Transcript PowerPoint ********* - Guidelines International Network

Guidelines International Network
Philadelphia, 2016
Plenary 3
Internet-Based Support for Guideline
Development, Maintenance, and
Adaptation in Japan; Current
Situation and Future Direction
Naohito Yamaguchi
Director, Minds Guideline Center, Japan Council for Quality Health Care,
Professor and Chair, Department of Public Health, School of Medicine, Tokyo
Women’s Medical University.
1
Disclosure of Interests (last 3 years)
Naohito Yamaguchi
I certify that, to the best of my knowledge, no aspect of my current personal or
professional situation might reasonably be expected to affect significantly my
views on the subject on which I am presenting, other than the following*:
Direct
Employment; Tokyo Women‘s Medical University
Executuve Board Memerby; Japan Council for Quality Health Care
Indirect
Academic Interest; Epidemiology and Public Health
Progress in Japan
• In 1999, the Ministry of Health, Labor and Welfare
decided to help develop 26 clinical practice
guidelines for diseases of large burden in Japan,
with grant-in-aid from the Ministry
• In 2002, the Japan Council for Quality Health Care,
non-profit third-party organization for quality
improvement in healthcare, launched the EBM
Promotion Project funded by the Ministry to
disseminate guidelines developed in Japan
EBM Promotion Project (Minds)
• Launched in 2002
• Website opened in 2004
http://minds.jcqhc.or.jp
Minds Website (2015-)
167 guidelines developed in Japan
22 guidelines translated into English
Guideline Development
Support
Brief History
2002
Format
Topic
Evidence
Synthesis
Procedure
2007
2014
Handbook 2007
Handbook 2014
Textbook with
extensive
citation
Clinical question
+
Recommendation
Clinical question
+
Recommendation
Standard
Knowledge
Standard
Knowledge
Key Clinical
Issues
Descriptive
Descriptive
• Systematic review
• Benefit-Harm
Balance
• COI Management
• Stakeholders
Involvement
Minds Handbook for CPG Development
2014
• Chapter 1:
Overview
• Chapter 2:
Preparation
• Chapter 3:
Scope
• Chapter 4:
Systematic Review
• Chapter 5:
Recommendations
• Chapter 6:
Finalization
• Chapter 7:
Dissemination, Implementation and
Assessment of Clinical Practice Guidelines
http://minds4.jcqhc.or.jp/minds/guideline/pdf/MindsHB2014.pdf
Proposed CPG Development Process
Guideline
Development
Group
Systematic
Review
Team
Guideline
Development
Group
Scoping
Systematic
Review
Formulation of
Recommendation
• Scoping search
• Clinical questions
• Outcome selection
•
•
•
•
Literature search
Risk of Bias
Certainty of evidence
Meta-analysis
• Consensus formation
• Patients’ preference
and value
Internet-based guideline editing tool:
GUIDE
• Templates of spread sheets and text files can
be downloaded to locally edit the content of
guideline.
• Locally edited files then can be uploaded to
make a draft file of guideline.
GUIDE Features
Systematic
Review
Scoping
Down
Formulation of
Recommendation
Up
GUIDE System
DRAFT
Text
file
Text
file
Text
file
Flexibility
• Guideline developers can select and arrange
filled templates to make a draft guideline.
• A part of filled templates can be selected to edit
ready-to-use practical and brief versions of
guideline in addition to detailed version with full
inclusion of systematic review results.
Proposed sets of templates to edit practical
version, brief version and version for the public
Modularization
• By modularized structure, any part of
guideline can be used, for example, to give
information for adaptation in other
guidelines with GUIDE templates.
Guideline Adaptation Using GUIDE
From Guideline A
Scoping
Down
From Guideline B
Adaptation
Up
GUIDE System
DRAFT
Formulation of
Recommendation
Standardization
• Database of structured CPGs can be used to
disseminate online with various search
options
Guideline A
Guideline B
CQサマリー
CQサマリー
CQ／目次項目
CQサマリー
CQ／目次項目
CQ CQ／目次項目
Summary
CQサマリー
CQサマリー
CQ／目次項目
CQサマリー
CQ／目次項目
CQ CQ／目次項目
Summary
CQサマリー
CQサマリー
CQ／目次項目
CQサマリー
CQ／目次項目
CQ CQ／目次項目
Summary
CQ
CQ
CQ
CQ
CQ
CQ
CQ
CQ
CQ
CQ
CQ
CQ
Clinical 推奨／会等
Question
推奨／会等
推奨／会等
Recommendation
推奨の強さ
推奨の強さ
推奨の強さ
Grade
Clinical 推奨／会等
Question
推奨／会等
推奨／会等
Recommendation
推奨の強さ
推奨の強さ
推奨の強さ
Grade
Guideline C
Clinical 推奨／会等
Question
推奨／会等
推奨／会等
Recommendation
推奨の強さ
推奨の強さ
推奨の強さ
Grade
解説
解説
解説
Explanation
解説
解説
解説
Explanation
解説
解説
解説
Explanation
Document of
CPG
Document of
CPG
Document of
CPG
CQ Search
・・・・・・・・・・
Minds Mobile
• For tablets and smartphones
• For practitioners to refer to guidelines at the site of care
• Search for a clinical question from guidelines database
One Possible Future Direction: Automation
by Artificial Intelligence (AI) techniques
• Literature Classification/Selection
• Article Review
• Personalized risk estimation
Automation
Literature
DB
Search
Scoping
Supervised
Machine
Learning
Search
Review
Systematic
Review
Data
Mining
Natural
Language
Processing
Formulation of
Recommendation
Personalized
Patient
BigData
Collaborators
Masahiro Yoshida
Akiko Okumura
Yosuke Hatakeyama
Yasuto Sato
And other Minds staff members
Thank You!