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A description is given of the Oxford System of Medicine, (OSM) project, the goal of which is a decision support system (DSS) that general practitioners can use during routine clinical work to support such decision-making tasks as diagnosing illnesses, planning investigations and patient treatment schedules, prescribing drugs, screening for disease, assessing the risk of a particular disease, and determining whether to refer a patient to a specialist. The OSM consists of the following modules: a user model, models of the decision-making tasks, an inference layer, and domain models for top-down development of the medical knowledge base. An abstract medical knowledge model that deals primarily with the static part of the knowledge base, defining the types of objects this contains and their interrelations, was developed, along with specialist domain theories that help to maintain the integrity of the knowledge. The model provides a specification of what is required in the knowledge base.