title: Applying openEHR's Guideline Definition Language to the SITS international stroke treatment registry: a European retrospective observational study.
abstract: Interoperability standards intend to standardise health information, clinical practice guidelines intend to standardise care procedures, and patient data registries are vital for monitoring quality of care and for clinical research. This study combines all three: it uses interoperability specifications to model guideline knowledge and applies the result to registry data.
  
  
  
  We applied the openEHR Guideline Definition Language (GDL) to data from 18,400 European patients in the Safe Implementation of Treatments in Stroke (SITS) registry to retrospectively check their compliance with European recommendations for acute stroke treatment.
  
  
  
  Comparing compliance rates obtained with GDL to those obtained by conventional statistical data analysis yielded a complete match, suggesting that GDL technology is reliable for guideline compliance checking.
  
  
  
  The successful application of a standard guideline formalism to a large patient registry dataset is an important step toward widespread implementation of computer-interpretable guidelines in clinical practice and registry-based research. Application of the methodology gave important results on the evolution of stroke care in Europe, important both for quality of care monitoring and clinical research.
authors.affiliation: Health Informatics Centre, LIME, Karolinska Institutet, Tomtebodavägen 18, Stockholm, SE 17177, Sweden. nanani@gmx.de.
authors.forename: Nadim
authors.identifier: 0000-0003-2975-4589
authors.initials: N
authors.lastname: Anani
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Neurology, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Mazya
authors.affiliation: Health Informatics Centre, LIME, Karolinska Institutet, Tomtebodavägen 18, Stockholm, SE 17177, Sweden.|Cambio Healthcare Systems, Stockholm, Sweden.
authors.forename: Rong
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Neurology, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Tiago
authors.initials: T
authors.lastname: Prazeres Moreira
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Neurology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bill
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Neurology, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Niaz
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Neurology, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Nils
authors.initials: N
authors.lastname: Wahlgren
authors.affiliation: Health Informatics Centre, LIME, Karolinska Institutet, Tomtebodavägen 18, Stockholm, SE 17177, Sweden.
authors.forename: Sabine
authors.initials: S
authors.lastname: Koch
mesh_terms: D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005060:Europe; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D017410:Practice Guidelines as Topic; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*
keywords: Guideline adherence; Knowledge management; Practice guidelines; Registries; Standards