Clinical practice guidelines

Text-based clinical practice guidelines

Clinical practice guidelines are expert medical papers solving diagnostic and therapeutic processes of single diseases of their groups. They can be used for treatment standardization, clinical care improvement, comparison between medical institutions, educational purposes, automation of some medical procedures and many other objectives.

Text-based guidelines are presented as a scientific publication in medical journals both printed or distributed electronically. Even in electronical version they still have simple text structure. The formalization proces is a way how to access informations included in clinical guidelines and enable to use them in developed applications.

Formalized guidelines and their applications:

By the term of guideline formalization we mean an extraction of knowledge from text based medical papers into an electronical form, easy for computer processing. We obtain guideline procedural structure and list of signicical parametres by a formalization process. As a result of this process we get a graphical GLIF model (GuideLine Interchange Format - developed in a cooperation of Columbia University, Harvard University, McGill University and Stanford University, see http://www.glif.org). The pass through the separate branches of the GLIP diagram depends on conditions in decision steps or on an interactive choice of a relevant branch by user. It is necessary to encode guideline algorithm into XML (eXtensible Markup Language) before further processing, because GLIF is only grafical model.

List of Guidelines formalized within the scope of EuroMISE Center:

• Recommended procedures for prevention of Cardiovascular Disease, Hypertension, DM and Dyslipidemy (Czech only)
  2005, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• Recommendations for diagnostics and treatment of patients with Atrial Fibrillation (Czech only)
  2004, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• Recommendations for diagnostics and treatment of Pulmonary Arterial Hypertension (Czech only)
  2004, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• Combined 2003 European Guidelines on Cardiovascular Disease Prevention and Hypertension
  2005, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• European Guidelines on Cardiovascular Disease Prevention in Clinical Practice
  2004, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• Diagnostics and Hypertension treatment (Czech only)
  2003, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• Recommendations for diagnostic and treatment of unstable Angina Pectoris (Czech only)
  2003, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.
• 1999 WHO/ISH Hypertension Guideline (Czech only)
  2003, Anger Z., Buchtela D., Peleška J., Tomečková M., Veselý A., Zvárová J.

For the correct application run it is necessary to allow Java applets in your Internet browser and running the Java runtime environment on your computer (click to download here ).

GLIF model detailed description and manual for applications listed above dowloadable in PDF or HTML version here.

Processing guidelines

In contrast to foregoing examples, the application named Processing guidelines allows to process concrete patient data together with formalised practice guideline. As a result it chooses the most accurate order of actions, that is highlited in the diagram and it also can be used for comparison between actual treatment and general standards.