Analysis of a clinical process of schizophrenia and other psychoses with a process mining method

• Published in: European psychiatry Vol. 64; no. S1; p. S400
• Main Authors: Toscano, E. Rodríguez, Reneses, B., Pérez, S., Andrés, P., Seara, G., Sevilla, J., Cortés, A., Del Rey-Mejías, Á.
• Format: Journal Article
• Language: English
• Published: Paris Cambridge University Press 01.04.2021
• Subjects: Abstract; Clinical medicine; Clinical pathways; Clinical stage; E-Poster Presentation; Process mining method; Psychosis; Schizophrenia; schizophrénia
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1192/j.eurpsy.2021.1071

IntroductionClinical pathways (CPWs) are tools used to guide evidence-based healthcare. They translate clinical practice guideline recommendations into clinical processes of care within the characteristics of a healthcare institution. There are few studies about the impact of CPW in the field of Psychosis in terms of adequacy to their recommendations and clinical outcomes.ObjectivesPSYCHSTAGE project has been designed to study the adjustment of psychosis clinical care to a CPW based in a Clinical Practice Guideline according to a clinical staging model in a network of psychiatric services covering 580.000 inhabitants in a University Hospital in Madrid.MethodsRetrospective and observational study in a sample of 1780 subjects 18 years old or above, diagnosed with schizophrenia and other psychosis. Socio-demographic and clinical variables were collected from clinical records, including ICG, GAF and DAS at the time they were included in the study. Clinical stage was established according to McGorry model at the same time. CPW was analysed in 1,391 subjects with 15,254 care events using a Process mining method. Process discovery, process checking and process enhancement analysis have been used.ResultsPatients were grouped according the clinical stage. 9,2% were in stage 2; 18,5% in 3a; 47% in 3b; 22,1% in 3c and 4,1% in 4. A different CPW is represented for each clinical stage in routine practice. Then, every pathway is compared with the recommendations in the established Psychosis CPW.ConclusionsProcess mining can be a useful tool for the study of CPW in the field of psychosis