Authors:
Gustavo Marísio Bacelar-Silva
1
;
Rong Chen
2
and
Ricardo Cruz-Correia
1
Affiliations:
1
Center for Research in Health Technologies and Information Systems and University of Porto, Portugal
;
2
Linköping University and Cambio Healthcare Systems, Sweden
Keyword(s):
Guideline, Hypertension, JNC 7, Electronic health record, Clinical decision support system.
Related
Ontology
Subjects/Areas/Topics:
Biomedical Engineering
;
Clinical Problems and Applications
;
Data Engineering
;
Decision Support Systems
;
Electronic Health Records and Standards
;
Enterprise Information Systems
;
Health Information Systems
;
Information Systems Analysis and Specification
;
Knowledge Management
;
Ontologies and the Semantic Web
;
Society, e-Business and e-Government
;
Web Information Systems and Technologies
Abstract:
Introduction. Due to the increasing use of Electronic Health Records there is a tendency to implement clinical decision support system (CDSS) based on existing clinical guidelines. The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) is well known and widely used worldwide guideline. Transforming published guidelines into CDSS is a process that still needs to be improved. Aim. To describe the difficulties in understanding the guideline, to recommend better suited descriptions for the contents. Methods. Systematic reading of the guideline for the extraction of the main patient variables, processes and evaluation suggested. The issues were evaluated considering the Domain 4 of the Appraisal of Guidelines for Research & Evaluation II Instrument. Results. Several problems were identified considering whether the recommendations are specific and unambiguous, the different options for management of the cond
ition or health issue are clearly presented and key recommendations are easily identifiable. Discussion. Some initiatives have been made, as the Guideline Elements Models and the development of guideline model representations. This attempt to formalise the JNC 7 guideline allowed to discover many ambiguities, concepts related to prior knowledge and issues related to the distribution of the content presentation.
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