Publishing biomedical journals on the World-Wide Web using an open architecture model.

BACKGROUND: In many respects, biomedical publications are ideally suited for distribution via the World-Wide Web, but economic concerns have prevented the rapid adoption of an on-line publishing model. PURPOSE: We report on our experiences with assisting biomedical journals in developing an online presence, issues that were encountered, and methods used to address these issues. Our approach is based on an open architecture that fosters adaptation and interconnection of biomedical resources. METHODS: We have worked with the New England Journal of Medicine (NEJM), as well as five other publishers. A set of tools and protocols was employed to develop a scalable and customizable solution for publishing journals on-line. RESULTS: In March, 1996, the New England Journal of Medicine published its first World-Wide Web issue. Explorations with other publishers have helped to generalize the model. CONCLUSIONS: Economic and technical issues play a major role in developing World-Wide Web publishing solutions.

Representation of clinical practice guidelines through an interactive World-Wide-Web interface.

The widespread utility of clinical practice guidelines is greatly dependent on the ease with which they can be accessed, used, and applied. Because it supports hyperlinking and is widely accessible, the World-Wide Web is a medium that is well suited for browsing through guidelines. We have developed a process for implementing algorithmic guidelines into a graphical format that allows the user to browse these guidelines in an interactive fashion. The guidelines we used were already in or could be transformed to an algorithmic format that lends itself well to analysis with decision table techniques, which in turn permits a fairly straightforward conversion into a graphical representation. The results of this process allow a user to browse a particular guideline algorithm and to visualize the traversed parts of the algorithm by flowcharts. Our first experiences with this method of representing a few sample clinical practice guidelines have been encouraging, and we hope to extend this method to other guidelines.