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Will 'Computable' Clinical Guidelines Be Compatible with Personalised Care?

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This summary is machine-generated.

Digitalizing clinical guidelines requires addressing conceptual challenges, not just technical ones. Making guidelines computable may conflict with personalized care if disease definitions embed pre-empted patient preferences.

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Area of Science:

  • Health Informatics
  • Clinical Guideline Development
  • Personalized Medicine

Background:

  • Digitalization of healthcare offers potential benefits but faces conceptual and technical challenges.
  • Interoperability is a key technical challenge in healthcare digitalization.
  • The integration of clinical guidelines into digital formats raises questions about compatibility with personalized care.

Purpose of the Study:

  • To investigate the conceptual challenges in digitalizing clinical guidelines.
  • To assess the compatibility of computable clinical guidelines with personalized care.
  • To examine the definition of diabetes in glycaemic management guidelines as a case study.

Main Methods:

  • Case study analysis of diabetes definition in glycaemic management guidelines.
  • Examination of the dominant diagnostic criterion for diabetes (HbA1c ≥6.5%).
  • Analysis of the embedded preferences within the guideline definition.

Main Results:

  • The definition of diabetes, specifically the HbA1c ≥6.5% threshold, embeds a consensus preference from a 2009 International Expert Committee.
  • This preference-sensitive diagnostic threshold has been widely adopted in glycaemic management guidelines.
  • Awareness and concern regarding the implications of this threshold are emerging.

Conclusions:

  • Digitalizing clinical guidelines requires acknowledging and addressing their inherent preference-sensitivity.
  • Computable guidelines must be designed to accommodate rather than pre-empt individual patient preferences.
  • Failure to address inbuilt preferences may hinder the goal of providing personalized care.