Supporting Knowledge-Based Decision Making in the Medical Context

Introduction

Nowadays, the rationalization of the healthcare systems is a task of fundamental importance in order to grant both the quality and the standardization of healthcare services, and the minimization of costs. Clinical Practice Guidelines (CPGs) are one of the major tools that have been introduced to achieve such a challenging task. CPGs are, in the definition of the USA Institute of Medicine, “systematically developed statements to assist practitioner and patient decisions about appropriate health care in specific clinical circumstances” (Institute of Medicine, 2001, p. 151). Thousands of CPGs have been devised in the last years. For instance, the Guideline International Network (http://www.g-i-n.net) groups 77 organizations of 4 continents, and provides a library of more than 5000 CPGs. CPGs are commonly recognized as a tool to encode and support the practical adoption of evidence-based medicine (EBM). They can be used by managers as a means to optimize the organization of clinical processes. However, the main purpose of CPGs is to support physicians in their everyday knowledge-based decision making when treating patients.

The adoption of computerized approaches to acquire, represent, execute and reason with CPGs can further increase the advantages of CPGs, providing crucial advantages to:

• 1.

  Patients, granting them that they will receive the best quality medical treatments (since CPGs are actually a way of putting EBM into practice);

• 2.

  Physicians, providing them with a standard reference which they may consult, with a way of certifying the quality of their activity (e.g., for insurance or legal purposes), as well as with advanced support to their decision-making activity;

• 3.

  Hospitals and health-care centers, providing them with tools to grant the quality and the standardization of their services, as well as with a means to evaluate quality, and to optimize costs and resources.