Measurement of provider adherence to a guideline-based decision support system (DSS) presents a number of important challenges. Establishing a causal relationship between the DSS and change in concordance requires consideration of both the primary intention of the guideline and different ways providers attempt to satisfy the guideline. During our work with a guideline-based decision support sys...

background : inappropriate use of vancomycin not only increase health care costs but also contribute to the emergence of resistant organisms. higher trough serum vancomycin concentrations (>10mg/l) has been recommended for avoidance of development of resistance. we aim to compare the administered dose with recommended doses based on guideline-recommended weight-based dosing. methods : in a cros...

Pain is the most frequent and distressing symptom in cancer patients. As part of a worldwide effort to improve the quality of pain control, several clinical guidelines for the management of cancer pain have been published and revised in the last decade. The Japanese Society of Palliative Medicine first published a Japanese clinical guideline for the management of cancer pain in 2000. Since then...

The SAGE (Standards-Based Active Guideline Environment) project was formed to create a methodology and infrastructure required to demonstrate integration of decision-support technology for guideline-based care in commercial clinical information systems. This paper describes the development and innovative features of the SAGE Guideline Model and reports our experience encoding four guidelines. I...

This is the first of the IPCRG Guideline papers. The IPCRG took on the task of producing an integrated guideline for the management of chronic respiratory diseases in primary care. This included some original work aimed at developing questionnaires suitable for improving the diagnosis and recognition of respiratory diseases in the primary care setting. This paper provides the background evidenc...

OBJECTIVES To investigate the effect of an educational and feedback intervention to enhance consideration of sex differences in clinical guideline development. DESIGN Preintervention and postintervention questionnaires in intervention and control groups. Content analysis of intervention guidelines and former versions. SETTING Guideline consultants, working-group members and guideline docume...

BACKGROUND Patient participation is essential in developing high-quality guidelines but faces practical challenges. Evidence on timing, methods, evaluations, and outcomes of methodologies for patient participation in guideline development is lacking. OBJECTIVE To assess the feasibility of a wiki as a participatory tool for patients in the development of a guideline on infertility determined b...

BACKGROUND Clinical practice guidelines describe optimal strategies for disease prevention, diagnosis, or treatment. Increasing evidence indicates that sex-related factors may have an impact on these strategies. We examined the way in which two Dutch guideline organizations address evidence on sex factors in their guideline development methodologies. We then determined whether attention to thes...

OBJECTIVE The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN Systematic guideline development methodology including systematic evidence retrie...