Structural Patterns in Chronic Disease Clinical Practice Guidelines Formalized for Clinical Decision Support.

Making recommendations from clinical practice guidelines (CPGs) computable for clinical decision support (CDS) has typically been a laborious and costly process. Identifying domain-specific regularities helps clinicians and knowledge engineers conceptualize, extract, and encode evidence-based recommendations. Based on our work to provide complex CDS in the management of multiple chronic diseases, we propose nine chronic disease CPG structural patterns, discuss considerations in representing the necessary knowledge, and illustrate them with the solutions that our CDS system provides.

Automating Performance Measures and Clinical Practice Guidelines: Differences and Complementarities.

Through close analysis of two pairs of systems that implement the automated evaluation of performance measures (PMs) and guideline-based clinical decision support (CDS), we contrast differences in their knowledge encoding and necessary changes to a CDS system that provides management recommendations for patients failing performance measures. We trace the sources of differences to the implementation environments and goals of PMs and CDS.

Automating Guidelines for Clinical Decision Support: Knowledge Engineering and Implementation.

As utilization of clinical decision support (CDS) increases, it is important to continue the development and refinement of methods to accurately translate the intention of clinical practice guidelines (CPG) into a computable form. In this study, we validate and extend the 13 steps that Shiffman identified for translating CPG knowledge for use in CDS. During an implementation project of ATHENA-CDS, we encoded complex CPG recommendations for five common chronic conditions for integration into an existing clinical dashboard.

Test Case Selection in Pre-Deployment Testing of Complex Clinical Decision Support Systems.

Clinical decision support (CDS) systems with complex logic are being developed. Ensuring the quality of CDS is imperative, but there is no consensus on testing standards. We tested ATHENA-HTN CDS after encoding updated hypertension guidelines into the system.