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Analysis of Dutch general practice guidelines for inconsistencies with respect to the management of cardiovascular disease risk factors

机译：关于荷兰一般实践指南对心血管疾病危险因素管理不一致的一般实践指南

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Presenting guidelines relating to cardiovascular disease (CVD) in a clinical decision support system (CDSS) is viewed as a mechanism for introducing evidence based practice in to daily practice. Analysis of guidelines on consistency is needed before constructing such a system, We analyzed 74 electronically available Dutch general practice guidelines for statement inconsistencies with respect to the management of CVD, and for each inconsistency, whether incomplete cross referencing existed between the guidelines. Results: Six of the 74 guidelines had either CVD or CVD risk factors as subject of the guideline, all adhering to a common structure corresponding to four sections reflecting distinctive clinical management stages, which correspond to the subjective, objective, assessment and plan stages of SOAP methodology for structured patient data recording. Ten statement inconsistencies were found and for each a reference inconsistency was present. Conclusions: In a CDSS, statement inconsistencies will lead to poor system functioning. With electronically published guidelines, guideline developers could link statements in guidelines, to comparable statements in previously issued guidelines, facilitating the review process with respect to inconsistencies in related guidelines, and consistent cross referencing. Furthermore, it could enable the updating of existing guidelines with new evidence. Despite the determined statement inconsistencies, the authors would be able to construct a CDSS based on the DCGP guidelines dealing with the management of CVD risk factors.
机译：临床决策支持系统（CDSS）中有关心血管疾病（CVD）的指导方针被视为将基于证据的实践引入日常实践的机制。在构建此类系统之前，需要对一致性指南进行分析，我们分析了74个以上可用的荷兰一般实践指南关于CVD管理的声明不一致，以及每个不一致，是否在指南之间存在不完整的交叉参考。结果：74个指南中的6个具有CVD或CVD危险因素，作为指南的主题，遵循对应于反映独特临床管理阶段的四个部分的共同结构，这与肥皂的主观，目标，评估和计划阶段相对应结构化患者数据记录的方法论。发现了十个声明不一致，每个参考不一致都存在。结论：在CDS中，声明不一致会导致系统运行差。通过电子公布的指南，指南开发人员可以将指导方针的陈述链接到以前发布的指导方针的可比性陈述，促进了相关指导方针的不一致审查进程，并持续交叉参考。此外，它可以通过新的证据更新现有指导方针。尽管坚定的声明不一致，作者将能够根据处理CVD危险因素管理的DCGP指南来构建CDS。

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