Classification of psychiatric disorders.
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Diagnostic and Statistical Manual of Mental Disord↗
Biomedical subjects
Robert A Jenders
Publications and source records attributed to Robert A Jenders.
Clinical decision support in electronic prescribing: recommendations and an action plan: report of the joint clinical decision support workgroup.
Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus white paper, we set forth recommendations and action plans in three critical domains: (1) advances in system capabilities, including basic and advanced sets of CDS interventions and knowledge, supporting database elements, operational features to improve usability and measure performance, and management and governance structures; (2) uniform standards, vocabularies, and centralized knowledge structures and services that could reduce rework by vendors and care providers, improve dissemination of well-constructed CDS interventions, promote generally applicable research in CDS methods, and accelerate the movement of new medical knowledge from research to practice; and (3) appropriate financial and legal incentives to promote adoption.
Decision Support Systems, Clinical↗
Convergence on a standard for representing clinical guidelines: work in health level seven.
Concern regarding patient safety and practice variation has focused attention on clinical guidelines as a way of influencing the behavior of health care providers in order to improve patient outcomes. Despite the abundant number of guidelines produced, their use has been limited, in part because the necessary knowledge is relatively inaccessible at the point of care. In turn, this has led researchers to make guidelines computable so that they can be employed in information systems that provide tailored decision support. A number of different efforts have been mounted to create a standard formalism. Health Level Seven (HL7) is a key international standards development organization. Ongoing work in HL7 attempts to synthesize the best aspects of these efforts, producing along the way shareable components of a guideline representation, such as a common expression language and standard data model. These shareable components require in turn an information architecture that makes available a range of patient data encoded in an appropriate format. Convergence on a standard guideline formalism will facilitate use of guidelines and thus enhance patient care.
Decision Support Systems, Clinical↗
Making the standard more standard: a data and query model for knowledge representation in the Arden syntax.
CONTEXT: Arden Syntax is a Health Level Seven (HL7) standard that can be used to encode computable knowledge. However, dissemination of knowledge is hampered by lack of standard database linkages in Arden knowledge bases (KB). Moreover, the HL7 Reference Information Model (RIM) is object-oriented and hence incompatible with the current Arden data model. Also, significant investment has been made in Arden KBs that would be lost if a backward-incompatible data model were adopted. OBJECTIVE: To define a data model that standardizes database linkages and provides object-oriented features while maintaining backward compatibility. ANALYSIS: We identified the objects of the RIM that could be used as a schema for standard database queries. We propose extensions to Arden to accommodate this model, including the manipulation of objects. CONCLUSION: A data model that standardizes database linkages and introduces object-oriented constructs will facilitate knowledge transfer without violation of backward compatibility in the Arden Syntax.
Artificial Intelligence↗
Challenges in implementing a knowledge editor for the Arden Syntax: knowledge base maintenance and standardization of database linkages.
CONTEXT: Incorporation of research findings into clinical practice lags behind their dissemination in the medical literature. Arden Syntax is a standard that could be used to encode evidence in a clinical decision support system (CDSS). However, dissemination of knowledge is hampered by lack of standard linkages to clinical databases. OBJECTIVE: To create a knowledge editor that facilitates transfer of knowledge from the medical literature to clinical practice via a CDSS. METHODS: Using a Web browser-based application, we implemented linkages to MEDLINE to permit queries on demand and registration of queries to be executed periodically, with results copied into Arden Medical Logic Modules (MLMs). To facilitate standardization of MLMs, database linkages are encoded using emerging HL7 standards such as a data model (virtual medical record). CONCLUSIONS: A Web-based application can facilitate transfer of knowledge into clinical practice and knowledge base maintenance through periodic queries and deployment of standards for knowledge representation.
Artificial Intelligence↗