style

JO - Proceedings of the 2nd International Conference on Data Technologies and Applications - Volume 1: DATA,
TI - Towards a Second Generation of Computer Interpretable Guidelines
SN - 978-989-8565-67-9
AU - Terenziani P.
AU - Bottrighi A.
AU - Giordano L.
AU - Franceschinis G.
AU - Montani S.
AU - Portinale L.
AU - Theseider Dupre D.
PY - 2013
SP - 199
EP - 205
DO - 10.5220/0004585501990205