Cancer Research UK (J Fox, P Ferguson, C Gierl, C Gordon, S Hajnal, J Huang, Z Ilic, A Jackson-Smale, R Thomson)
    General Practice Research Group, Imperial Cancer Research Fund (now Cancer Research UK), Oxford
    Hewlett-Packard Ltd., Bristol
    Royal Brompton Hospital, London
    Institut Bergonié, Bordeaux
    IMG(E) NHS Information Management Centre, Birmingham
    German Cancer Research Centre, Heidelberg
    MDA Group, Linköping University, Sweden
    UNINOVA, Lisbon
    Centre for Quality Assurance Research, Nijmegen University


The DILEMMA project addressed clinical, technical and methodological questions in the design and implementation of aids for medical decision making and patient management. Technically, the project focused on the use of logic programming and knowledge-based methods for constructing a generic technology to support clinical decision making, and for assisting in the scheduling and execution of clinical tasks in protocol-based care. DILEMMA integrated its decision support technology and electronic health care record with existing clinical information systems in a number of clinical domains, thereby adding value in such areas as patient data entry and retrieval and knowledge based and hypermedia access to clinical knowledge and data. Software results included the following: DILEMMA decision technology comprising a decision engine and a protocol task manager (based on the DILEMMA generic guideline model) electronic patient record knowledge and protocol authoring tools Shared care oncology work station (BOSS2) incorporating an electronic patient record and decision support primary care decision support system (SYNERGY: an integration of Meditel UK system 5 with DILEMMA decision support technology); cardiology shared care demonstrator (PARSEC) software to support a study in the use of decision support in primary care prescribing (CAPSULE, winner of the John Perry prize from the British Computer Society, 1995) trial software on the use of a patient-held smart care in cancer follow up (ONKO card).


The DILEMMA project was supported by the European Commission under the 3rd Framework AIM (Advanced Informatics in Medicine)/Health Telematics sub-programme (1992-5).