Understanding Deviations from Clinical Practice Guidelines in Adult Soft Tissue Sarcoma

Esther Goldbraich, Zeev Waks, Ariel Farkash, Marco Monti, Michele Torresani, Rossella Bertulli, Paolo Giovanni Casali, Boaz Carmeli

Research output: Chapter in Book/Report/Conference proceedingConference contribution


In recent years we have witnessed the increasing adoption of clinical practice guidelines (CPGs) as decision support tools that guide medical treatment. As CPGs gain popularity, it has become evident that physicians frequently deviate from CPG recommendations, both erroneously and due to sound medical rationale. In this study we developed a methodology to computationally identify these deviation cases and understand their movitation. This was achieved using an integrated approach consisting of natural language processing, data modeling, and comparison methods to characterize deviations from CPG recommendations for 1431 adult soft tissue sarcoma patients. The results show that 48.9% of patient treatment programs deviate from CPG recommendations, with the largest deviation type being overtreatment, followed by differences in drug treatments. Interestingly, we identified over a dozen potential reasons for these deviations, with those directly related to the patients' cancer status being most abundant. These findings can be used to modify CPGs, increase adherence to CPG recommendations, reduce treatment cost, and potentially impact sarcoma care. Our approach can be applied to additional diseases that are subject to high deviation levels from CPGs.

Original languageEnglish
Title of host publicationStudies in Health Technology and Informatics
PublisherIOS Press
Number of pages5
ISBN (Print)9781614995630
Publication statusPublished - 2015
Event15th World Congress on Health and Biomedical Informatics, MEDINFO 2015 - Sao Paulo, Brazil
Duration: Aug 19 2015Aug 23 2015

Publication series

NameStudies in Health Technology and Informatics
ISSN (Print)09269630
ISSN (Electronic)18798365


Other15th World Congress on Health and Biomedical Informatics, MEDINFO 2015
CitySao Paulo


  • Decision Support Techniques [L01.700.508.190]
  • Natural Language Processing [L01.224.065.580]
  • Physician's Practice Patterns [N04.590.748]
  • Practice Guideline [V02.515.500]
  • Sarcoma [C04.557.450.795]

ASJC Scopus subject areas

  • Biomedical Engineering
  • Health Informatics
  • Health Information Management


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