en
Scientific article
Open access
English

Digitalizing clinical guidelines : experiences in the development of clinical decision support algorithms for management of childhood illness in resource-constrained settings

Published inGlobal health science and practice, vol. 11, no. 4, e2200439
Publication date2023-08-28
First online date2023-08-28
Abstract

Clinical decision support systems (CDSSs) can strengthen the quality of integrated management of childhood illness (IMCI) in resource-constrained settings. Several IMCI-related CDSSs have been developed and implemented in recent years. Yet, despite having a shared starting point, the IMCI-related CDSSs are markedly varied due to the need for interpretation when translating narrative guidelines into decision logic combined with considerations of context and design choices. Between October 2019 and April 2021, we conducted a comparative analysis of 4 IMCI-related CDSSs. The extent of adaptations to IMCI varied, but common themes emerged. Scope was extended to cover a broader range of conditions. Content was added or modified to enhance precision, align with new evidence, and support rational resource use. Structure was modified to increase efficiency, improve usability, and prioritize care for severely ill children. The multistakeholder development processes involved syntheses of recommendations from existing guidelines and literature; creation and validation of clinical algorithms; and iterative development, implementation, and evaluation. The common themes surrounding adaptations of IMCI guidance highlight the complexities of digitalizing evidence-based recommendations and reinforce the rationale for leveraging standards for CDSS development, such as the World Health Organization's SMART Guidelines. Implementation through multistakeholder dialogue is critical to ensure CDSSs can effectively and equitably improve quality of care for children in resource-constrained settings.

eng
Keywords
  • Child
  • Humans
  • Decision Support Systems, Clinical
  • Algorithms
  • Ichthyosiform Erythroderma, Congenital
  • Lipid Metabolism, Inborn Errors
Citation (ISO format)
BEYNON, Fenella et al. Digitalizing clinical guidelines : experiences in the development of clinical decision support algorithms for management of childhood illness in resource-constrained settings. In: Global health science and practice, 2023, vol. 11, n° 4, p. e2200439. doi: 10.9745/GHSP-D-22-00439
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Article (Published version)
Identifiers
ISSN of the journal2169-575X
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Technical informations

Creation01/11/2024 9:54:41 AM
First validation03/12/2024 10:06:18 AM
Update time03/12/2024 10:06:18 AM
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