title: Towards evidence-based CDSSs implementing the medical reasoning contained in CPGs: application to antibiotic prescription.
abstract: Clinical practice guidelines (CPGs) are documents giving recommendations based on expert reasoning, weighing up the pros and cons of treatments on the basis of the available evidence. We propose a new approach to the construction of clinical decision support systems (CDSS), making use of the evidence-based medical reasoning used by experts in CPGs. In this study, we determined whether this approach could retrieve the recommendations for antibiotic prescription for empirical treatment in primary care.
  
  
  METHODS
  We manually extracted, from CPGs, all the properties of antibiotics underlying recommendations for their prescription or non-prescription. We then used these properties to establish an algorithm in the form of a sequence of conditions, leading to a list of recommended antibiotics. The optimal sequence was determined by studying, for each sequence, the degree of similarity between the list of antibiotics recommended in CPGs and the list obtained with the algorithm.
  
  
  RESULTS
  12 antibiotic properties were used in the form of conditions in an algorithm. For 95% of clinical situations, 10 sequences retrieved the recommended treatment.
  
  
  CONCLUSIONS
  This algorithm could be used in a CDSS for antibiotic treatment and would be useful for experts drawing up CPGs.
authors.affiliation: INSERM, U1142, LIMICS, F-75006, Paris; Université Paris 13, Sorbonne Paris Cité, F-93000, Bobigny; Sorbonne Universités, Univ Paris 06, F-75006, Paris, France.
authors.forename: Rosy
authors.initials: R
authors.lastname: Tsopra
authors.affiliation: INSERM, U1142, LIMICS, F-75006, Paris; Université Paris 13, Sorbonne Paris Cité, F-93000, Bobigny; Sorbonne Universités, Univ Paris 06, F-75006, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Venot
authors.affiliation: INSERM, U1142, LIMICS, F-75006, Paris; Université Paris 13, Sorbonne Paris Cité, F-93000, Bobigny; Sorbonne Universités, Univ Paris 06, F-75006, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Duclos
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D020000:Decision Support Systems, Clinical / Q000592:standards*; D004360:Drug Therapy, Computer-Assisted / Q000592:standards*; D055695:Electronic Prescribing / Q000592:standards*; D019317:Evidence-Based Medicine; D005602:France; D006801:Humans; D050316:Medical Order Entry Systems / Q000592:standards*; D017410:Practice Guidelines as Topic
chemical_list: D000900:Anti-Bacterial Agents