ArticleBMC health services research2025
High effectiveness of the digitalization of the GESIDA clinical guideline for HIV patient management.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe management of HIV patients is inherently complex, requiring the integration of evolving clinical guidelines such as GESIDA 2023. These guidelines are extensive and demand coordinated implementation by healthcare professionals with diverse expertise. These challenges highlight the need for strategies that facilitate their adoption and improve patient care. In this study, we evaluated the impact of digitalizing clinical guidelines for AIDS patients on the efficiency of the clinical workflow in the internal medical services at a secondary public hospital. For this, we developed HIV-matic, a software to automate the implementation of the Spanish clinical guideline (GESIDA) for HIV management. MATERIALS &
methodsThe software codifies the guideline into a comprehensive set of 69 "if-then" rules within the CLIPS environment, including AIDS data, antiretroviral treatment recommendations, biochemistry data, comorbidities, and neoplasm screenings. These rules rely on 103 input variables, categorized into laboratory data from the Laboratory Information System (Gestlab), diagnostic data from the Hospital Information System (OrionClinic), and specific information compiled by the doctors through a structured questionnaire in the HIV-matic web interface. The clinical guideline digitalization was evaluated on a generated dataset of 191 prospective unique patient visits attended by clinical authors of the manuscript between 24/09/2024 and 20/12/2024. Evaluation metrics were calculated for rules and patients.
resultsWhen evaluating the rules, we observed a precision of 99,82%, a recall of 99,36%, a specificity of 99,96%, and an F1 score of 99,59% across the test dataset. Moreover, 87.43% of the evaluated patients received 100% correct messages.
conclusionsThe GESIDA, implemented as a computerized clinical guideline in the HIV-matic software, supports clinicians in decision-making with a high level of performance. Its modular design and seamless integration with existing systems in the hospital make it scalable and adaptable for broader deployments in the health service for HIV patients.
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