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Clinical Guidelines Veli Bi?er Outline Evidence-Based Medicine Clinical Guidelines Developing Guidelines Computerized Clinical Guidelines Arden Syntax GEM PROforma Arezzo Outline cont’d Asbru DeGel GUIDE NewGuide MyHeart EON Athena GLIF Towards Standardization What is next? References Evidence-Based Medicine Advocates the use of up-to-date “best” scientific evidence from healthcare research as the basis of making decisions. It offers: Objective way to determine high quality and safety standards The process of transfering clinical findings into practice Potential to reduce healthcare costs. Clinical Guidelines “systematically developed statements to assist practitioners and patients on decisions about appropriate health care for specific circumstances [Field and Lohr [1990] ] Developing Guidelines Prioritizing Guideline Topic: Major causes of mortality for a population Uncertainty about the appropriateness of healthcare Need to conserve resources in providing care Cardiovascular Diseases is a major category. Developing Guidelines The topic is usually refined since the task of developing a guideline for Cardiovascular diseases is considerable Care Elements: Primary (The initial and nonspecialized health care) Secondary (Specialist care in a hospital setting ) Tertiary (Services provided by highly specialized providers and tech.) Aspects of Management: Screening Diagnosis Drug Therapy Risk Factor Management Developing Guidelines Setting Inpatient Outpatient Time Frame Emergency Acute Chronic Developing Guidelines Identifying and Assessing the evidence Best done by systematic review. The Cochrane Library contains references to over 218000 clinical trials / Once gathered, the evidence is interpreted and translated into CPG. Computerized Clinical Guidelines Most clinical guidelines are text-based All of them is not accessible online Physicians have difficulties in deciding which of multiple guidelines best pertains to their patient A clear need for effective guideli