Representation of evidence-based clinical practice guideline recommendations on FHIR

  1. Gregor Lichtner
  2. Brian S. Alper
  3. Carlo Jurth
  4. Claudia Spies
  5. Martin Boeker
  6. Joerg J. Meerpohl
  7. Falk von Dincklage

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Abstract

No abstract available

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  1. Version published to 10.1016/j.jbi.2023.104305
  2. ScreenIT

    SciScore for 10.1101/2022.05.16.22275120: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    In this process, we included five clinical stakeholders (health care professionals) and five guideline developers from German university hospitals, medical societies and Cochrane Germany to identify both the required information for practical use of clinical guideline recommendations and the metadata that is required to assess e.g. the credibility and strength of recommendations, as well as the information required to connect individual recommendations to their underlying evidence from systematic reviews of primary studies.
    Cochrane Germany
    suggested: None
    The Cochrane PICO Ontology guided discussions for medical relationships among the recommendation contents [15].
    Cochrane PICO Ontology
    suggested: None
    Automated syntax and code checking were performed using the HL7 FHIR validator as implemented in the FSH validator python package (version 0.2.2; [17]).
    python
    suggested: (IPython, RRID:SCR_001658)

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our proposed FHIR-based representation of guideline recommendations has three main limitations: First, it is based on EBMonFHIR resources, which are mostly at a low maturity level and subject to frequent, even breaking, changes. The implementation guide therefore needs to be constantly kept in synchronization with current developments of EBMonFHIR resources. However, this is ensured by our active collaboration and participation in the development of the EBMonFHIR resources. Second, there is currently no execution engine available for our representation format that would allow to automatically integrate the recommended interventions with clinical data to provide clinical decision support. However, a prototype implementation for such an execution engine to be used with clinical data in the OMOP common data model (CDM) format is currently being developed. Additionally, translators may be implemented that translate the FHIR-based representation to other guideline recommendation formalisms that already have an execution engine implemented (e.g. the GLIF3 execution engine or the SAGE execution engine for EON [35,36]). Third, not all information for guideline recommendation execution can be expressed in current FHIR resources: The dependence and relationship between recommendations from the same or different guidelines cannot be modeled in the PlanDefinition resource without the introduction of extensions. We expect that in the maturation process of resources from the Clinical Decis...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2022.05.16.22275120v1 on medRxiv