IDE 4 ICDS: A human-centric and model-driven proposal to improve the digitization of clinical practice guideline

Abstract

Clinical practice guidelines (CPGs) are a formalization of specific clinical knowledge that states the best evidence-based clinical practices for treating pathologies. However, CPGs are limited because they are usually expressed as text. This gives rise to a certain level of ambiguity, subjective interpretation of the actions to be performed, and variability in clinical practice by different health professionals facing the same circumstances. The inherent complexity of CPGs is also a challenge for software engineers designing, developing, and maintaining software systems and clinical decision support system to manage and digitise them. This challenge stems from the need to evolve CPGs and design software systems capable of allowing their evolution. This paper proposes a model-driven, human-centric and tool-supported framework (called IDE 4 ICDS) for improving digitisation of CPG in practical environments. This framework is designed from a human-centric perspective to be used by mixed teams of clinicians and software engineers. It was also validated with the type 2 diabetes mellitus CPG in the Andalusian Public Health System (Spain) involving 89 patients and obtaining a kappa-based analysis. The recommendations were acceptable (0.61 - 0.80) with a total kappa index of 0.701, leading to the conclusion that the proposal provided appropriate recommendations for each patient.