KNOWLEDGE PROCESSING FOR CLINICAL PRACTICE GUIDELINES

临床实践指南的知识处理

• 批准号: 6391263
• 负责人: RICHARD N SHIFFMAN
• 金额: $ 11.45万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6391263
• 关键词: adolescence (12-20); artificial intelligence; asthma; clinical research; computer assisted medical decision making; computer human interaction; decision making; health care professional practice; health care quality; health care service evaluation; human subject; middle childhood (6-11); outpatient care; patient care management; pediatrics; primary care physician

THIS IS A SHANNON AWARD PROVIDING PARTIAL SUPPORT FOR THE RESEARCH PROJECTS THAT FALL SHORT OF THE ASSIGNED INSTITUTE'S FUNDING RANGE BUT ARE IN THE MARGIN OF EXCELLENCE. THE SHANNON AWARD IS INTENDED TO PROVIDE SUPPORT TO TEST THE FEASIBILITY OF THE APPROACH; DEVELOP FURTHER TESTS AND REFINE RESEARCH TECHNIQUES; PERFORM SECONDARY ANALYSIS OF AVAILABLE DATA SETS; OR CONDUCT DISCRETE PROJECTS THAT CAN DEMONSTRATE THE PI'S RESEARCH CAPABILITIES OR LEAD ADDITIONAL WEIGHT TO AN ALREADY MERITORIOUS APPLICATION. THE APPLICATION BELOW IS TAKEN FROM THE ORIGINAL DOCUMENT SUBMITTED BY THE PRINCIPAL INVESTIGATOR. This proposal describes research intended to support informatics requirements for the development, implementation, and evaluation of clinical practice guidelines. The work is expected to result both in the development of improved guidelines and, concomitantly, to produce structured, computer-accessible repositories of medical knowledge that can be used for decision support. A research program with the following 4 specific aims is proposed: (l) To devise and extend fundamental techniques for modeling and processing guideline knowledge using augmented decision tables. Methods will be defined to deal with guideline knowledge complexity and uncertainty. (2) To refine and disseminate techniques by which knowledge can be acquired for clinical guidelines and verified to assure its consistency and comprehensiveness. Working with the American Academy of Pediatrics, newly developed guidelines will be logically analyzed and verified prior to publication. (3) To evaluate the effectiveness of a guideline-based, decision support device to improve compliance with a national guideline for outpatient management of asthma in children. A randomized, controlled trial will be conducted to measure the effect of the AsthMonitor system on guideline adherence, encounter documentation, patient outcomes, and costs of care. (4) To develop a suite of interactive computer applications that support decision making and clinical workflow for the management of a broad range of common pediatric problems. Knowledge gained from the clinical trial will be combined with workflow analysis, sound application design principles, and advanced digital technologies to create useful and usable tools for guideline implementation. Individual providers will benefit from the availability of decision support applications based on guidelines knowledge. From a public health perspective, effective implementation of evidence-based guidelines for the outpatient management of asthma and other common pediatric disorders should contribute to a reduction in inappropriate practice and to improved quality of care.

这是为研究提供部分支持的香农奖 未达到指定机构资助范围但 处于卓越边缘。香农奖旨在提供 支持测试该方法的可行性；开展进一步的测试 并完善研究技术；对可用数据进行二次分析 数据集；或开展可以展示 PI 的离散项目 研究能力或给已经取得的成绩带来额外的影响 应用。以下应用程序取自原始文档 由首席研究员提交。 该提案描述了旨在支持信息学的研究 开发、实施和评估的要求 临床实践指南。这项工作预计将导致 制定改进的指导方针，并同时制定 结构化的、计算机可访问的医学知识存储库 可用于决策支持。具有以下内容的研究计划 提出4个具体目标： (l) 设计和扩展建模和分析的基本技术 使用增强决策表处理指南知识。方法 将被定义来处理指南知识的复杂性和 不确定。 (2) 完善和传播知识的技术 获取临床指南并进行验证以确保其一致性 和全面性。与美国儿科学会合作， 新制定的指南将事先进行逻辑分析和验证 到出版。 (3) 评估基于指南的决策支持的有效性 提高对国家门诊指南的遵守情况的设备 儿童哮喘的管理。将进行一项随机对照试验 旨在衡量 AsthMonitor 系统对指南的影响 依从性、遭遇记录、患者结果和护理费用。 (4) 开发一套交互式计算机应用程序 用于管理广泛范围的决策和临床工作流程 常见的儿科问题。从临床试验中获得的知识 将与工作流程分析、健全的应用程序设计相结合 原则和先进的数字技术来创造有用和可用的 指南实施工具。 个体提供商将受益于决策的可用性 支持基于指南知识的应用程序。从公共卫生 观点，有效实施基于证据的指南 哮喘和其他常见儿科疾病的门诊治疗 应有助于减少不当做法并 提高护理质量。