Adapting a large database of point of care summarized guidelines: a process description

Delvaux, Nicole; Velde, Stijn Van de; Aertgeerts, Bert; Goossens, Martine; Fauquert, Benjamin; Kunnamo, Ilka; Royen, Paul Van

doi:10.1111/jep.12426

Cited by 10 publications

(14 citation statements)

References 39 publications

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“…32 Similar barriers were identified elsewhere. 31,[33][34][35] Our observations are in line with the literature.…”

Section: Findings Related To Pilot Adaptationssupporting

confidence: 92%

“…Delvaux and colleagues used ADAPTE as the main framework, but adapted the whole summarized guidelines of Duodecim's EBMG database . They evaluated content and context separately.…”

Section: Discussionmentioning

confidence: 99%

“…Delvaux and colleagues used ADAPTE as the main framework, but adapted the whole summarized guidelines of Duodecim's EBMG database. 31 They evaluated content and context separately. The criteria used to assess the context included a review of recommended drugs and their local availability, differences in legislation that may interfere with the recommendations, differences in guidelines for referral, differences in resources and organization, differences in transport modalities and differences compared with existing national guidelines or other evidence-based practice.…”

Section: Findings Related To Pilot Adaptationsmentioning

confidence: 99%

See 2 more Smart Citations

Exploring guideline adaptation strategy for Turkey: Is “ADAPTE” feasible or does it need adaptation as well?

Başer

Kahveci

Artantaş

et al. 2017

Evaluation Clinical Practice

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“…32 Similar barriers were identified elsewhere. 31,[33][34][35] Our observations are in line with the literature.…”

Section: Findings Related To Pilot Adaptationssupporting

confidence: 92%

“…Delvaux and colleagues used ADAPTE as the main framework, but adapted the whole summarized guidelines of Duodecim's EBMG database . They evaluated content and context separately.…”

Section: Discussionmentioning

confidence: 99%

Section: Findings Related To Pilot Adaptationsmentioning

confidence: 99%

See 1 more Smart Citation

Exploring guideline adaptation strategy for Turkey: Is “ADAPTE” feasible or does it need adaptation as well?

Başer

Kahveci

Artantaş

et al. 2017

Evaluation Clinical Practice

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“…All healthcare professionals in Belgium have free access to an up-to-date database of validated Belgian and nearly 1000 international guidelines, incorporated in a portal that also provides evidence-based medicine (EBM) information from other sources than guidelines (EBP-Net), including a CCDS system that is integrated into the EHRs [22][23][24]. The CCDS system of EBPNet is called the EBMeDS system which was developed by Duodecim [25].…”

Section: Background and Rationalementioning

confidence: 99%

Computerized clinical decision support system for diabetes in primary care does not improve quality of care: a cluster-randomized controlled trial

et al. 2020

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Background: The EBMeDS system is the computerized clinical decision support (CCDS) system of EBPNet, a national computerized point-of-care information service in Belgium. There is no clear evidence of more complex CCDS systems to manage chronic diseases in primary care practices (PCPs). The objective of this study was to assess the effectiveness of EBMeDS use in improving diabetes care. Methods: A cluster-randomized trial with before-and-after measurements was performed in Belgian PCPs over 1 year, from May 2017 to May 2018. We randomly assigned 51 practices to either the intervention group (IG), to receive the EBMeDS system, or to the control group (CG), to receive usual care. Primary and secondary outcomes were the 1-year pre-to post-implementation change in HbA1c, LDL cholesterol, and systolic and diastolic blood pressure. Composite patient and process scores were calculated. A process evaluation was added to the analysis. Results were analyzed at 6 and 12 months. Linear mixed models and logistic regression models based on generalized estimating equations were used where appropriate.Results: Of the 51 PCPs that were enrolled and randomly assigned (26 PCPs in the CG and 25 in the IG), 29 practices (3815 patients) were analyzed in the study: 2464 patients in the CG and 1351 patients in the IG. No change differences existed between groups in primary or secondary outcomes. Change difference between CG and IG after 1-year follow-up was − 0.09 (95% CI − 0.18; 0.01, p-value = 0.06) for HbA1c; 1.76 (95% CI − 0.46; 3.98, p-value = 0.12) for LDL cholesterol; and 0.13 (95% CI − 0.91; 1.16, p-value = 0.81) and 0.12 (95% CI − 1.25;1.49, p-value = 0.86) for systolic and diastolic blood pressure respectively. The odds ratio of the IG versus the CG for the probability of no worsening and improvement was 1.09 (95% CI 0.73; 1.63, p-value = 0.67) for the process composite score and 0.74 (95% CI 0.49; 1.12, p-value = 0.16) for the composite patient score. All but one physician was satisfied with the EBMeDS system. Conclusions: The CCDS system EBMeDS did not improve diabetes care in Belgian primary care. The lack of improvement was mainly caused by imperfections in the organizational context of Belgian primary care for chronic disease management and shortcomings in the system requirements for the correct use of the EBMeDS system (e.g., complete structured records). These shortcomings probably caused low-use rates of the system.

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“…Such point-of-care summaries have been defined as Web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information to clinicians [ 3 ]. Based on a broad evaluation, we eventually chose to subscribe to the Duodecim Evidence-Based Medicine (EBM) Guidelines database with the intention to adapt them to the Belgian context [ 4 ]. This database contains (to date) 940 EBM Guidelines of Duodecim Medical Publications available in English.…”

Section: Introductionmentioning

confidence: 99%

Technology for Large-Scale Translation of Clinical Practice Guidelines: A Pilot Study of the Performance of a Hybrid Human and Computer-Assisted Approach

Velde¹,

Macken²,

Vanneste³

et al. 2015

JMIR Med Inform

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BackgroundThe construction of EBMPracticeNet, a national electronic point-of-care information platform in Belgium, began in 2011 to optimize quality of care by promoting evidence-based decision making. The project involved, among other tasks, the translation of 940 EBM Guidelines of Duodecim Medical Publications from English into Dutch and French. Considering the scale of the translation process, it was decided to make use of computer-aided translation performed by certificated translators with limited expertise in medical translation. Our consortium used a hybrid approach, involving a human translator supported by a translation memory (using SDL Trados Studio), terminology recognition (using SDL MultiTerm terminology databases) from medical terminology databases, and support from online machine translation. This resulted in a validated translation memory, which is now in use for the translation of new and updated guidelines.ObjectiveThe objective of this experiment was to evaluate the performance of the hybrid human and computer-assisted approach in comparison with translation unsupported by translation memory and terminology recognition. A comparison was also made with the translation efficiency of an expert medical translator.MethodsWe conducted a pilot study in which two sets of 30 new and 30 updated guidelines were randomized to one of three groups. Comparable guidelines were translated (1) by certificated junior translators without medical specialization using the hybrid method, (2) by an experienced medical translator without this support, and (3) by the same junior translators without the support of the validated translation memory. A medical proofreader who was blinded for the translation procedure, evaluated the translated guidelines for acceptability and adequacy. Translation speed was measured by recording translation and post-editing time. The human translation edit rate was calculated as a metric to evaluate the quality of the translation. A further evaluation was made of translation acceptability and adequacy.ResultsThe average number of words per guideline was 1195 and the mean total translation time was 100.2 minutes/1000 words. No meaningful differences were found in the translation speed for new guidelines. The translation of updated guidelines was 59 minutes/1000 words faster (95% CI 2-115; P=.044) in the computer-aided group. Revisions due to terminology accounted for one third of the overall revisions by the medical proofreader.ConclusionsUse of the hybrid human and computer-aided translation by a non-expert translator makes the translation of updates of clinical practice guidelines faster and cheaper because of the benefits of translation memory. For the translation of new guidelines, there was no apparent benefit in comparison with the efficiency of translation unsupported by translation memory (whether by an expert or non-expert translator).

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Adapting a large database of point of care summarized guidelines: a process description

Cited by 10 publications

References 39 publications

Exploring guideline adaptation strategy for Turkey: Is “ADAPTE” feasible or does it need adaptation as well?

Exploring guideline adaptation strategy for Turkey: Is “ADAPTE” feasible or does it need adaptation as well?

Computerized clinical decision support system for diabetes in primary care does not improve quality of care: a cluster-randomized controlled trial

Technology for Large-Scale Translation of Clinical Practice Guidelines: A Pilot Study of the Performance of a Hybrid Human and Computer-Assisted Approach

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