Consequences of the verification of completeness in clinical practice guideline modeling: a theoretical and empirical study with hypertension.
Building clinical decision support systems requires a formalization of clinical practice guidelines (CPGs) including the verification of completeness to ensure all medically relevant situations are addressed. Recommendations that rely on completed knowledge cannot be but expert-based. Using French hypertension management guidelines, we characterized the status of a patient profile as evidence-based (EB), consensus-based (CB), or expert-based (XB). The distribution of these status on the formal patient profiles of ASTIGM knowledge base showed that 12.6% (0.5% EB and 12.1% CB) lead to explicit CPG recommendations. The same analysis on a sample of 435 actual patients medical records showed that 55% were covered by CPGs. The characterization of guideline-based CDSSs should be based on empirical data estimated from the target population of CPGs.
Bouaud
J
J
AP-HP, DSI, STIM, Paris, France; INSERM, UMR_S 872, eq. 20, Paris, France.
Séroussi
B
B
Falcoff
H
H
Julien
J
J
Simon
C
C
Denké
D L
DL
D020000:Decision Support Systems, Clinical; D003663:Decision Trees; D057286:Electronic Health Records; D019317:Evidence-Based Medicine; D005602:France; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D051188:Knowledge Bases; D017410:Practice Guidelines as Topic / Q000592:standards