[Patient-centered consultation of "good practice guidelines": OncoDoc, a decision support system for the management of breast cancer patients].
Beyond considerations of cost-effectiveness, clinical practice guidelines (CPG) can reduce practice variations and thus improve the quality of care. However, despite the proliferation of implemented CPG and their wide diffusion thanks to Internet-based technologies, physicians' compliance with formal standards is weak. Developed according to a document-based paradigm, OncoDoc proposes an original framework for implementing CPG. Domain knowledge has been encoded as a decision tree whose branches are both exclusive and exhaustive. This generic knowledge is operationalized at the point of care by the interactive building, through hypertextual navigation, of a patient-based clinical context leading to specific therapeutic recommendations. OncoDoc has first been applied to the management of breast cancer patients and demonstrated within a full-scale experimentation in a clinical setting a compliance of 80 per cent.
Service d'Informatique Médicale, AP-HP, Université Paris 6, France.
J
J
Bouaud
B
B
Séroussi
E C
EC
Antoine
M
M
Gozy
D
D
Khayat
J F
JF
Boisvieux
D001943:Breast Neoplasms / Q000191:economics / Q000628:therapy*; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D020407:Internet; D018802:Patient-Centered Care; D017410:Practice Guidelines as Topic
Consultation centrée-patient d'un 'guide de bonnes pratiques': OncoDoc, un système d'aide à la décision thérapeutique appliqué au cancer du sein.