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Biomedical subjects

I N Purves

Publications and source records attributed to I N Purves.

10 recordsLinked to original sources
PubMed2000

Using scenarios in chronic disease management guidelines for primary care.

The Prodigy system is a guideline-based decision-support system designed to assist general practitioners in England choose the appropriate therapeutic action for their patients. As part of the system, we developed a novel model for encoding clinical guidelines for managing patients with chronic diseases such as asthma and hypertension. The model structures a guideline as a set of choices to be made by the clinician. It models patient scenarios which drive decision making and are used to synchronize the management of a patient with guideline recommendations. The model is robust with respect to available input data and leaves the control of decision-making to the clinician. We have built execution engines to verify the computability of the model. We intend to test the model integrated in up to 200 live systems from at least four system vendors in English General practice.

Angina Pectoris↗
PubMed1999

The PRODIGY project--the iterative development of the release one model.

We summarise the findings of the first two research phases of the PRODIGY project and describe the guidance model for Release One of the ensuing nationally available system. This model was a result of the iterative design process of the PRODIGY research project, which took place between 1995 and 1998 in up to 183 general practices in the England. Release One of PRODIGY is now being rolled out to all (27,000) General Practitioners in England during 1999-2000.

Attitude to Computers↗
PubMed1998

A PIL for every ill? Patient information leaflets (PILs): a review of past, present and future use.

This article reviews the usefulness and importance of written information, specifically leaflets, being given to patients. Evidence suggesting how both patient and doctor may benefit from the giving of written information is reviewed. Identification of good practice relating to the content and readability of leaflets is discussed. An argument is put forward that the giving of written information is an under-utilized resource in contributing to improving patient outcomes but that this may be changing with the increasing use of patient leaflet databases. The advantages and disadvantages of computer-generated patient leaflets are discussed and desirable further areas of research on computer-generated leaflets are proposed.

Computers↗
PubMed1996

Facing future challenges in general practice: a clinical method with computer support.

This paper proposes a clinical method for general practice which is patient-centred and which ensures that the doctor's agenda is supported to secure 'best practice'. It encompasses self-learning for GPs which is patient-focused and describes the encouragement and support of patient self-care. The method attempts to be pragmatic and usable within GPs' available time. The method, however, is not solely focused on the GP; it encompasses the primary health care team and the patient. It uses clinical information systems to assist in the management of the patient care plan, to supply information to the GP and patient, in order to aid shared decision making and to quality assure clinical activity. It goes further by extending the care process to handle 'virtual' encounters in which the clinical information systems play a central role.

Education, Medical, Continuing↗
PubMed1996

Medical records and other stories: a narratological framework.

A new model of the medical record is introduced which can incorporate context, structure, process and use of the medical record within a single narratological framework. It is claimed that the analysis of narrative and, in particular, the study of the story metaphor can provide a theoretical model which provides coherence within the broad discipline of Medical Informatics. It is argued that this framework maintains different levels of abstraction, is useful for teaching and clinical practice, and that its concepts can be readily understood by those in both lay and technical healthcare professions.

Communication↗
PubMed1993

Comparison of prescribing unit with index including both age and sex in assessing general practice prescribing costs.

OBJECTIVE: To examine and compare the prescribing unit and a new prescribing index adjusting for age and sex in assessing general practice prescribing. DESIGN: Analysis of all prescriptions issued by two practices in one year. Use of data to derive a prescribing index adjusting for age and sex. Comparison of effect of prescribing unit and new index on relation between 80 practices' prescribing data and family health services authority average. SETTING: Newcastle and Gateshead Family Health Services Authorities. Two urban practices with eight doctors and combined list size of 16,300 patients. MAIN OUTCOME MEASURES: Cost and number of prescriptions issued to each age and sex group. Effect of index on relation between practice data and family health services authority average. RESULTS: The number of items prescribed and total costs rose with age. Although total costs were greater for women than for men, individual items cost more for men aged 25-84. Comparison of data adjusted by the prescribing unit and the new index with authority averages produced no significant differences except in a few practices with skewed age-sex demography. Results with the two indexes differed by over 5% in 34% (27/80) of practices for costs and in 14% (11/80) for items prescribed. CONCLUSIONS: The age and sex profile of a practice does not explain interpractice variation in prescribing patterns. Other unidentified factors need to be considered.

Adolescent↗