Improvement of clinical practice guidelines based on the DRAKON medical language

• Vladimir D. Parondzhanov

Abstract

Aim – to develop a time-saving technology that allows to increase the productivity of both the development and study of clinical practice guidelines, to eliminate systemic defects in the clinical algorithms, to facilitate understanding, study and assimilation of algorithms and, on this basis, to offer a more advanced methodology for the development of clinical practice guidelines in the interests of practicing physicians.

Material and methods. In Russia, the DRAKON graphical medical language was created, designed to develop clinical algorithms in the form of ergonomic drawings (DRAKON-charts). Detailed information about the DRAKON medical language is given in the textbook ‘‘Clinical algorithmic medicine. Algorithms for diagnosis and treatment in the DRAKON medical language”. To increase the productivity of clinical guidelines developers, an automated workplace for the algorithm developer has been created. With these tools, 20 professional clinical algorithms of high accuracy have been developed and demonstrated in various fields of medicine: respiratory therapy, neurology and phthisiology.

Results. The time-saving technology has been developed that allows increasing the productivity of both the development and study of clinical practice guidelines. The technology contains the DRAKON medical language and the automated workplace for the doctor-developer of clinical practice guidelines (the DRAKON-builder program). The workplace serves not only for development, but also for study of the DRAKON language, and for the analysis of the algorithms created.

On the website of the Russian Ministry of Health, in the section “Rubricator of clinical practice guidelines”, systemic defects in the clinical algorithms were revealed. To eliminate the shortcomings, the method for developing clinical practice guidelines based on the DRAKON medical language is proposed. The concept of “medical algorithmic system” is introduced and a real algorithmic system containing 9 clinical algorithms is demonstrated. Its name is “Respiratory therapy for respiratory failure associated with COVID-19”. The use of the medical algorithmic system in the development of clinical practice guidelines is shown.

Conclusion. The time-saving technology based on the DRAKON medical language has been created, which makes it possible to increase the productivity of both the development and study of clinical practice guidelines. Clinical guidelines containing ergonomic algorithms of high accuracy acquire a new quality: they become ergonomic, convenient for studying, assimilating, analyzing, errors searching, checking and certifying. As a result, difficulties in implementing clinical guidelines in medical practice are eliminated or weakened.

Keywords: clinical practice guidelines; clinical algorithm; ergonomic algorithm of high accuracy; DRAKON medical language; DRAKON-builder; DRAKON-chart

References

1. Smorkalov A.Yu., Bochanova E.N., Gusev S.D., et al. Clinical algorithmic medicine. Algorithms of diagnosis and treatment in the DRAKON medical language: textbook. Moscow: RuScience, 2024: 536 p. ISBN: 978-5-466-07905-0. (in Russian).
2. Seven reviews from Doctors of Sciences on the textbook. URL: https://drakon.su/_media/0_shest_recenzij_dlja_sajta_pdf (date of access October 15, 2024). (in Russian)
3. Review of the Expert commission for work with educational publications. Minutes No. 074 dated November 16, 2023. URL: https://drakon.su/_media/grif_filippova_2420.pdf (date of access October 15, 2024). (in Russian)
4. Expert council on science of the Moscow Health Department: Minutes No. 10 of September 15, 2023. URL: https://bit.ly/3ZKk5Ol (date of access October 15, 2024). (in Russian)
5. Rubricator of clinical practice guidelines. Clinical practice guidelines. URL: https://cr.minzdrav.gov.ru/clin_recomend (date of access October 15, 2024). (in Russian)
6. Judicial chamber for civil cases of the Supreme Court of the Russian Federation. P. 11. URL: https://vsrf.ru/stor_pdf.php?id=2282598 (date of access October 15, 2024). (in Russian)
7. Global patient safety report 2024. Geneva: World Health Organization, 2024.
8. Poryadin G.V. Preface. Prospects for the development of medicine and medical education. In: V.D. Parondzhanov. Why doctors kill and cripple patients, or Why a doctor needs algorithm flowcharts? Illustrated algorithms for diagnosis and treatment are a promising way of medical development. Clinical thinking of high accuracy and patient safety. Moscow: DMK Press; 2017: 16–20. ISBN: 978-5-97060-422-9. (in Russian)
9. Clinical practice guidelines of the Ministry of Health of the Russia. Incisional ventral hernia. 2024. URL: https://cr.minzdrav.gov.ru/recomend/685_2 (date of access October 15, 2024). (in Russian)
10. Kazakov A.S., Zyryanov S.K., Ushkalova E.A. Clinical practice guidelines in the light of new legislation. RMZh [Russian Medical Journal]. 2020; (6): 15–9. (in Russian)
11. Andreeva I.V., Stetsyuk O.U., Egorova O.A. Clinical practice guidelines: what to know for a practicing doctor. RMZh [Russian Medical Journal]. 2020; (5): 21–5. (in Russian)
12. Rebrova O.Yu. On three ways of preparing clinical practice guidelines. ADAPTE and AGREE GRS tools. Problemy endokrinologii [Problems of Endocrinology]. 2019; 65 (3): 197–203. (in Russian)
13. Prialukhin I.A., Sheshko E.L., Seryapina Yu.V. et al. Proposals for medical guidelines creation at the time of digital transformation of healthcare in Russian Federation. Natsional’noe zdravookhranenie [National Health Care]. 2024; 5 (2): 36–47. DOI: https://doi.org/10.47093/2713-069X.2024.5.2.36-47 (in Russian)
14. Nadishauskene R.-Y. Afterword. Reviews of doctors of the Republic of Lithuania. In: V.D. Parondzhanov. Why doctors kill and cripple patients, or Why a doctor needs algorithm flowcharts? Illustrated algorithms for diagnosis and treatment are a promising way of medical development. Clinical thinking of high accuracy and patient safety. Moscow: DMK Press, 2017: 312–7. ISBN: 978-5-97060-422-9. (in Russian)
15. Conclusion of the Federal educational and methodological association for an enlarged group of specialties and directions of training «Clinical medicine» dated 28.02.2017 URL: https://drakon.su/_media/otvet_iz_minzdrava.pdf (date of access October 15, 2024). (in Russian)

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