The SAGE (Standards-Based Active Guideline Environment) project was formed to create a methodology and infrastructure required to demonstrate integration of decision-support technology for guideline-based care in commercial clinical information systems. This paper describes the development and innovative features of the SAGE Guideline Model and reports our experience encoding four guidelines. I...

A commonly accepted definition of a clinical practice guideline is “a systematically developed statement to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances” [1]. Guidelines are written to improve the quality of care, to improve the appropriateness of care, to improve cost-effectiveness, and to serve as educational tools [2, 3]. The goa...

Guidelines are collections of practical information that assist with clinical decision making. Evidence-based guideline development includes a critique of the quality and an evaluation of the strength of published evidence. Evolution From opinion-based to evidence-based guidelines is incomplete in many of the organizations that author them, so perioperative nurses must become skillful at critiq...

A multi-site, collaborative, research and development project has been initiated to develop a standards-based, comprehensive technology infrastructure that will enable encoding and dissemination of interoperable, electronic clinical practice guidelines. The goal of this project is to provide technologies with which 1) Health care organizations can author and encode guidelines in a standard elec...

BACKGROUND Delirium in critically ill patients has a strong adverse impact on prognosis. In spite of its recognized importance, however, delirium screening and treatment procedures are often not in accordance with current guidelines. This implementation study is designed to assess barriers and facilitators for guideline adherence and next to develop a multifaceted tailored implementation strate...

We have developed the GLIF3 Guideline Execution Engine (GLEE) as a tool for executing guidelines encoded in the GLIF3 format. In addition to serving as an interface to the GLIF3 guideline representation model to support the specified functions, GLEE provides defined interfaces to electronic medical records (EMRs) and other clinical applications to facilitate its integration with the clinical in...

Hyponatraemia, defined as a serum sodium concentration <135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditi...

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline w...

This guideline is a revision of the clinical practice guideline, “Diagnosis and Management of Bronchiolitis,” published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements ar...