scholarly journals Impact of web-based clinical practice guidelines on paediatric fracture clinics

2017 ◽  
Vol 88 (3) ◽  
pp. 232-235 ◽  
Author(s):  
Mark W. Camp ◽  
James R. Barnes ◽  
Mohita Damany ◽  
Leo T. Donnan
2004 ◽  
Vol 43 (04) ◽  
pp. 413-426 ◽  
Author(s):  
H.-J. Gausepohl ◽  
M. Haak ◽  
S. Knaebel ◽  
O. Linderkamp ◽  
T. Wetter ◽  
...  

Summary Objectives: In order to implement clinical practice guidelines for the Department of Neonatology of the Heidelberg University Medical Center we developed a modular framework consisting of tools for authoring, browsing and executing encoded clinical practice guidelines (CPGs). Methods: Based upon a comprehensive analysis of literature, we set up requirements for guideline representation systems. Additionally, we analyzed further aspects such as the critical appraisal and known bridges and barriers for implementing CPGs. Thereafter we went through an evolutionary spiral model to develop a comprehensive ontology. Within this model each cycle focuses on a certain topic of management and implementation of CPGs. Results: In order to bring the resulting ontology into practice we developed a framework consisting of a tool for authoring, a server for web-based browsing, and an engine for the execution of certain elements of CPGs. Based upon this framework we encoded and implemented several CPGs in varying medical domains. Conclusions: This paper shall present a practical framework for both authors and implementers of CPGs. We have shown the fruitful combination of different knowledge representations such as narrative text and algorithm for implementing CPGs. Finally, we introduced a possible approach for the explicit adaptation of CPGs in order to provide institution-specific recommendations and to support sharing with other medical institutions.


2021 ◽  
Vol 22 (4) ◽  
pp. 250-258
Author(s):  
Kyu Yeon Hur

The most important change introduced in the pharmacotherapy session for the 2021 Clinical Practice Guidelines for Diabetes is the recommendation of two different strategies according to the patient’s condition. One approach is to optimize the blood glucose levels, while the other approach is to reduce adverse cardiovascular events or mortality, especially in patients with comorbidities (e.g., heart failure, atherosclerotic cardiovascular disease, or chronic kidney disease). We suggest four algorithms that take into account the patient’s condition (algorithms 1 to 4). The Korean Diabetes Association (KDA) developed a web-based clinical decision support system, known as the KDA support system (KDASS), which helps with the diagnosis of diabetes or gestational diabetes and whether to use glucose-lowering agents according to the patient’s condition.


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5954-5954
Author(s):  
Dominique Farge

Abstract Venous thromboembolism (VTE) is a major therapeutic concern in cancer patients and the leading cause of death after metastasis. Providing anticoagulant therapy to this patient population is challenging because cancer patients are at increased risk of VTE recurrence and bleeding, and treatment management is often complicated by other co-morbidities that affect choice of anticoagulation. The International Initiative on Thrombosis and Cancer (ITAC-CME) is a multidisciplinary group of International academic clinicians, researchers, and experts dedicated to reducing the global burden of VTE and its consequences in cancer patients. In 2013, the group published international clinical practice guidelines for the treatment and prophylaxis of VTE in cancer (1, 2). In collaboration with CME solutions, an accredited CME provider, ITAC-CME developed a mobile web-based application to promote the international implementation of the 2013 guidelines, in English and French (www.itacc-cme.org). Usage of the app has steadily increased every year since its release. ITAC-CME recently revised its consensus recommendations according to a systematic review of the literature up to January 2016. In particular, the ISTH-endorsed updated recommendations provide a guidance on the use of the direct oral anticoagulants based on the current level of evidence (3). ITAC-CME and CME solutions have updated the web-based application to support the 2016 guidelines. The app also includes several new features, including interactive case-based CME learning activities, with pre- and post-activity practice assessments. These pre- and post-test metrics will be documented to record international clinical practice patterns, and monitor the impact of the app on the adoption of the 2016 guidelines into clinical practice worldwide. Translation of the 2016 updated app into additional languages is planned. The application has been submitted for accreditation with the royal College of Physicians and surgeons of Canada, the American Medical Association, the European Union of Medical Specialists, l' Organisme Gestionnaire du Développement Professionnel Continu, and the European Board for Accreditation in Hematology. 1 Debourdeau P, Farge D, Beckers M, Baglin C, Bauersachs RM, Brenner B, Brilhante D, Falanga A, Gerotzafias GT, Haim N, Kakkar AK, Khorana AA, Lecumberri R, Mandala M, Marty M, Monreal M, Mousa SA, Noble S, Pabinger I, Prandoni P, Prins MH, Qari MH, Streiff MB, Syrigos K, Büller HR, Bounameaux H. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost. 2013 Jan;11(1):71-80. 2 Farge D, Debourdeau P, Beckers M, Baglin C, Bauersachs RM, Brenner B, Brilhante D, Falanga A, Gerotzafias GT, Haim N, Kakkar AK, Khorana AA, Lecumberri R, Mandala M, Marty M, Monreal M, Mousa SA, Noble S, Pabinger I, Prandoni P, Prins MH, Qari MH, Streiff MB, Syrigos K, Bounameaux H, Büller HR. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer.J Thromb Haemost. 2013 Jan;11(1):56-70 3 Farge D, Bounameaux H , Brenner B, Cajfinger F, Debourdeau P, Khorana AA, Pabinger I, Solymoss S, Douketis J, Kakkar A. 2016 International Clinical Practice Guidelines Including Guidance for the Direct Oral Anticoagulants in the Treatment and Prophylaxis of Venous Thromboembolism in Patients With Cancer. Lancet Onccology 2016 (in press) Disclosures No relevant conflicts of interest to declare.


2012 ◽  
Vol 14 (6) ◽  
pp. e169 ◽  
Author(s):  
Melissa M Norberg ◽  
Michael W Turner ◽  
Sally E Rooke ◽  
Julia M Langton ◽  
Peter J Gates

2014 ◽  
Vol 6 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Jiae Choi ◽  
Tae-Young Choi ◽  
Ju Ah Lee ◽  
Kyung-Jin Yun ◽  
Hyun-Ja Lim ◽  
...  

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