A quantitative assessment of a methodology for collaborative specification and evaluation of clinical guidelines

  • Authors:

  • Erez Shalom;Yuval Shahar;Meirav Taieb-Maimon;Guy Bar;Avi Yarkoni;Ohad Young;Susana B. Martins;Laszlo Vaszar;Mary K. Goldstein;Yair Liel;Akiva Leibowitz;Tal Marom;Eitan Lunenfeld

  • Affiliations:

  • Medical Informatics Research Center, Department of Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Medical Informatics Research Center, Department of Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;Geriatric Research Educational and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA;Geriatric Research Educational and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA;Geriatric Research Educational and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA;Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Edith Wolfson Medical Center, Holon 58100, Israel;Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

  • Venue:
  • Journal of Biomedical Informatics
  • Year:
  • 2008

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Abstract

We introduce a three-phase, nine-step methodology for specification of clinical guidelines (GLs) by expert physicians, clinical editors, and knowledge engineers and for quantitative evaluation of the specification's quality. We applied this methodology to a particular framework for incremental GL structuring (mark-up) and to GLs in three clinical domains. A gold-standard mark-up was created, including 196 plans and subplans, and 326 instances of ontological knowledge roles (KRs). A completeness measure of the acquired knowledge revealed that 97% of the plans and 91% of the KR instances of the GLs were recreated by the clinical editors. A correctness measure often revealed high variability within clinical editor pairs structuring each GL, but for all GLs and clinical editors the specification quality was significantly higher than random (p