Improving clinical guidelines with logic and decision-table techniques

Application to hepatitis immunization recommendations

R. N. Shiffman, Robert Greenes

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Clinical practice guidelines can be clarified, verified, and simplified by the use of logical analysis and the application of decision-table techniques. This methodology is applied to a CDC guideline for the prevention of perinatal transmission of hepatitis B by immunization. Relevant clinical variables are identified and possible values for each variable are defined. An exhaustive enumeration of value combinations is generated. Logically impossible combinations are identified and eliminated. The guideline's recommendations are next translated into a set of rules and compared with the remaining value combinations. Variable combinations that are not covered by guideline recommendations represent incomplete guideline specifications. Inconsistency can be identified by finding identical condition sets in two or more rules. The procedure demonstrates that the hepatitis guideline is incomplete. Logical analysis can improve the quality of clinical practice guidelines by assuring comprehensiveness and consistency.

Original languageEnglish (US)
Pages (from-to)245-254
Number of pages10
JournalMedical Decision Making
Volume14
Issue number3
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

Hepatitis
Immunization
Guidelines
Practice Guidelines
Decision Support Techniques
Centers for Disease Control and Prevention (U.S.)
Hepatitis B

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Informatics
  • Health Information Management
  • Nursing(all)

Cite this

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