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A brief history

The GRAIL formalism was developed for use in the GALEN programme for formal representation of medical terminologies. It has since been found useful for a variety of other applications both within and outside medicine where there is a need to describe and classify information - be it the function of enzymes or DNA sequences, the content of pictures, or the nature of diseases and medical procedures.

The motivation for the special features of GRAIL is closely tied to its origins: the support for high quality user interfaces for doctors in the PEN&PAD system. PEN&PAD’s aim is to allow the direct entry of detailed clinical data by the practitioner during the consultation, and to display that data in a useful way - to shed light on the medical record.

It was found that building the interface which emerged from our User Centred Design Trials while using existing enumerative coding schemes (e.g. the enumerative Read classification of clinical terms) was simply impossible - a view borne out by the current state of commercial GP systems that attempt to use such schemes. GRAIL’s immediate ancestor, SMK (Structured Meta Knowledge), was developed to overcome some of the limitations of enumerative representations. SMK integrated medical terminological knowledge, medical records and the medical dialogue into a single formalism, with the knowledge base of medical terminology providing the semantic control over the patient record.

GRAIL is the development of the terminological, or conceptual, aspects of SMK.

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