GEM Cutter accepts as input a guideline text file. Users mark up the file, classifying guideline text into appropriate elements of the standardized GEM II hierarchy.
Output is a standard XML file that comprises information critical for implementation:
- The guidelines's intended audience
- The target population of patients
- The recommendations themselves including decision variables
- The reason(s) for making the recommendation
- The evidence quality and recommendation strength supporting each recommendation
Missing information must be filled in locally by Clinical Experts. By cataloging and documenting these circumstances, implementers can provide feedback to guideline development teams about content that is critical for implementation but missing from the published guideline. A careful record of modifications should be logged and reviewed by an independent team of clinical experts to assure that the meaning of the implemented recommendation is consonant with the published text.