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  1. Article ; Online: EBMonFHIR-based tools and initiatives to support clinical research.

    Alper, Brian S

    Journal of the American Medical Informatics Association : JAMIA

    2022  Volume 30, Issue 1, Page(s) 206–207

    MeSH term(s) Health Policy
    Language English
    Publishing date 2022-10-11
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1205156-1
    ISSN 1527-974X ; 1067-5027
    ISSN (online) 1527-974X
    ISSN 1067-5027
    DOI 10.1093/jamia/ocac193
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  2. Article ; Online: Reflections on defining a standard for computable expression of scientific knowledge: What teach us Yoda can.

    Alper, Brian S

    Learning health systems

    2022  Volume 7, Issue 1, Page(s) e10312

    Abstract: Science advances at a slow pace but can be accelerated with a standard for computable expression of scientific knowledge, more precisely a technical standard for electronic data exchange of machine-interpretable data expressing scientific knowledge. ... ...

    Abstract Science advances at a slow pace but can be accelerated with a standard for computable expression of scientific knowledge, more precisely a technical standard for electronic data exchange of machine-interpretable data expressing scientific knowledge. Efforts to achieve this vision include Evidence-Based Medicine on Fast Healthcare Interoperability Resources (EBMonFHIR), COVID-19 Knowledge Accelerator (COKA), Computable Publishing LLC, Scientific Knowledge Accelerator Foundation, and the Fast Evidence Interoperability Resources (FEvIR) Platform. The vision for communicating scientific research results to be instantly found, viewed, sent, received, and incorporated into thousands of system is a Just-in-time Evidence Dissemination and Integration (JEDI) vision. Reflections on JEDI teachings in a fun way helps explain the focus on the "Resource" to make science computable, how a precise specification of evidence changes perspectives, the need to reset standard terminologies, the inclusive nature of efforts to achieve the vision, and the critical demand to realize the vision.
    Language English
    Publishing date 2022-05-04
    Publishing country United States
    Document type Journal Article
    ISSN 2379-6146
    ISSN (online) 2379-6146
    DOI 10.1002/lrh2.10312
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  3. Article ; Online: Letter in reply to 'Evidence pyramids' from Dr Kaufmann.

    Alper, Brian S / Haynes, Brian R

    Evidence-based medicine

    2016  Volume 21, Issue 6, Page(s) 238–239

    Language English
    Publishing date 2016-12
    Publishing country England
    Document type Editorial
    ZDB-ID 1324346-9
    ISSN 1473-6810 ; 1356-5524
    ISSN (online) 1473-6810
    ISSN 1356-5524
    DOI 10.1136/ebmed-2016-110572
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    Zs.A 4793: Show issues Location:
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  4. Article ; Online: Striking a match between FHIR-based patient data and FHIR-based eligibility criteria.

    Alper, Brian S / Dehnbostel, Joanne / Shahin, Khalid / Ojha, Neeraj / Khanna, Gopal / Tignanelli, Christopher J

    Learning health systems

    2023  Volume 7, Issue 4, Page(s) e10368

    Abstract: Inputs and outputs: The Strike-a-Match Function, written in JavaScript version ES6+, accepts the input of two datasets (one dataset defining eligibility criteria for research studies or clinical decision support, and one dataset defining characteristics ...

    Abstract Inputs and outputs: The Strike-a-Match Function, written in JavaScript version ES6+, accepts the input of two datasets (one dataset defining eligibility criteria for research studies or clinical decision support, and one dataset defining characteristics for an individual patient). It returns an output signaling whether the patient characteristics are a match for the eligibility criteria.
    Purpose: Ultimately, such a system will play a "matchmaker" role in facilitating point-of-care recognition of patient-specific clinical decision support.
    Specifications: The eligibility criteria are defined in HL7 FHIR (version R5) EvidenceVariable Resource JSON structure. The patient characteristics are provided in an FHIR Bundle Resource JSON including one Patient Resource and one or more Observation and Condition Resources which could be obtained from the patient's electronic health record.
    Application: The Strike-a-Match Function determines whether or not the patient is a match to the eligibility criteria and an Eligibility Criteria Matching Software Demonstration interface provides a human-readable display of matching results by criteria for the clinician or patient to consider. This is the first software application, serving as proof of principle, that compares patient characteristics and eligibility criteria with all data exchanged using HL7 FHIR JSON. An Eligibility Criteria Matching Software Library at https://fevir.net/110192 provides a method for sharing functions using the same information model.
    Language English
    Publishing date 2023-04-18
    Publishing country United States
    Document type Journal Article
    ISSN 2379-6146
    ISSN (online) 2379-6146
    DOI 10.1002/lrh2.10368
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  5. Article ; Online: EBHC pyramid 5.0 for accessing preappraised evidence and guidance.

    Alper, Brian S / Haynes, R Brian

    Evidence-based medicine

    2016  Volume 21, Issue 4, Page(s) 123–125

    MeSH term(s) Evidence-Based Medicine ; Humans
    Language English
    Publishing date 2016
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1324346-9
    ISSN 1473-6810 ; 1356-5524
    ISSN (online) 1473-6810
    ISSN 1356-5524
    DOI 10.1136/ebmed-2016-110447
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  6. Article ; Online: Reply to 'Shaneyfelt T. Pyramids are guides not rules: the evolution of the evidence pyramid. Evid Based Med 2016;21:121-2'.

    Alper, Brian S / Haynes, R Brian

    Evidence-based medicine

    2016  Volume 21, Issue 5, Page(s) 200

    Language English
    Publishing date 2016
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1324346-9
    ISSN 1473-6810 ; 1356-5524
    ISSN (online) 1473-6810
    ISSN 1356-5524
    DOI 10.1136/ebmed-2016-110538
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  7. Article ; Online: Stroke Rate Variation and Anticoagulation Benefit in Atrial Fibrillation.

    Mayer, Martin / Alper, Brian S / Leff, Louis

    Annals of internal medicine

    2019  Volume 170, Issue 11, Page(s) 817–818

    MeSH term(s) Anticoagulants ; Atrial Fibrillation ; Humans ; Stroke
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2019-05-31
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/L19-0125
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  8. Article ; Online: Clinical Quality Measures: A Challenge for-and to-Family Physicians.

    Drabkin, Alan / Adler, Ronald N / Altman, Wayne / Ehrlich, Alan M / Agnoli, Alicia / Alper, Brian S

    Journal of the American Board of Family Medicine : JABFM

    2022  Volume 35, Issue 2, Page(s) 427–434

    Abstract: Introduction: Improving design, selection and implementation of appropriate clinical quality measures can reduce harms and costs of health care and improve the quality and experience of care delivery. These measures have not been evaluated for ... ...

    Abstract Introduction: Improving design, selection and implementation of appropriate clinical quality measures can reduce harms and costs of health care and improve the quality and experience of care delivery. These measures have not been evaluated for appropriateness for use in performance measurement in a systematic, reproducible, and widely accepted manner.
    Methods: We defined 10 criteria for evaluation of measure appropriateness in 4 domains: Patient-centeredness of outcomes, specification of population measured and measure detail, reliable evidence that benefits likely outweigh harms, and independence from significant confounders. We applied these criteria to 24 measures under consideration for statewide use in Massachusetts in public and private incentive-based programs. We appraised each measure as Appropriate or Not Appropriate for such use.
    Results: We rated 15 measures as Appropriate (62.5%). Three measures (12.5%) were considered Appropriate only if applied at a system level but not for patient-provider assessment and 6 measures (25%) were rated Not Appropriate. Reasons for designation as "Not Appropriate" included benefits not clearly outweighing harms, lack of preservation of patient autonomy, inappropriate specification of population and measure detail, confounding by locus of control, and confounding by social determinants of health.
    Conclusions: Using this consensus-driven, 10-criteria methodology we were able to evaluate appropriateness of clinical quality measures. This methodology may improve measure design and inform selection of the most appropriate measures for use in quality measurement, financial incentives, and reporting.
    MeSH term(s) Delivery of Health Care ; Humans ; Massachusetts ; Motivation ; Physicians, Family
    Language English
    Publishing date 2022-04-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2239939-2
    ISSN 1558-7118 ; 1557-2625
    ISSN (online) 1558-7118
    ISSN 1557-2625
    DOI 10.3122/jabfm.2022.02.210294
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  9. Article ; Online: Representation of evidence-based clinical practice guideline recommendations on FHIR.

    Lichtner, Gregor / Alper, Brian S / Jurth, Carlo / Spies, Claudia / Boeker, Martin / Meerpohl, Joerg J / von Dincklage, Falk

    Journal of biomedical informatics

    2023  Volume 139, Page(s) 104305

    Abstract: Background: Various formalisms have been developed to represent clinical practice guideline recommendations in a computer-interpretable way. However, none of the existing formalisms leverage the structured and computable information that emerge from the ...

    Abstract Background: Various formalisms have been developed to represent clinical practice guideline recommendations in a computer-interpretable way. However, none of the existing formalisms leverage the structured and computable information that emerge from the evidence-based guideline development process. Thus, we here propose a FHIR-based format that uses computer-interpretable representations of the knowledge artifacts that emerge during the process of evidence-based guideline development to directly serve as the basis of evidence-based recommendations.
    Methods: We identified the information required to represent evidence-based clinical practice guideline recommendations and reviewed the knowledge artifacts emerging during the evidence-based guideline development process. We then conducted a consensus-based design process with domain experts to develop an information model for guideline recommendation representation that is structurally aligned to the evidence-based guideline recommendation development process and a corresponding representation based on FHIR resources developed for evidence-based medicine (EBMonFHIR). The resulting recommendations were modelled and represented in conformance with the FHIR Clinical Guidelines (CPG-on-FHIR) implementation guide.
    Results: The information model of evidence-based clinical guideline recommendations and its EBMonFHIR-/CPG-on-FHIR-based representation contain the clinical contents of individual guideline recommendations, a set of metadata for the recommendations, the ratings for the recommendations (e.g., strength of recommendation, certainty of overall evidence), the ratings of certainty of evidence for individual outcomes (e.g., risk of bias) and links to the underlying evidence (systematic reviews based on primary studies). We created profiles and an implementation guide for all FHIR resources required to represent the knowledge artifacts generated during evidence-based guideline development and their re-use as the basis for recommendations and used the profiles to implement an exemplary clinical guideline recommendation.
    Conclusions: The FHIR implementation guide presented here can be used to directly link the evidence assessment process of evidence-based guideline recommendation development, i.e. systematic reviews and evidence grading, and the underlying evidence from primary studies to the resulting guideline recommendations. This not only allows the evidence on which recommendations are based on to be evaluated transparently and critically, but also enables guideline developers to leverage computable evidence in a more direct way to facilitate the generation of computer-interpretable guideline recommendations.
    MeSH term(s) Evidence-Based Medicine/methods ; Practice Guidelines as Topic
    Language English
    Publishing date 2023-02-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2057141-0
    ISSN 1532-0480 ; 1532-0464
    ISSN (online) 1532-0480
    ISSN 1532-0464
    DOI 10.1016/j.jbi.2023.104305
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  10. Article ; Online: It is time for computable evidence synthesis: The COVID-19 Knowledge Accelerator initiative.

    Alper, Brian S / Richardson, Joshua E / Lehmann, Harold P / Subbian, Vignesh

    Journal of the American Medical Informatics Association : JAMIA

    2020  Volume 27, Issue 8, Page(s) 1338–1339

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Evidence-Based Medicine ; Humans ; Information Dissemination ; Meta-Analysis as Topic ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-05-19
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1205156-1
    ISSN 1527-974X ; 1067-5027
    ISSN (online) 1527-974X
    ISSN 1067-5027
    DOI 10.1093/jamia/ocaa114
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