ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium2011
Revisiting the EBM decision model to formalize non-compliance with computerized CPGs: results in the management of breast cancer with OncoDoc2.
Article in AMIA ... Annual Symposium proceedings. AMIA Symposium, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Characteristics and impact of interventions to support healthcare providers' compliance with guideline recommendations for breast cancer: a systematic literature review.Implementation science : IS · 2023Pooled it
- Healthcare providers' adherence to breast cancer guidelines in Europe: a systematic literature review.Breast cancer research and treatment · 2020Pooled it
- A scoping review of medical practice variation research within the informatics literature.International journal of medical informatics · 2022Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In 2002, Haynes et al. founded a prescriptive model of evidence-based medicine based on the patient's clinical state, her preferences, and research evidence, clinical expertise synthesizing the other three components. Revisiting this model of medical decision making, we propose a descriptive model introducing clinicians' preferences and formalize four reasons of non-compliance with clinical practice guidelines (CPGs). The approach has been applied to breast cancer management decisions taken by multidisciplinary staff meetings (MSMs) at the Tenon hospital, Paris, France, while using a clinical decision support system (CDSS): OncoDoc2. 1,889 MSM decisions have been recorded [February 2007-October 2009]. The compliance rate with CPGs was measured at 91.0%. Non-compliant decisions are mainly "MSM choices" (39.1%) and "particular cases" (34.9%). "Practice evolution" and "patient choices" are less frequent (12.4% and 11.2%). Even with a CDSS, a 100% compliance rate cannot be reached because particular cases fall outside CPGs and borderline cases need to be interpreted by clinicians.
Indexed as
Identifiers
22195063PMC3243232What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.