Clinical Guideline Authoring Tools: Exploring Features and Requirements

Abstract

The design, development, maintenance, and publication process of clinical guidelines is complex, time-consuming, and requires collaboration among different stakeholders. Complex guideline development, management and revision processes have led guideline development organisations to adopt software tools and content management systems. To comprehend stakeholders’ requirements, and address both the variability in guideline development processes adapted in organizations, and those suggested in guideline manuals by different organizations, this thesis investigates the features and functionalities for guideline development tools. The main motivation behind this thesis is to improve the efficiency, consistency and streamlining of the guideline authoring by information systems support. This thesis has three goals: exploring the authoring process and requirements, exploring the available tools supporting the authoring process, and exploring the extent published guidelines on the Web is usable. These overall goals will be pursued through the following three research questions: ▪ RQ1: What is the current state of practice in guideline organizations (the tools they use, and how the tools support authoring)? ▪ RQ2: What tools are used or proposed, and how do they support authoring? ▪ RQ3: How does presentation affect guideline usage? For data collection we have conducted several case studies, semi-structured interviews, and a literature review. In addition, we explored how the guideline presentation affects usage by conducting three usability evaluations of published guidelines on the Web. We also explored a group of representative authoring tools hands-on and an applied thematic analysis method for data analysis. The main contributions of this thesis are: C1 Identify challenges encountered by guideline authors in using tools for carrying out a collaborative authoring process. C2 Review the existing guideline manual and evaluate whether a set of guideline development tools are able to support the authoring process as suggested in guideline manual. C3 Review the existing tools and research prototypes that facilitate guideline development process. C4 Explored the extent guideline authoring tools have been evaluated by researchers, guideline organizations, or GL authors in literature C5 Explored users’ needs and evaluated the guideline users’ satisfaction, performance, efficiency, effectiveness, and learnability in using guideline websites. C6 Evaluated the usability of guideline websites and identified users’ needs.