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Introduction <p>The management of HIV patients is inherently complex, requiring the integration of evolving clinical guidelines such as GESIDA 2023. These guidelines are extensive and demand coordinated implementation by healthcare professionals with diverse expertise. These challenges highlight the need for strategies that facilitate their adoption and improve patient care. In this study, we evaluated the impact of digitalizing clinical guidelines for AIDS patients on the efficiency of the clinical workflow in the internal medical services at a secondary public hospital. For this, we developed HIV-matic, a software to automate the implementation of the Spanish clinical guideline (GESIDA) for HIV management.</p> Materials &amp; methods <p>The software codifies the guideline into a comprehensive set of 69 “if-then” rules within the CLIPS environment, including AIDS data, antiretroviral treatment recommendations, biochemistry data, comorbidities, and neoplasm screenings. These rules rely on 103 input variables, categorized into laboratory data from the Laboratory Information System (Gestlab), diagnostic data from the Hospital Information System (OrionClinic), and specific information compiled by the doctors through a structured questionnaire in the HIV-matic web interface. The clinical guideline digitalization was evaluated on a generated dataset of 191 prospective unique patient visits attended by clinical authors of the manuscript between 24/09/2024 and 20/12/2024. Evaluation metrics were calculated for rules and patients.</p> Results <p>When evaluating the rules, we observed a precision of 99,82%, a recall of 99,36%, a specificity of 99,96%, and an F1 score of 99,59% across the test dataset. Moreover, 87.43% of the evaluated patients received 100% correct messages.</p> Conclusions <p>The GESIDA, implemented as a computerized clinical guideline in the HIV-matic software, supports clinicians in decision-making with a high level of performance. Its modular design and seamless integration with existing systems in the hospital make it scalable and adaptable for broader deployments in the health service for HIV patients.</p>

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High effectiveness of the digitalization of the GESIDA clinical guideline for HIV patient management

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月25日

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  • Víctor Montosa-i-Micó,
  • Cecilia Tortajada,
  • Álvaro Navarro Batet,
  • Raquel Alcalde Castillo,
  • Miguel Camacho,
  • David Rosello Perez,
  • Daniel Sánchez García,
  • Juan M. García-Gómez

摘要

Introduction

The management of HIV patients is inherently complex, requiring the integration of evolving clinical guidelines such as GESIDA 2023. These guidelines are extensive and demand coordinated implementation by healthcare professionals with diverse expertise. These challenges highlight the need for strategies that facilitate their adoption and improve patient care. In this study, we evaluated the impact of digitalizing clinical guidelines for AIDS patients on the efficiency of the clinical workflow in the internal medical services at a secondary public hospital. For this, we developed HIV-matic, a software to automate the implementation of the Spanish clinical guideline (GESIDA) for HIV management.

Materials & methods

The software codifies the guideline into a comprehensive set of 69 “if-then” rules within the CLIPS environment, including AIDS data, antiretroviral treatment recommendations, biochemistry data, comorbidities, and neoplasm screenings. These rules rely on 103 input variables, categorized into laboratory data from the Laboratory Information System (Gestlab), diagnostic data from the Hospital Information System (OrionClinic), and specific information compiled by the doctors through a structured questionnaire in the HIV-matic web interface. The clinical guideline digitalization was evaluated on a generated dataset of 191 prospective unique patient visits attended by clinical authors of the manuscript between 24/09/2024 and 20/12/2024. Evaluation metrics were calculated for rules and patients.

Results

When evaluating the rules, we observed a precision of 99,82%, a recall of 99,36%, a specificity of 99,96%, and an F1 score of 99,59% across the test dataset. Moreover, 87.43% of the evaluated patients received 100% correct messages.

Conclusions

The GESIDA, implemented as a computerized clinical guideline in the HIV-matic software, supports clinicians in decision-making with a high level of performance. Its modular design and seamless integration with existing systems in the hospital make it scalable and adaptable for broader deployments in the health service for HIV patients.