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The book consists of two parts. The first part consists of 9 chapters which together offer a comprehensive overview of the most important medical and computer-science aspects of clinical guidelines and protocols. The second part of the book consists of chapters that are extended versions of selected papers that were originally submitted to the ECAI-2006 workshop 'AI Techniques in Health Care: Evidence-based Guidelines and Protocols.'
The book consists of two parts. The first part consists of 9 chapters which together offer a comprehensive overview of the most important medical and computer-science aspects of clinical guidelines and protocols. The second part of the book consists of chapters that are extended versions of selected papers that were originally submitted to the ECAI-2006 workshop 'AI Techniques in Health Care: Evidence-based Guidelines and Protocols.'
In recent years, guidelines and protocols have gained support as the vehicles for promoting best practices in clinical medicine. They offer the possibilities of reducing unwarranted practice variations, of containing cost while maintaining quality of care, and of defining standards of care for quality assurance purposes. These promises have led to an explosion of guideline publications. Yet studies have shown that dissemination and effective use of guidelines in clinical care remains a major bottleneck. A number of researchers have developed different technologies for delivering computerized guidelines in clinical care. These technologies range from alerts and reminders to knowledge-based systems, information-retrieval systems, and others. The tasks to which guidelines have been applied include classic clinical decision support, workflow management, quality assurance, and resource-requirement estimates. The research has spanned several communities (information retrieval, artificial intelligence, medical informatics, software engineering, clinical medicine), but unfortunately, there has been little cross-fertilization between the communities working in this area. This publication brings together researchers from different communities to examine cutting-edge approaches to guideline modeling and application development and to consider how different communities can leverage each other's strengths.
Clinical guidelines and Careflow systems have been recently identified as a means to improve and standardize health care services. A number of ICT-based management solutions have been proposed, focussing on several aspects such as specification, process logs verification with respect to specification (compliance), enactment and administration of careflows. In this paper we introduce the GPROVE framework, based on Computational Logic, and focused on the (formal) specification of careflows and on the compliance verification of the process executions w.r.t. the specified models. In particular, we show its application to the Cancer Screening Guideline used by the sanitary organization of the Emilia Romagna region, discussing its formalization in GPROVE and the results of the compliance checking applied to logs of the screening process.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Guidelines for the clinical practice of medicine have been proposed as the solution to the whole range of current health care problems. This new book presents the first balanced and highly practical view of guidelinesâ€"their strengths, their limitations, and how they can be used most effectively to benefit health care. The volume offers: Recommendations and a proposed framework for strengthening development and use of guidelines. Numerous examples of guidelines. A ready-to-use instrument for assessing the soundness of guidelines. Six case studies exploring issues involved when practitioners use guidelines on a daily basis. With a real-world outlook, the volume reviews efforts by agencies and organizations to disseminate guidelines and examines how well guidelines are functioningâ€"exploring issues such as patient information, liability, costs, computerization, and the adaptation of national guidelines to local needs.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Most industries have plunged into data automation, but health care organizations have lagged in moving patients' medical records from paper to computers. In its first edition, this book presented a blueprint for introducing the computer-based patient record (CPR). The revised edition adds new information to the original book. One section describes recent developments, including the creation of a computer-based patient record institute. An international chapter highlights what is new in this still-emerging technology. An expert committee explores the potential of machine-readable CPRs to improve diagnostic and care decisions, provide a database for policymaking, and much more, addressing these key questions: Who uses patient records? What technology is available and what further research is necessary to meet users' needs? What should government, medical organizations, and others do to make the transition to CPRs? The volume also explores such issues as privacy and confidentiality, costs, the need for training, legal barriers to CPRs, and other key topics.