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The over-use of antibiotics in clinical domains is causing an alarming increase in bacterial resistance, thus endangering their effectiveness as regards the treatment of highly recurring severe infectious diseases. When analyzing requirements from the implementation viewpoint, knowledge of successes and failures in related software-engineering efforts can guide implementers in the choice of effective design and development strategies. We cite previous work under each category and then provide sub-requirements under each category, and provide example of similar work in software-engineering efforts that have addressed a similar problem in a non-biomedical context. The sub-requirements are discussed by conveniently grouping them into the categories used by the review of Isern and Moreno 2008. In addition to requirements described by guideline-system authors, comparative reviews of such systems, and publications discussing information needs for guideline systems and clinical decision support systems in general, we have incorporated additional requirements related to production-system robustness and functionality from publications in the business workflow domain, in addition to drawing on our own experience in the development of the Proteus guideline system (). During such an analysis, study of examples of existing, software-engineering efforts in non-biomedical fields can provide useful signposts to the implementer of a clinical guideline system. Further, additional requirements emerge as a result of such analysis. Detailed analysis of requirements from an implementation perspective can be useful in helping define sub-requirements to the point where they are implementable.
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A large body of work in the clinical guidelines field has identified requirements for guideline systems, but there are formidable challenges in translating such requirements into production-quality systems that can be used in routine patient care.