FHIR-Based Arden Syntax Compiler for Clinical Decision Support.

The Arden Syntax is a language designed for the encoding of medical knowledge into clinical decision support systems. Its evolution is overseen by Health Level 7. A significant enhancement in its new version 3.0 is the incorporation of FHIR for data retrieval, which addresses the long-standing curly braces problem. We introduce a newly developed compiler for Arden Syntax 3.0, which employs modern tools such as ANTLR for lexical and parsing analysis and GraalVM with the Truffle Language Implementation Framework for semantic processing, optimization, and language execution. Comprehensive testing against a legacy compiler revealed substantial improvements in execution speed, memory efficiency, and code quality. These advancements, coupled with superior maintainability and extensibility, position the Truffle compiler as a robust replacement, supporting future development and enhancing the user experience with Arden-Syntax-based clinical decision support.