The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. Create a link to share a read only version of this article with your colleagues and friends. Please read and accept the terms and conditions and check the box to generate a sharing link. Local tailoring of clinical practice guidelines CPGs requires experts in medicine and evidence synthesis unavailable in many practice settings.
The authors' computer-based system enables developers and users to create, disseminate, and tailor CPGs, using normative decision models DMs. ALCHEMIST'S interface enables remote users to tailor the guideline by changing underlying input variables and observing the new annotated algorithm that is developed automatically.
In a pilot evaluation of the system, a DM was used to evaluate strategies for staging non-small-cell lung cancer.
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The results demonstrate the feasibility of a web-based system that automatically analyzes a DM and creates a CPG as an annotated algorithm, enabling remote users to develop site-specific CPGs. The high usability and usefulness ratings suggest that such systems can be a good tool for guideline development. Key words: clinical practice guidelines; computer-based systems; normative decision models; guideline development. Med Decis Making ; Research off-campus without worrying about access issues. Find out about Lean Library here. Skip to main content. Medical Decision Making.
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How to cite this article If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Gillian D. Sanders, PhD , Robert F. Owens, MD, MSc. Download Citation If you have the appropriate software installed, you can download article citation data to the citation manager of your choice.
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Share Share. Recommend to a friend. Sharing links are not available for this article. I have read and accept the terms and conditions. Copy to clipboard. Sanders , PhD Gillian D. See all articles by this author Search Google Scholar for this author. Robert F. Nease, JR.
Douglas K. Article information. Article Information Volume: 20 issue: 2, page s : Sanders , PhD Robert F. Owens , MD, MSc. Abstract Abstract. Sign Out.
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Air pollution is also associated with the risk of cardiac arrest. The mechanism responsible for the majority of sudden cardiac deaths is ventricular fibrillation. Cardiac arrest is synonymous with clinical death. A cardiac arrest is usually diagnosed clinically by the absence of a pulse. In many cases lack of carotid pulse is the gold standard for diagnosing cardiac arrest, as lack of a pulse particularly in the peripheral pulses may result from other conditions e. Nonetheless, studies have shown that rescuers often make a mistake when checking the carotid pulse in an emergency, whether they are healthcare professionals  or lay persons.
Owing to the inaccuracy in this method of diagnosis, some bodies such as the European Resuscitation Council ERC have de-emphasised its importance.
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The Resuscitation Council UK , in line with the ERC's recommendations and those of the American Heart Association,  have suggested that the technique should be used only by healthcare professionals with specific training and expertise, and even then that it should be viewed in conjunction with other indicators such as agonal respiration. Various other methods for detecting circulation have been proposed. Guidelines following the International Liaison Committee on Resuscitation ILCOR recommendations were for rescuers to look for "signs of circulation", but not specifically the pulse.
Clinicians classify cardiac arrest into "shockable" versus "non—shockable", as determined by the ECG rhythm. This refers to whether a particular class of cardiac dysrhythmia is treatable using defibrillation. With positive outcomes following cardiac arrest unlikely, an effort has been spent in finding effective strategies to prevent cardiac arrest. With the prime causes of cardiac arrest being ischemic heart disease , efforts to promote a healthy diet , exercise , and smoking cessation are important. For people at risk of heart disease, measures such as blood pressure control, cholesterol lowering, and other medico-therapeutic interventions are used.
In medical parlance, cardiac arrest is referred to as a "code" or a "crash". This typically refers to "code blue" on the hospital emergency codes. A dramatic drop in vital sign measurements is referred to as "coding" or "crashing", though coding is usually used when it results in cardiac arrest, while crashing might not.
Treatment for cardiac arrest is sometimes referred to as "calling a code". People in general wards often deteriorate for several hours or even days before a cardiac arrest occurs. In response to this, many hospitals now have increased training for ward-based staff.