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Titolo:
Value of XML in the implementation of clinical practice guidelines - the issue of content retrieval and presentation
Autore:
Hoelzer, S; Schweiger, RK; Boettcher, HA; Tafazzoli, AG; Dudeck, J;
Indirizzi:
Univ Giessen, Univ Hosp, Inst Med Informat, D-35392 Giessen, Germany Univ Giessen Giessen Germany D-35392 Informat, D-35392 Giessen, Germany
Titolo Testata:
MEDICAL INFORMATICS AND THE INTERNET IN MEDICINE
fascicolo: 2, volume: 26, anno: 2001,
pagine: 131 - 146
SICI:
1463-9238(200104/06)26:2<131:VOXITI>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
PHYSICIAN PERFORMANCE; COMPUTER REMINDERS; GENERAL-PRACTICE; ARDEN-SYNTAX; SYSTEMS; CARE;
Keywords:
eXtensible Markup Language; XML schema definition; clinical practice guidelines; evaluation; implementation; presentation; style sheets;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Hoelzer, S Univ Giessen, Univ Hosp, Inst Med Informat, Heinrich Buff Ring 44, D-35392Giessen, Germany Univ Giessen Heinrich Buff Ring 44 Giessen Germany D-35392 any
Citazione:
S. Hoelzer et al., "Value of XML in the implementation of clinical practice guidelines - the issue of content retrieval and presentation", MED INF IN, 26(2), 2001, pp. 131-146

Abstract

The purpose of guidelines in clinical practice is to improve the effectiveness and efficiency of clinical care. It is known that nationally or internationally produced guidelines which, in particular, do not involve medical processes at the time of consultation, do not take local factors into account, and have no consistent implementation strategy, have limited impact in changing either the behaviour of physicians, or patterns of care. The literature provides evidence for the effectiveness of computerization of CPGs for increasing compliance and improving patient outcomes. Probably the most effective concepts are knowledge-based functions for decision support or monitoring that are integrated in clinical information systems. This approach is mostly restricted by the effort required for development and maintenanceof the information systems and the limited number of implemented medical rules. Most of the guidelines are text-based, and are primarily published inmedical journals and posted on the internet. However, internet-published guidelines have little impact on the behaviour of physicians. It can be difficult and time-consuming to browse the internet to find (a) the correct guidelines to an existing diagnosis and (b) and adequate recommendation for a specific clinical problem. Our objective is to provide a web-based guideline service that takes as input clinical data on a particular patient and returns as output a customizable set of recommendations regarding diagnosis and treatment. Information in healthcare is to a very large extent transmitted and stored as unstructured or slightly structured text such as discharge letters, reports, forms, etc. The same applies for facilities containing medical information resources for clinical purposes and research such as textbooks, articles, guidelines, etc. Physicians are used to obtaining information from text-based sources. Since most guidelines are text-based, it would be practical to use a document-based solution that preserves the originalcohesiveness. The lack of structure limits the automatic identification and extraction of the information contained in these resources. For this reason, we have chosen a document-based approach using eXtensible Markup Language (XML) with its schema definition and related technologies. XML empowers the applications for in-context searching. In addition it allows the same content to be represented in different ways. Our XML reference clinical datamodel for guidelines has been realized with the XML schema definition. Theschema is used for structuring new text-based guidelines and updating existing documents. It is also used to establish search strategies on the document base. We hypothesize that enabling the physicians to query the available CPGs easily, and to get access to selected and specific information at the point of care will foster increased use. Based on current evidence we areconfident that it will have substantial impact on the care provided, and will improve health outcomes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/09/20 alle ore 22:53:51