Implementation and evaluation of practice guidelines.

Practice guidelines for the management of deep vein thrombosis were implemented in a Problem-Oriented Patient Management System on the HELP Hospital Information System at the LDS Hospital. A hierarchical knowledge representation was used. The Problem-Oriented Patient Management System was designed to generate patient-specific guideline suggestions according to the clinical situation at the time of generation. A retrospective evaluation was used to compare the appropriateness of the generated guideline suggestions to the appropriateness of the attending physician's management decisions. A significantly higher proportion of guideline suggestions was evaluated to be appropriate, compared to the proportion of attending physician's management decisions found to be appropriate.