In last week’s practice question, we covered the Process of Knowledge Transformation and how we take Evidence Based Medicine (EBM) and transform it into something clinical decision support systems can use. In this week’s post we’ll be applying last week’s focus on EBM to the point of care – in the form of clinical guidelines and algorithms.
In the larger scheme of things, this topic falls under the following sequence in the clinical informatics core content.
- 1. Fundamentals
- 2. Clinical Decision Making and Care Process Improvement
- 2.1 Clinical Decision Support
- 2.2 Evidence-based Patient Care
- 2.2.1 Evidence Sources
- 2.2.2 Evidence Grading
- 2.2.3 Clinical Guidelines
- 2.2.3 Implementation of Guidelines as Clinical Algorithms
- 2.2.5 Information Retrieval and Analysis
- 2.3 Clinical Workflow Analysis, Process Redesign, and Quality Improvement
- 3. Health Information Systems
- 4. Leading and Managing Change
We don’t want to give away too much information before we get into the question. But don’t worry – we’ll get into some meat and potatoes in the answer and explanation section.
Let’s get on with it.
Question
Choose the best answer:
A clinical guideline differs from a clinical algorithm in that guidelines are _________ while algorithms are __________ .
A. Self-contained step-by-step sets of operations to be performed for clinical actions, general recommendations used by clinical decision support systems to guide providers towards a higher quality level of care
B. General recommendations used by clinical decision support systems to guide providers towards a higher quality level of care, self-contained step-by-step sets of operations to be performed for clinical actions
C. Tools and processes that encompass EBM codified into clinical pathways & rules, systematically developed statements designed to help practitioners and patients decide on appropriate healthcare depending on the condition and/or circumstance
D. Systematically developed statements designed to help practitioners and patients decide on appropriate healthcare depending on the condition and/or circumstance, tools and processes that encompass EBM codified into clinical pathways & rules
Answer and Explanation
We’ll quickly review the definitions of guidelines and algorithms, then review the answers to the question.
Clinical Guideline Definitions
Statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. – IOM
A medical guideline (also called a clinical guideline, clinical protocol or clinical practice guideline) is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. – Wikipedia
Clinical Algorithm Definitions
The clinical algorithm is a text format that is specially suited for presenting a sequence of clinical decisions, for teaching clinical decision making, and for guiding patient care. – Clinical algorithms in the treatment of status epilepticus in children
Any computation, forumla, statistical survey, nomogram, or look-up table, useful in healthcare – Wikipedia
Question Review
A. – The first part of the answer (step-by step set of operations) would better describe an algorithm rather than a guideline – can eliminate – wrong answer order
B. – This seems like a reasonable answer, but guidelines are not used only by clinical decision support systems – incorrect definition of guidelines
C. – Tools and processes that encompass EBM codified into clinical pathways & rules would better describe a clinical algorithm and not a guideline – wrong answer order
D. – Systematically developed statements designed to help practitioners and patients decide on appropriate healthcare depending on the condition and/or circumstance accurately defines a clinical guideline while tools and process […] accurately defines a clinical algorithm. Correct answer.
Therefore, the correct answer is D.
Algorithms are codified, guidelines are recommendations.
If you’re looking for other study resources, check out some of our other practice questions of the week.
You can also purchase our text – Clinical Informatics Board Review: Pass the Exam the First Time. It’s the only board review book for the clinical informatics exam and comes with a money back guarantee if you don’t pass the exam on your first attempt – it’s the only study material for the clinical informatics exam with one.
You can also sign up for practice questions through learn.informaticspro.com if you’re looking to test your readiness for the exam. A full-length practice exam should be dropping in the next couple of weeks.
References and Resources
AHRQ’s National Guideline Clearing House. www.guideline.gov
Clinical algorithms in the treatment of status epilepticus in children. http://www.ncbi.nlm.nih.gov/pubmed/10870634?report=abstract
Uses of clinical algorithms. http://jama.jamanetwork.com/article.aspx?articleid=382921