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IctNeo is a complex decision support system (DSS) for the management of a common disease: neonatal jaundice. This article discusses the system implementation with a wide point of view, which has produced a general tool for DSSs construction with influence diagrams (IDs). The knowledge representation of the problem as an ID, and the user interface are only the specific modules for IctNeo. The other components can be reused for further developments. A grammar is defined for IDs representation, dividing the specification and manipulation of this graphical model. The compiler of IDs (expressed with this grammar) will produce a compiled version of the diagram, once it is correct and prepared for evaluation. Finally, various mechanisms are required to reduce the computational complexity of the evaluation of so large IDs: a genetic algorithm to determine an efficient sequence of node reductions, evidence …