scholarly journals A layered computer-interpretable guideline model for easing the update of locally adapted clinical guidelines

2018 ◽  
Vol 26 (1) ◽  
pp. 156-171
Author(s):  
Adi Fux ◽  
Pnina Soffer ◽  
Mor Peleg
Keyword(s):  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Medical Knowledge ◽  
Single Layer ◽  
Pilot Experiment ◽  
Local Practice ◽  
Primary Layer ◽  
Layered Approach ◽  
Update Process ◽  
Java Code

Maintenance of computer-interpretable guidelines is complicated by evolving medical knowledge and by the requirement to customize content to local practice settings. We developed a framework to support knowledge engineers in customization and maintenance of computer-interpretable guidelines specified in the PROforma formalism. In our layered approach, the computer-interpretable guidelines containing the original clinical guideline serves as the primary layer and local customizations form secondary layers that adhere to its schema while augmenting it. Java code unifies the layers into a single enactable computer-interpretable guidelines. We performed a pilot experiment to verify the effectiveness of a layered framework. In this first attempt, we evaluated the hypothesis that the layered computer-interpretable guidelines framework supports knowledge engineers in maintenance of customized computer-interpretable guidelines. Participants who used the layered framework completed an update process of the primary knowledge in less time and made fewer errors as compared to those using the single-layer framework.

scholarly journals Development of clinical guidelines for service provision of functional electrical stimulation to support walking: mixed method exploration of stakeholder views

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C Bulley ◽  
C Meagher ◽  
T Street ◽  
A Adonis ◽  
C Peace ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Clinical Guidelines ◽  
Service Provision ◽  
Clinical Guideline ◽  
Service Providers ◽  
Delphi Consensus ◽  
Stakeholder Views ◽  
Key Stakeholders ◽  
The Uk

Abstract Background Over the past 20 years Functional Electrical Stimulation (FES) has grown in clinical use to support walking in people with lower limb weakness or paralysis due to upper motor neuron lesions. Despite growing consensus regarding its benefits, provision across the UK and internationally is variable. This study aimed to explore stakeholder views relating to the value of a clinical guideline focusing on service provision of FES to support walking, how people might use it and what should be included. Methods A mixed methods exploration sought the views of key stakeholders. A pragmatic online survey (n = 223) focusing on the study aim was developed and distributed to the email distribution list of the UK Association for Chartered Physiotherapists Interested in Neurology (ACPIN). In parallel, a qualitative service evaluation and patient public involvement consultation was conducted. Two group, and seven individual interviews were conducted with: FES-users (n = 6), their family and carers (n = 3), physiotherapists (n = 4), service providers/developers (n = 2), researchers (n = 1) and distributors of FES (n = 1). Descriptive analysis of quantitative data and framework analysis of qualitative data were conducted. Results Support for clinical guideline development was clear in the qualitative interviews and the survey results. Survey respondents most strongly endorsed possible uses of the clinical guideline as ensuring best practice and supporting people seeking access to a FES service. Data analysis and synthesis provided clear areas for inclusion in the clinical guidelines, including current research evidence and consensus relating to who is most likely to benefit and optimal service provision as well as pathways to access this. Specific areas for further investigation were summarised for inclusion in the first stage of a Delphi consensus study. Conclusions Key stakeholders believe in the value of a clinical guideline that focuses on the different stages of service provision for FES to support walking. A Delphi consensus study is being planned based on the findings.

Multi-Version Ontology-Based Personalization of Clinical Guidelines for Patient-Centric Healthcare

2017 ◽  
Vol 13 (1) ◽  
pp. 104-127 ◽  
Author(s):  
Fabio Grandi ◽  
Federica Mandreoli ◽  
Riccardo Martoglia
Keyword(s):  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Patient Case ◽  
Annotation Scheme ◽  
Specific Patient ◽  
Personalized Care ◽  
Care Plans ◽  
Ontology Structure ◽  
Patient Centric ◽  
Access Efficiency

When dealing with a specific patient case, physicians are often interested in retrieving a personalized version of a clinical guideline, that is a version tailored to their use needs. In a patient-centric scenario, empowered patients make up another class of users interested in retrieving personalized care plans from a guideline repository. In their previous work, the authors proposed techniques to efficiently provide ontology-based personalized access to very large collections of multi-version clinical guidelines. In this paper, they address the problem of also dealing with a multi-version ontology used to support personalized access to clinical guidelines. The authors' approach allows the semantic indexing of guideline contents with respect to multi-version ontology classes and exploits the IS-A relationship among such classes for granting personalized access. Efficiency is ensured by a newly introduced annotation scheme for guidelines and solutions to cope with the evolution of ontology structure. The tests performed on a prototype implementation confirm the goodness of the approach.

Comparison of European Clinical Guidelines on the Management of Alcohol Use Disorders

2020 ◽  
pp. 1-9
Author(s):  
Colin Drummond ◽  
Miriam Hillyard ◽  
Marja Leonhardt ◽  
Frieder Wurst ◽  
Geert Dom ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Literature Review ◽  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Alcohol Use Disorders ◽  
World Health ◽  
European Region ◽  
World Health Report ◽  
Standard Drink ◽  
Health Report

<b><i>Background:</i></b> Alcohol is a leading cause of morbidity and mortality in the European region, and tackling the harmful use of alcohol is a public health priority. Most countries in the region have national strategies for treating alcohol use disorders (AUD), but there is significant between-country variation. <b><i>Objectives:</i></b> This study aimed to compare clinical guidelines for the management of AUD from countries of the European region and to determine whether countries’ relative wealth or quality of their health systems had affected the guidelines. <b><i>Methods:</i></b> A survey was conducted of 24 countries. The survey encompassed how AUD clinical guidelines were researched, the range and expertise of contributors, which topics of AUD treatment were included, the definition of a “standard drink” used, and the publishing, funding, endorsement, and dissemination of the guideline. <b><i>Results:</i></b> Twenty-one of the 24 countries surveyed had a clinical guideline for AUD. All guidelines were underpinned by a literature review, and psychiatrists were the professional group most commonly involved in producing them. Most of the guidelines covered typical cornerstones of AUD care such as treatment of alcohol dependence, pharmacotherapy for relapse prevention, and detoxification. Definitions of a “standard drink” ranged from 8 to 20 grams of ethanol. Governments or governmental bodies were the main publishers and funders of guidelines, and the vast majority of guidelines were freely available online. There were no statistically significant effects of GDP, GDP per capita, or World Health Organization’s World Health Report rankings on whether countries were more likely to have an AUD clinical guideline, to have performed a systematic literature review, or to have involved service users in producing their guideline. <b><i>Conclusions:</i></b> The results of this survey reflect widespread good practice in producing AUD clinical guidelines across European countries. Regional research collaborations could offer significant time and cost savings in producing the evidence base from which guidelines are then written.

scholarly journals How to Build the Plane While Flying: VTE/PE Thromboprophylaxis Clinical Guidelines for COVID-19 Patients

2020 ◽  
Vol 14 (3) ◽  
pp. 391-405 ◽  
Author(s):  
Alessandro Costa ◽  
Eric S. Weinstein ◽  
D. Ruby Sahoo ◽  
Stanley C. Thompson ◽  
Roberto Faccincani ◽  
...  
Keyword(s):  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Treatment Guidelines ◽  
Meta Analysis ◽  
Evidence Based ◽  
Scientific Process ◽  
Randomized Controlled ◽  
Practice Of Medicine ◽  
Novel Coronavirus ◽  
Time Required

AbstractOver the years, the practice of medicine has evolved from authority-based to experience-based to evidence-based with the introduction of the scientific process, clinical trials, and outcomes-based data analysis (Tebala GD. Int J Med Sci. 2018;15(12):1397-1405). The time required to perform the necessary randomized controlled trials, a systematic literature review, and meta-analysis of these trials to then create, accept, promulgate, and educate the practicing clinicians to use the evidence-based clinical guidelines is typically measured in years. When the severe acute respiratory syndrome novel coronavirus-2 (SARS-nCoV-2) pandemic commenced in Wuhan, China at the end of 2019, there were few available clinical guidelines to deploy, let alone adapt and adopt to treat the surge of coronavirus disease 2019 (COVID-19) patients. The aim of this study is to first explain how clinical guidelines, on which bedside clinicians have grown accustomed, can be created in the midst of a pandemic, with an evolving scientific understanding of the pathophysiology of the hypercoagulable state. The second is to adapt and adopt current venous thromboembolism diagnostic and treatment guidelines, while relying on the limited available observational reporting of COVID-19 patients to create a comprehensive clinical guideline to treat COVID-19 patients.

scholarly journals Effect of Training Eye Care Clinical Guideline for ICU Patients on Clinical Competence of Eye Care in Nurses

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zakieh Momeni Mehrjardi ◽  
Samaneh Mirzaei ◽  
Mohsen Gohari ◽  
Abbass Hafezieh ◽  
Khadijeh Nasiriani
Keyword(s):  
Clinical Competence ◽  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Eye Care ◽  
Control Groups ◽  
Icu Patients ◽  
Attitude And Practice ◽  
Significant Difference ◽  
And Control ◽  
Knowledge Attitude And Practice

Introduction. Sight is one of the most important and vital human senses. Lack of proper eye care (EC) in anesthetized patients can lead to serious ocular complications and even vision loss. Insufficient knowledge, attitude, and skills of nurses are considered as a barrier to providing EC in the intensive care unit (ICU). The aim of the present study was to determine the effect of training EC clinical practice guidelines for ICU patients on nurses’ knowledge, attitude, and practice of EC. Methods. This was an interventional study with a pre-post design performed on 60 ICU nurses. For the experimental group, EC clinical guideline training was performed for anesthetized patients in three sessions. The data collection tool included nurses’ clinical competence of the EC questionnaire with a possible score range of 0–86. This tool consists of three domains, including knowledge (0–18), attitude (0–28), and practice (0–40), which was completed in a self-assessment manner before and three months after the training program. Data analysis was carried out using SPSS16. Findings. The mean scores of knowledge, attitude, and practice after the intervention in the experimental and control groups were 15.03 ± 2.72 and 11.11 ± 3.50, 25.65 ± 3.47 and 22.07 ± 3.08, and 33.88 ± 4.14 and 28.5 ± 55.08, respectively, which were statistically significant ( P ≤ 0.001 ). Also, the total score of clinical competence of EC after the intervention in the experimental and control groups was 74.56 ± 7.93 and 61.74 ± 9.66, which showed a significant difference ( P ≤ 0.001 ). Conclusion. Training nurses based on EC clinical guidelines for anesthetized patients can improve the knowledge, attitude, and practice of ICU nurses. Evidence-based EC practice requires continuous training based on clinical guidelines and EC practice monitoring by nursing managers according to EC clinical guideline for an anesthetized patient.

Playing it close to the VEST and the clinical guidelines: Clinical guideline compliance in HFrEF patients-Role of WCD

2018 ◽  
Vol 41 (10) ◽  
pp. 1314-1320 ◽  
Author(s):  
Michael J. Mirro ◽  
Emily E. Keltner ◽  
Amelia E. Roebuck ◽  
Samuel F. Sears
Keyword(s):  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Guideline Compliance

Clinical Guideline Development for Otitis Media: A Report on Methodology

1993 ◽  
Vol 109 (3) ◽  
pp. 478-481 ◽  
Author(s):  
Anthony E. Magit ◽  
Sylvan E. Stool
Keyword(s):  
Otitis Media ◽  
Clinical Guidelines ◽  
Clinical Guideline ◽  
Otitis Media With Effusion ◽  
Guideline Development ◽  
Clinical Settings ◽  
Multiple Factors ◽  
Contemporary Practice ◽  
Major Emphasis ◽  
Head Neck

Clinical guideline development is a major emphasis of recent health policy efforts. Interest in clinical guidelines is the result of multiple factors, including economic pressures and the desire to achieve a baseline level of practice in clinical settings. Guidelines have always been of fundamental importance in medicine. This article will discuss the place clinical guidelines have in contemporary practice and the difficulties encountered in the process of developing a meaningful guideline for managing otitis media with effusion. (OTOLARYNGOL HEAD NECK SURG 1993;109:478-81.)

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