title: Implementing clinical practice guidelines while taking account of changing evidence: ATHENA DSS, an easily modifiable decision-support system for managing hypertension in primary care.
abstract: This paper describes the ATHENA Decision Support System (DSS), which operationalizes guidelines for hypertension using the EON architecture. ATHENA DSS encourages blood pressure control and recommends guideline-concordant choice of drug therapy in relation to comorbid diseases. ATHENA DSS has an easily modifiable knowledge base that specifies eligibility criteria, risk stratification, blood pressure targets, relevant comorbid diseases, guideline-recommended drug classes for patients with comorbid disease, preferred drugs within each drug class, and clinical messages. Because evidence for best management of hypertension evolves continually, ATHENA DSS is designed to allow clinical experts to customize the knowledge base to incorporate new evidence or to reflect local interpretations of guideline ambiguities. Together with its database mediator Athenaeum, ATHENA DSS has physical and logical data independence from the legacy Computerized Patient Record System (CPRS) supplying the patient data, so it can be integrated into a variety of electronic medical record systems.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Goldstein
authors.forename: B B
authors.initials: BB
authors.lastname: Hoffman
authors.forename: R W
authors.initials: RW
authors.lastname: Coleman
authors.forename: M A
authors.initials: MA
authors.lastname: Musen
authors.forename: S W
authors.initials: SW
authors.lastname: Tu
authors.forename: A
authors.initials: A
authors.lastname: Advani
authors.forename: R
authors.initials: R
authors.lastname: Shankar
authors.forename: M
authors.initials: M
authors.lastname: O'Connor
mesh_terms: D001185:Artificial Intelligence; D020000:Decision Support Systems, Clinical; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D016347:Medical Records Systems, Computerized; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D017010:Reminder Systems; D018511:Systems Integration; D013813:Therapy, Computer-Assisted