Description:
<jats:p>Introduction: The use of Clinical Prediction Rules (CPRs) has been advocated as
one way of implementing actionable evidence-based rules in clinical practice. The
current highly manual nature of deriving CPRs makes them difficult to use and maintain.
Addressing the known limitations of CPRs requires implementing more flexible and dynamic
models of CPR development. We describe the application of Information and Communication
Technology (ICT) to provide a platform for the derivation and dissemination of CPRs
derived through analysis and continual learning from electronic patient data.Model
Components: We propose a multistep maturity model for constructing electronic and
computable CPRs (eCPRs). The model has six levels – from the lowest level of CPR
maturity (literaturebased CPRs) to a fully electronic and computable service-oriented
model of CPRs that are sensitive to specific demographic patient populations. We
describe examples of implementations of the core model components – focusing on CPR
representation, interoperability, electronic dissemination, CPR learning, and user
interface requirements.Conclusion: The traditional focus on derivation and narrow
validation of CPRs has severely limited their wider acceptance. The evolution and
maturity model described here outlines a progression toward eCPRs consistent with the
vision of a learning health system (LHS) – using central repositories of CPR knowledge,
accessible open standards, and generalizable models to avoid repetition of previous
work. This is useful for developing more ambitious strategies to address limitations of
the traditional CPR development life cycle. The model described here is a starting point
for promoting discussion about what a more dynamic CPR development process should look
like.</jats:p>