Clinical practice guidelines consistency for patients with multimorbidity: a case-study in the management of type 2 diabetes and hypertension

Stud Health Technol Inform. 2015;210:344-8.

Abstract

Decision support for the guideline-based management of patients with multimorbidity is a challenge since it relies on the combination of single-disease clinical practice guidelines (CPGs). The aim of this work is to present a framework to check, at the modelling level, whether two CPGs overlap and are potentially inconsistent, thus requiring further reconciliation. The method relies on an ontological comparison of the patient profiles covered by CPGs and the recommended actions attached. It was applied to check the consistency of CPGs for the management of arterial hypertension and for the management of type 2 diabetes. Results showed that the two CPGs had only one common patient profile, although more profiles were impacted through profile subsumption. In this specific case, recommended actions were not found inconsistent since antihypertensive and anti-diabetic drugs could be combined in an additive way.

MeSH terms

  • Case-Control Studies
  • Comorbidity
  • Decision Support Systems, Clinical / organization & administration*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / therapy*
  • Documentation / standards*
  • France
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / therapy*
  • Meaningful Use / standards*
  • Natural Language Processing
  • Practice Guidelines as Topic / standards*
  • Vocabulary, Controlled