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P Barahona

Publications and source records attributed to P Barahona.

10 recordsLinked to original sources
PubMed2001

Computerising a guideline for the management of diabetes.

This paper reports an experience of computerising a clinical guideline for the management of non-insulin-dependent diabetes mellitus (NIDDM). The guideline, designed by the European NIDDM Policy Group is being used in a National Programme for Diabetes supported by the Portuguese Ministry of Health, who is keen to supporting its widespread use by general practitioners, namely in computerised form. The paper presents the main characteristics of the prototype that was implemented within the European project Prestige, and was developed according to the Prestige Protocol Model. The model is briefly described, together with the generic architecture that supports it. Then the main design decisions of the prototype are explained, regarding the modelling of a general practitioner workflow during a typical consultation and the user interface, two key issues for obtaining acceptance from the users. The limitations of the system are discussed and a number of directions are outlined in order to circumvent such limitations, and broaden the scope of applicability of the system.

Diabetes Mellitus, Type 2↗
PubMed2000

A computerised guideline for the management of diabetes.

This paper describes an experience of computerising a clinical guideline for the management of Diabetes. This guideline is being used in a National Programme for Diabetes supported by the Health Ministry in Portugal, who is interested in supporting its use by General Practitioners. The prototype system was developed according to the Prestige Protocol Model that is briefly outlined. The main conclusions regarding practical design decisions are then reported, partly based on a preliminary evaluation of the system by GPs.

Diabetes Mellitus, Type 2↗
PubMed1997

From hospital information system components to the medical record and clinical guidelines & protocols.

This paper introduces an ongoing project towards the development of a new generation HIS, aiming at the integration of clinical and administrative information within a common framework. Its design incorporates explicit knowledge about domain objects and professional activities to be processed by the system together with related knowledge management services and act management services. The paper presents the conceptual model of the proposed HIS architecture, that supports a rich and fully integrated patient data model, enabling the implementation of a dynamic electronic patient record tightly coupled with computerised guideline knowledge bases.

Clinical Protocols↗
PubMed1995

Guideline based care: the challenge for knowledge based decision support.

The EPISTOL action was included in the accompanying measures of AIM '91-'94 as a strategic study, aimed at clarifying the impact in the near future of knowledge based systems and techniques for the health sector, and provide recommendations with respect to the research and development work required within this period. In all the EPISTOL events, namely the Munich and Brussels workshops, the topic of clinical guidelines and protocol and based care raised considerable interest. This paper summarises these discussions, focussing on the KBS support for clinical guidelines.

Artificial Intelligence↗
PubMed1995

ESTEEM: a European telematic project for quality assurance within clinical neurophysiology.

From the prospective multi-center evaluation study of the decision support system KANDID, significant variations were revealed in local epidemiology, local examination techniques, local preferred examination protocols, and local diagnostic criteria among seven European EMG laboratories. A clinical network of eight Electromyographic (EMG) centers has, due to this study, harmonized terminology and the interpretation of EMG examinations. The ESTEEM project has, based on these specifications, developed the EMG-Platform for the local data acquisition, storage, interpretation, and telecommunication between the clinical ESTEEM centers. On this basis, a medical audit and consensus process across Europe is being carried out on a daily basis. This process has shown an impact on diagnostic criteria within the clinical group. This study has illustrates informatics as a necessary prerequisite for the quality assurance of clinical EMG practice.

Computer Systems↗
PubMed1994

EPISTOL: the future of knowledge based systems and techniques for the health sector.

This paper reports on EPISTOL, a project set up to provide a perspective on how knowledge based systems are going to be used in the health sector 5-10 years from now, and how should this expected use influence the planning of research and development work up to that period. The results of the project are aimed to aid the planning of future programmes concerned with research and development in health telematics, namely the fourth Framework Programme of the Commission of the European Communities.

Artificial Intelligence↗
PubMed1994

ESTEEM (European Standardised Telematic Tool to Evaluate EMG Knowledge-Based Systems and Methods): AIM Project A2010.

ESTEEM is an AIM project which is primarily concerned with how to develop, integrate and clinically test knowledge-based systems for electromyography (EMG) in order to get them generally acceptable, useful and applicable into disseminated clinical routines. A medical workstation entitled the 'EMG-Platform' on which different kinds of application modules including KBSs can be interfaced to a kernel is being developed. Accordingly, an EMG communication protocol is being developed. The ESTEEM consortium is composed of a technical specialist group and a group of clinical experts in EMG from seven European countries. The last group has, besides extensive data collection for building up a multicentre EMG database, agreed on a common EMG terminology and a subsequent general EMG data set specification which covers the informatic needs for describing an EMG examination of different 'EMG schools'.

Electromyography↗
PubMed1994

A causal and temporal reasoning model and its use in drug therapy applications.

Superficial knowledge about drug effects and interactions may provide clinicians with only a limited support for the elaboration of therapy plans. Deeper knowledge of the mechanisms through which drugs produce their effects, together with their temporal constraints, should be modelled to predict the effects and interactions of their joint administration. The present paper describes a method for modelling such deep medical knowledge, together with its causal and temporal reasoning capabilities, and compares it with classical approaches to temporal and causal reasoning, namely in the context of drug treatment applications. This method extends a previous causal functional model by allowing the representation of quantitative knowledge, the explicit representation of time intervals, and a temporal reasoning technique, Simulation by Interval Constraining. The method is illustrated by a number of examples of basic drug metabolic mechanisms; and its future use in the development of decision support systems for complex drug therapy applications is discussed.

Artificial Intelligence↗
PubMedDate not supplied

Deep medical knowledge to design clinical guidelines.

Guideline-based care is becoming increasingly important given the surging costs and requirement for quality assessment of health care, and is likely to be a major application of knowledge-based technology into the health sector. Our preliminary experiences with implementing a paper-based guideline in a computer have shown problems that may prevent the dissemination and use by clinicians of the computer-based guideline. Based on these experiences, we propose that deep knowledge, often implicit in guidelines specification, is explicitly considered to provide more adequate support and thus promote its acceptability by clinicians.

Asthma↗