Guideline Development & Implementation - XML-Based Tools

指南制定

基本信息

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
项目类别：
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

项目摘要

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.

长期以来的信息挑战是开发有效的医疗机制知识诸如实践指南中包含的知识可以在支持的系统中进行操作临床医生的决策。但是，令人沮丧的障碍是对此目标的满意度是将指南知识转换为可计算格式的困难。在此竞争续约申请中我们提出了一项研究计划，以扩大成功的成就。 1。认识到投票和模棱两可的建议会阻碍指南实施和依从性，我们将模拟和表征普遍存在的歧义和选项形式指南声明，确定这种陈述导致临床不确定性的程度，并确定减少这种不确定性的方法。 2。与美国儿科学院和美国家庭学会合作医师，我们将开发，安装和评估软件工具，以支持有效的创作科学有效且可实施的准则。与国家专业社会合作提供了将在上一个赠款期间开发的工具和技术转移到现实世界中的机会它们将进行评估并迭代改进。 3。我们将通过开发工具来帮助翻译自然的工具来促进指南知识将语言建议纳入正式规则，并将基于动作类型的框架应用于设计可重复使用的实施策略，可以在国家和地方一级使用。 4。我们将修改并进一步扩展指南元素模型，以适应对于指导文件建模，创作和实施活动至关重要。我们将创建一个XML 模式并为当前用户提供功能，以确保其宝石文件保持兼容。此外，我们将向HL7和/或ASTM提交新模型。将指南知识转化为运营决策支持系统的系统过程在提供高质量的基于证据的医疗保健方面有很大的好处。另外，提议活动专注于将优先影响儿童的系统。