Guideline Development & Implementation - XML-Based Tools

指南制定

• 批准号: 7356160
• 负责人: RICHARD N SHIFFMAN
• 金额: $ 8.46万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-03-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7356160
• 关键词: Academy; Adherence; Algorithms; American; Caring; Classification; Clinical; Clinical Practice Guideline; Collaborations; Compatible; Computer software; Decision Making; Decision Support Systems; Development; Elements; Evidence Based Medicine; Extensible Markup Language; Family Physicians; Fruit; Funding; Goals; Grant; Guidelines; Health; Health Care Costs; Healthcare; Informatics; Knowledge; Language; Lead; Medical; Methods; Modeling; Numbers; Outcome; Pediatrics; Practice Guidelines; Process; Protocols documentation; Recommendation; Research; Resources; Societies; Software Tools; Speed; Standardization; Standards of Weights and Measures; Support System; System; Techniques; Translating; Translations; Uncertainty; United States National Library of Medicine; Update; Utilization Review; Vulnerable Populations; Work; base; concept; design; improved; programs; repository; research to practice; satisfaction; success; tool

A longstanding informatics challenge has been to develop efficient mechanisms whereby valid medical knowledge¿such as that contained in practice guidelines¿can be operationalized in systems that support decision making by clinicians. However, a frustrating impediment to the satisfaction of this goal has been the difficulty of translation of guideline knowledge into computable formats. In this competing renewal application we propose a research program that will extend successful accomplishments. 1. Recognizing that vague and ambiguous recommendations impede both guideline implementation and adherence, we will model and characterize the forms of ambiguity and vagueness that are prevalent in guideline statements, ascertain the degree to which such statements lead to clinical uncertainty, and identify methods to diminish this uncertainty. 2. In collaboration with the American Academy of Pediatrics and the American Academy of Family Physicians, we will develop, install, and evaluate software tools that support efficient authoring of scientifically valid and implementable guidelines. Working with the national professional societies offers an opportunity to move the tools and techniques developed in the last grant period into the real world where they will be evaluated and iteratively improved. 3. We will facilitate implementation of guideline knowledge by developing tools to help translate natural language recommendations into formal rules and apply a framework based on action-types to design reusable implementation strategies that can be used at national and local levels. 4. We will modify and further extend the Guideline Elements Model to accommodate concepts that are critical for guideline document modeling, authoring, and implementation activities. We will create an XML Schema and provide capabilities to current users to assure their GEM files remain compatible. Furthermore, we will submit the new model as a proposed standard to HL7 and/or ASTM. A systematic process for translating guideline knowledge into operational decision support systems can have substantial benefits for delivery of high-quality, evidence based health care. In addition, the proposed activities focus on systems that will preferentially impact children¿a particularly vulnerable population.

长期以来信息学面临的挑战是建立有效的机制，使有效的医疗