Recommandations de pratique clinique sous la forme d'un document textuel et d'un système d'aide à la décision : une expérience de production et diffusion simultanées des deux types de format pour la prise en charge du diabète de type 2

Clinical decision support systems (CDSSs) are expected to promote the implementation of clinical practice guidelines (CPGs) and improve the quality of care. However, originally produced as texts often incomplete and ambiguous, CPGs are difficult to formalize. In addition, CPG modellers work a posteriori on textual CPGs with no connexion with CPG authors. In conjunction with the development of type 2 diabetes CPGs, conducted in France by the HAS (Haute autorité de Santé), we have simultaneously developed a formal counterpart of the text as a CDSS named RecosDoc-diabète. The system allows to interactively build a patient-centered pathway, and get the appropriate recommendations. Textual CPGs and RecosDoc-diabète were published together in February 2013 and made available online. Between February 12 and December 31, 2013, 55,203 visitors accessed the narrative CPGs whereas 10,565 accessed the system. 186 visitors of RecosDoc-diabète (2%) responded to the survey provided, evidencing that the system was globally positively evaluated, although assessments were mixed illustrating that users’ needs are varied and that “one size does not fit all” in terms of CDSSs. Mots-clés : Recommandations de pratique clinique, Publication de recommandations de pratique clinique, Système d’aide à la décision clinique, Diabète de type 2.