Guideline adaptation: an appealing alternative to de novo guideline development.

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Experience of using OWL ontologies for automated inference of routine pre-operative screening tests

We describe our experience of designing and implementing a knowledge-based pre-operative assessment decision support system. We developed the system using semantic web technology, including modular ontologies developed in the OWL Web Ontology Language, the OWL Java Application Programming Interface and an automated logic reasoner. Using ontologies at the core of the system’s architecture permits to efficiently manage a vast repository of pre-operative assessment domain knowledge, including classification of surgical procedures, classification of morbidities, and guidelines for routine pre-operative screening tests. Logical inference on the domain knowledge, according to individual patient’s medical context (medical history combined with planned surgical procedure) enables to generate personalised patients’ reports, consisting of a risk assessment and clinical recommendations, including relevant pre-operative screening tests

International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia

International audienceBackground HHT is an autosomal dominant disease with an estimated prevalence of at least 1/5000 which can frequently be complicated by the presence of clinically significant arteriovenous malformations in the brain, lung, gastrointestinal tract and liver. HHT is under-diagnosed and families may be unaware of the available screening and treatment, leading to unnecessary stroke and life-threatening hemorrhage in children and adults. Objective The goal of this international HHT guidelines process was to develop evidence-informed consensus guidelines regarding the diagnosis of HHT and the prevention of HHT-related complications and treatment of symptomatic disease. Methods The overall guidelines process was developed using the AGREE framework, using a systematic search strategy and literature retrieval with incorporation of expert evidence in a structured consensus process where published literature was lacking. The Guidelines Working Group included experts (clinical and genetic) from eleven countries, in all aspects of HHT, guidelines methodologists, health care workers, health care administrators, HHT clinic staff, medical trainees, patient advocacy representatives and patients with HHT. The Working Group determined clinically relevant questions during the pre-conference process. The literature search was conducted using the OVID MEDLINE database, from 1966 to October 2006. The Working Group subsequently convened at the Guidelines Conference to partake in a structured consensus process using the evidence tables generated from the systematic searches. Results The outcome of the conference was the generation of 33 recommendations for the diagnosis and management of HHT, with at least 80% agreement amongst the expert panel for 30 of the 33 recommendations