Coupling computer-interpretable guidelines with a drug-database through a web-based system – The PRESGUID project

Jean-Charles Dufour,Marius Fieschi,Dominique Fieschi

doi:10.1186/1472-6947-4-2

Jean-Charles Dufour, Marius Fieschi + Show 1 more

Open Access

https://doi.org/10.1186/1472-6947-4-2

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Abstract

BackgroundClinical Practice Guidelines (CPGs) available today are not extensively used due to lack of proper integration into clinical settings, knowledge-related information resources, and lack of decision support at the point of care in a particular clinical context.ObjectiveThe PRESGUID project (PREScription and GUIDelines) aims to improve the assistance provided by guidelines. The project proposes an online service enabling physicians to consult computerized CPGs linked to drug databases for easier integration into the healthcare process.MethodsComputable CPGs are structured as decision trees and coded in XML format. Recommendations related to drug classes are tagged with ATC codes. We use a mapping module to enhance computerized guidelines coupling with a drug database, which contains detailed information about each usable specific medication. In this way, therapeutic recommendations are backed up with current and up-to-date information from the database.ResultsTwo authoritative CPGs, originally diffused as static textual documents, have been implemented to validate the computerization process and to illustrate the usefulness of the resulting automated CPGs and their coupling with a drug database. We discuss the advantages of this approach for practitioners and the implications for both guideline developers and drug database providers. Other CPGs will be implemented and evaluated in real conditions by clinicians working in different health institutions.

Highlights

Clinical Practice Guidelines (CPGs) available today are not extensively used due to lack of proper integration into clinical settings, knowledge-related information resources, and lack of decision support at the point of care in a particular clinical context
The PRESGUID project is based on such a Web architecture including a CPG development and distribution platform as well as a drug database
Two textual CPGs issued by the ANAES have been coded and implemented to test and validate the computerization process

Summary

Introduction

Clinical Practice Guidelines (CPGs) available today are not extensively used due to lack of proper integration into clinical settings, knowledge-related information resources, and lack of decision support at the point of care in a particular clinical context. CPGs integrate generic recommendations for specific medical circumstances. They have been defined as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific medical circumstances" [1]. They are designed to compile the best medical knowledge in order to provide physicians with a practical decisional aid. Most CPGs are accessible on specialized web sites. The National Guideline Clearinghouse.[2] alone has almost 1,000 publicly accessible guidelines. The ANAES (Agence Nationale d'Accréditation et d'Evaluation en Santé: The agency tasked by the French government with the production of medical references (page number not for citation purposes)

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