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Related Experiment Videos

Design and pilot evaluation of a system to develop computer-based site-specific practice guidelines from decision

G D Sanders1, R F Nease, D K Owens

  • 1Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, California 94305-6019, USA. sanders@stanford.edu

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|April 20, 2000
PubMed
Summary

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A new web-based system, ALCHEMIST, automatically creates tailored clinical practice guidelines (CPGs) from decision models. Pilot studies show these computer-generated CPGs are superior in quality and usability compared to traditional guidelines.

Area of Science:

  • Medical Informatics
  • Clinical Decision Support
  • Health Services Research

Background:

  • Local tailoring of clinical practice guidelines (CPGs) is challenging due to the scarcity of medical experts.
  • Decision models (DMs) offer a framework for guideline development.
  • A computer-based system can facilitate the creation, dissemination, and tailoring of CPGs.

Purpose of the Study:

  • To develop and evaluate a web-based system (ALCHEMIST) for automated CPG generation and tailoring.
  • To assess the quality, usability, accountability, and accuracy of ALCHEMIST-generated CPGs compared to published guidelines.

Main Methods:

  • ALCHEMIST analyzes a DM to create an annotated algorithm CPG.
  • Remote users can tailor CPGs by modifying input variables.

Related Experiment Videos

  • A pilot study involved 15 subjects comparing ALCHEMIST CPGs with published guidelines for non-small-cell lung cancer staging.

    • Main Results:

    • ALCHEMIST CPGs received significantly higher overall quality scores (1.502) than published CPGs (0.987).
    • ALCHEMIST CPGs outperformed published guidelines in usability, accountability, and accuracy (p < 0.05 for all).
    • Users rated ALCHEMIST highly for ease of use (4.76/5), content usefulness (3.98/5), and presentation (4.64/5).

    Conclusions:

    • A web-based system can feasibly automate CPG creation as annotated algorithms.
    • ALCHEMIST facilitates the development of site-specific CPGs by remote users.
    • ALCHEMIST-generated CPGs demonstrate favorable quality and usability, suggesting their utility in guideline development.