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Towards an Event-Condition-Action (ECA)-Based Formalization of Clinical Guidelines.

Marcel Ebbinghaus¹, Bora Gashi², Martin Boeker²

¹University of Freiburg, Freiburg im Breisgau, Germany.

Studies in Health Technology and Informatics

|July 3, 2026

Summary

Formalizing clinical practice guidelines (CGs) is challenging. A new Event-Condition-Action (ECA) formalism offers a clear, consistent, and usable approach for computable medical knowledge representation.

Keywords:

Arden Syntax Asbru Clinical guidelines ECA-rules formalization

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Web-based Clinician Guide to Record Compatible Video of Standardized Drinking Task Kinematics for Computer Vision Analysis

Published on: November 28, 2025

Area of Science:

Medical Informatics
Computer Science

Background:

Existing computable medical knowledge representations like Arden Syntax and Asbru face challenges in formalizing clinical practice guidelines (CGs).
Clear, consistent, and usable logic for CG recommendations remains a significant hurdle.

Purpose of the Study:

To propose a novel pre-structuring formalism for CGs based on the Event-Condition-Action (ECA) paradigm.
To demonstrate the applicability of the ECA formalism to real-world clinical scenarios.
To map the proposed ECA formalism to existing systems like Arden Syntax and Asbru.

Main Methods:

Developed a pre-structuring formalism utilizing the Event-Condition-Action (ECA) model.
Applied the ECA formalism to practical examples of clinical practice guidelines.
Mapped the ECA formalism to Arden Syntax and Asbru for interoperability.

Main Results:

The proposed ECA-based formalism provides a semantically coherent foundation for CGs.
Demonstrated the practical applicability of the ECA formalism in real-world settings.
The formalism aligns well with the structural elements of other established guideline representations.

Conclusions:

The Event-Condition-Action (ECA) formalism presents a viable solution for the challenges in representing clinical practice guidelines.
This approach enhances clarity, consistency, and usability in computable medical knowledge.
The ECA formalism offers a foundation compatible with existing knowledge representation systems.