Decision-support systems based on clinical practice guidelines can support physicians and other healthcare personnel in the process of following best practice consistently. A knowledge-based approach to represent guidelines makes it possible to encode computer-interpretable guidelines in a formal manner,perform consistency checks, and use the guidelines directly in decision-support systems.Decision-support authors and guideline users require guidelines in human-readable formats in addition to

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... mputer-interpretable ones (e.g., for guideline review and quality assurance). We propose a new document-oriented information architecture that combines knowledge-representation models with electronic and paper documents. The approach integrates decision-support modes with standard document formats to create a combined clinical-guideline model that supports on-line viewing, printing, and decision support.