ObjectiveConceptual graphs (CGs) are used to represent clinical guidelines because they support visual reasoning with a logical background, making them a potentially valuable representation for guidelines. Materials and methodsConceptual graph formalism has an essential and basic component: a formal vocabulary that drives all of the other mechanisms, notably specialization and projection. The graph's theoretical operations, such as projection, rules, derivation, constraints, probabilities and uncertainty, support diagrammatic reasoning. ResultsA conceptual graph's graphical user interface includes a multilingual vocabulary management, some query and decision-making facilities and visual graph representations that are simple and interesting for user interactions. The described proposition using the Conceptual Graph user interface (CoGui) improves the performance of the actors in the diagnostic context of heart failure with preserved ejection fraction. DiscussionCGs capture the essential features of the medical processes underlying clinical reasoning. CGs are indeed useful as a way for the physician to represent guidelines, and well-defined semantic representations allow users to have a maximal understanding of the knowledge reasoning process. ConclusionCG operations of visual representations that uncover some of the actual complexities of clinicians’ reasoning have been tested in clinical guideline comprehension and used to translate text and diagrammatic guidelines into computer interpretable representations.