Corlina J A Huibers1, Bastiaan T G M Sallevelt2, Dominique A de Groot3, Maarten J Boer4, Jos P C M van Campen5, Cathelijn J Davids5, Jacqueline G Hugtenburg6, Annemieke M A Vermeulen Windsant-Van den Tweel7, Hein P J van Hout3, Rob J van Marum3, Michiel C Meulendijk8. 1. Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: c.j.a.huibers-3@umcutrecht.nl. 2. Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands. 4. Medical Consultant, Expertdoc, Rotterdam, the Netherlands. 5. Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, the Netherlands. 6. Department of Clinical Pharmacology and Pharmacy, VU university Medical Center, Amsterdam, the Netherlands. 7. ZANOB, Hertogenbosch, the Netherlands. 8. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Abstract
BACKGROUND: The rapid digitalization of medical practice has attracted growing interest in developing software applications for clinical guidelines and explicit screening tools to detect potentially inappropriate prescribing, such as STOPP/START criteria. The aim of the current study was to develop and provide logically unambiguous algorithms of STOPP/START criteria version 2, encoded with international disease and medication classification codes, to facilitate the development of software applications for multiple purposes. METHODS: A four round multidisciplinary consensus and validation procedure was conducted to develop implementable coded algorithms for software applications of STOPP/START criteria version 2, based on ICD, ICPC, LOINC and ATC classification databases. RESULTS: Consensus was reached for all 34 START criteria and 76 out of 80 STOPP criteria. The resulting 110 algorithms, modeled as inference rules in decision tables, are provided as supplementary data. CONCLUSION: This is the first study providing implementable algorithms for software applications based on STOPP/START version 2, validated in a computer decision support system. These algorithms could serve as a template for applying STOPP/START criteria version 2 to any software application, allowing for adaptations of the included ICD, ICPC and ATC codes and changing the cut-off levels for laboratory measurements to match local guidelines or clinical expertise.
BACKGROUND: The rapid digitalization of medical practice has attracted growing interest in developing software applications for clinical guidelines and explicit screening tools to detect potentially inappropriate prescribing, such as STOPP/START criteria. The aim of the current study was to develop and provide logically unambiguous algorithms of STOPP/START criteria version 2, encoded with international disease and medication classification codes, to facilitate the development of software applications for multiple purposes. METHODS: A four round multidisciplinary consensus and validation procedure was conducted to develop implementable coded algorithms for software applications of STOPP/START criteria version 2, based on ICD, ICPC, LOINC and ATC classification databases. RESULTS: Consensus was reached for all 34 START criteria and 76 out of 80 STOPP criteria. The resulting 110 algorithms, modeled as inference rules in decision tables, are provided as supplementary data. CONCLUSION: This is the first study providing implementable algorithms for software applications based on STOPP/START version 2, validated in a computer decision support system. These algorithms could serve as a template for applying STOPP/START criteria version 2 to any software application, allowing for adaptations of the included ICD, ICPC and ATC codes and changing the cut-off levels for laboratory measurements to match local guidelines or clinical expertise.
Keywords:
Algorithm; Computer decision support system; Explicit screening tool; Inappropriate prescribing; International classification of medication and disease; START STOPP criteria
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Authors: Bastiaan T G M Sallevelt; Corlina J A Huibers; Jody M J Op Heij; Toine C G Egberts; Eugène P van Puijenbroek; Zhengru Shen; Marco R Spruit; Katharina Tabea Jungo; Nicolas Rodondi; Olivia Dalleur; Anne Spinewine; Emma Jennings; Denis O'Mahony; Ingeborg Wilting; Wilma Knol Journal: Drugs Aging Date: 2021-12-08 Impact factor: 3.923