PMID- 37703798 OWN - NLM STAT- MEDLINE DCOM- 20231003 LR - 20231003 IS - 1872-8243 (Electronic) IS - 1386-5056 (Linking) VI - 178 DP - 2023 Oct TI - A prospective observational concordance study to evaluate computational model-driven clinical practice guidelines for Type 2 diabetes mellitus. PG - 105208 LID - S1386-5056(23)00226-5 [pii] LID - 10.1016/j.ijmedinf.2023.105208 [doi] AB - BACKGROUND: Clinical Practice Guidelines (CPGs) provide healthcare professionals with performance and decision-making support during the treatment of patients. Sometimes, however, they are poorly implemented. The IDE(4)ICDS platform was developed and validated with CPGs for type 2 diabetes mellitus (T2DM). OBJECTIVE: The main objective of this paper is to present the results of the clinical validation of the IDE(4)ICDS platform in a real clinical environment at two health clinics in the Andalusian Public Health System (SSPA) in the southern Spanish region of Andalusia. METHODS: National and international knowledge sources on T2DM were selected and reviewed and used to define a diabetes CPG model on the IDE(4)ICDS platform. Once the diabetes CPG was configured and deployed, it was validated. A total of 506 patients were identified as meeting the inclusion criteria, of whom 130 could be recruited and 89 attended the appointment. RESULTS: A concordance analysis was performed with the kappa value. Overall agreement between the recommendations provided by the system and those recorded in each patient's EHR was good (0.61 - 0.80) with a total kappa index of 0.701, leading to the conclusion that the system provided appropriate recommendations for each patient and was therefore well-functioning. CONCLUSIONS: A series of possible improvements were identified based on the limitations for the recovery of variables related to the quality of these recolected variables, the detection of duplicate recommendations based on different input variables for the same patient, and clinical usability, such as the capacity to generate reports based on the recommendations generated. Nevertheless, the project resulted in the IDE(4)ICDS platform: a Clinical Decision Support System (CDSS) capable of providing appropriate recommendations for improving the management and quality of patient care and optimizing health outcomes. The result of this validation is a safe and effective pathway for developing and adopting digital transformation at the regional scale of the use of biomedical knowledge in real healthcare. CI - Copyright (c) 2023 Elsevier B.V. All rights reserved. FAU - Parra-Calderon, Carlos Luis AU - Parra-Calderon CL AD - Computational Health Informatics' Group. Seville Institute of Biomedicine (IbiS)/"Virgen del Rocio" University Hospital/CSIC/University of Seville, Avenida Manuel Siurot, 41013 Seville, Spain. Electronic address: carlos.parra.sspa@juntadeandalucia.es. FAU - Roman-Villaran, Esther AU - Roman-Villaran E AD - Computational Health Informatics' Group. Seville Institute of Biomedicine (IbiS)/"Virgen del Rocio" University Hospital/CSIC/University of Seville, Avenida Manuel Siurot, 41013 Seville, Spain. Electronic address: esther.roman@juntadeandalucia.es. FAU - Alvarez-Romero, Celia AU - Alvarez-Romero C AD - Computational Health Informatics' Group. Seville Institute of Biomedicine (IbiS)/"Virgen del Rocio" University Hospital/CSIC/University of Seville, Avenida Manuel Siurot, 41013 Seville, Spain. Electronic address: celia.alvarez@juntadeandalucia.es. FAU - Escobar-Rodriguez, German Antonio AU - Escobar-Rodriguez GA AD - Computational Health Informatics' Group. Seville Institute of Biomedicine (IbiS)/"Virgen del Rocio" University Hospital/CSIC/University of Seville, Avenida Manuel Siurot, 41013 Seville, Spain. Electronic address: german.antonio.er@gmail.com. FAU - Martinez-Brocca, Maria Asuncion AU - Martinez-Brocca MA AD - Virgen Macarena" University Hospital, Seville, Spain; Comprehensive Plan for Diabetes in Andalusia, Andalusian Health Service, Calle Doctor Fedriani, 3, 41009 Seville, Spain. Electronic address: carlos.parra.sspa@juntadeandalucia.es. FAU - Martinez-Garcia, Alicia AU - Martinez-Garcia A AD - Computational Health Informatics' Group. Seville Institute of Biomedicine (IbiS)/"Virgen del Rocio" University Hospital/CSIC/University of Seville, Avenida Manuel Siurot, 41013 Seville, Spain. Electronic address: alicia.martinez.ga.sspa@juntadeandalucia.es. FAU - Garcia-Garcia, Julian Alberto AU - Garcia-Garcia JA AD - Computer Languages and Systems Department, Escuela Tecnica Superior de Ingenieria Informatica, Avda. Reina Mercedes s/n. 41012 Seville, Spain. Electronic address: juliangg@us.es. FAU - Escalona-Cuaresma, Maria Jose AU - Escalona-Cuaresma MJ AD - Computer Languages and Systems Department, Escuela Tecnica Superior de Ingenieria Informatica, Avda. Reina Mercedes s/n. 41012 Seville, Spain. Electronic address: mjescalona@us.es. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20230909 PL - Ireland TA - Int J Med Inform JT - International journal of medical informatics JID - 9711057 SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2/therapy MH - Delivery of Health Care MH - *Decision Support Systems, Clinical MH - Records OTO - NOTNLM OT - Clinical decision support system OT - Clinical practice guideline OT - Evidence-based medicine OT - Type 2 diabetes mellitus COIS- Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Carlos Luis Parra-Calderon reports financial support was provided by Ministerio de Economia y Competitividad. Carlos Luis Parra-Calderon reports a relationship with Andalusian Health Service that includes: employment. Carlos Luis Parra-Calderon reports a relationship with Andalusian Public Foundation for Health Research Management in Seville that includes: non-financial support. Esther Roman Villaran reports a relationship with Andalusian Public Foundation for Health Research Management in Seville that includes: employment. Celia Alvarez Romero reports a relationship with Andalusian Public Foundation for Health Research Management in Seville that includes: employment. Alicia Martinez Garcia reports a relationship with Andalusian Public Foundation for Health Research Management in Seville that includes: employment. German Antonio Escobar Rodriguez reports a relationship with Andalusian Public Foundation for Health Research Management in Seville that includes: employment. Maria Asuncion Martinez-Brocca reports a relationship with Andalusian Health Service that includes: employment. Julian Alberto Garcia Garcia reports a relationship with University of Seville that includes: employment. Maria Jose Escalona Cuaresma reports financial support was provided by Ministerio de Economia y Competitividad. Maria Jose Escalona Cuaresma reports a relationship with University of Seville that includes: employment. EDAT- 2023/09/14 00:42 MHDA- 2023/10/03 06:47 CRDT- 2023/09/13 18:08 PHST- 2023/05/13 00:00 [received] PHST- 2023/08/18 00:00 [revised] PHST- 2023/08/30 00:00 [accepted] PHST- 2023/10/03 06:47 [medline] PHST- 2023/09/14 00:42 [pubmed] PHST- 2023/09/13 18:08 [entrez] AID - S1386-5056(23)00226-5 [pii] AID - 10.1016/j.ijmedinf.2023.105208 [doi] PST - ppublish SO - Int J Med Inform. 2023 Oct;178:105208. doi: 10.1016/j.ijmedinf.2023.105208. Epub 2023 Sep 9.