Clinical practice guidelines are textual recommendations based on the consensus of medical experts with the aim to solve diagnostic and therapeutic problems. For more advanced use in real medical applications it is necessary to find out mathematical models of physicians' decision-making processes. The acquisition of a formal model from text-based guidelines is a crucial point for development of decision support systems. We introduce a system for formalization and presentation of medical knowledge contained in clinical practice guidelines where knowledge formalization is based on the GLIF model.
- MeSH
- algoritmy MeSH
- expertní systémy * MeSH
- hodnocení rizik MeSH
- internet MeSH
- kardiovaskulární nemoci etiologie prevence a kontrola MeSH
- lidé MeSH
- navrhování softwaru MeSH
- řízený slovník MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- systémová integrace MeSH
- systémy pro podporu klinického rozhodování organizace a řízení MeSH
- teoretické modely MeSH
- znalostní báze * MeSH
- zpracování přirozeného jazyka * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Electronic Health Record (EHR) systems are now being developed in many places. More advanced systems provide also reminder facilities, usually based on if-then rules. In this paper we propose a method how to build the reminder facility directly upon the guideline interchange format (GLIF) model of medical guidelines. The method compares data items on the input of EHR system with medical guidelines GLIF model and is able to reveal if the input data item, that represents patient diagnosis or proposed patient treatment, contradicts with medical guidelines or not. The reminder facility can be part of EHR system itself or it can be realized by a stand-alone reminder system (SRS). The possible architecture of stand-alone reminder system is described in this paper and the advantages of stand-alone solution are discussed. The part of the EHR system could be also a browser that would present graphical GLIF model in easy to understand manner on the user screen. This browser can be data driven and focus attention of user to the relevant part of medical guidelines GLIF model.
- MeSH
- chorobopisy - počítačové systémy normy MeSH
- chorobopisy - spojování normy MeSH
- metody pro podporu rozhodování MeSH
- registrace MeSH
- rozhodovací podpůrné systémy pro řízení normy MeSH
- šíření informací metody MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- systémy řízení databází normy MeSH
- telemedicína normy MeSH
- ukládání a vyhledávání informací normy MeSH
- uživatelské rozhraní počítače * MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: A number of studies have reported increased violence in patients with schizophrenia. AIMS: To determine the prevalence of violence among those with schizophrenia in samples from 1949, 1969, 1989 and 2000 in Prague (Czech Republic) and to examine trends in this behaviour. METHOD: Records from 404 patients meeting DSM-IV criteria for schizophrenia were screened for violence (defined as 3 points on the Modified Overt Aggression Scale) from the first observed psychotic symptoms until the time of latest available information. RESULTS: Logistic regression revealed a marginally significant increase in violence only in the 2000 cohort. Overall, violence was associated with schizophrenia in 41.8% of men and 32.7% of women, with no association between substance misuse and violence. CONCLUSIONS: The violence rate found in our sample is expected to remain stable over time under stable conditions. Substance misuse is not the leading cause of violence among those with schizophrenia.
- MeSH
- délka pobytu statistika a číselné údaje MeSH
- diagnóza dvojí (psychiatrie) MeSH
- dospělí MeSH
- hospitalizace statistika a číselné údaje MeSH
- lidé MeSH
- násilí psychologie statistika a číselné údaje MeSH
- oběti zločinu psychologie MeSH
- poruchy spojené s užíváním psychoaktivních látek epidemiologie psychologie MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- rozložení podle pohlaví MeSH
- schizofrenie (psychologie) * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Free-text forms of medical guidelines that are used in medical care are often cumbersome and difficult to memorize. Therefore a system that is able to present guidelines in a user-friendly manner has been designed. Guidelines are at first formalized by means of the popular GLIF3 model. Subsequently, the GLIF3 model is coded in XML. The system uses patient data and an XML-coded GLIF3 model graph evaluating the conditions of decision steps. If some conditions cannot be evaluated, (due to the unavailability of required data items), the system stops and highlights a branch from the root of the decision tree to the final step. Then, the user can input missing data into the system so that the system can continue to provide visualization. Thus, the presentation of guidelines is data-driven, making its use easier. The visualization system and the Electronic Health Record can be integrated in a system that can, during examination of a patient, suggest subsequent medical actions according to medical guidelines. Such a system has been designed and is now under development.
An electronic form of 1999 ISH/WHO Guidelines for Management of Hypertension was developed. It concentrates on two main problems--assessment of a patient's cardiovascular risk and selecting drug treatment. Moreover, it can remind the risk of unfilled items both for a cardiovascular risk calculation and drug contraindications. It can be stored for comparison with other records from follow-up both in an electronic and paper form.
- MeSH
- antihypertenziva terapeutické užití MeSH
- hypertenze * farmakoterapie MeSH
- lidé MeSH
- rizikové faktory MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- systémy pro podporu klinického rozhodování * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antihypertenziva MeSH
