Example XML for Plavix Indication

To write a guideline for recommending Plavix for patients between the ages of 45 and 75 of both genders who have any of the following conditions in the disease registry:

NSTEMI ACS – including those who are to be managed with percutaneous coronary intervention (with or without stent) or coronary artery bypass graft surgery (CABG), aspirin and clopidogrel for 12 months then aspirin monotherapy (see notes below)

STEMI ACS – as alternative to primary angioplasty, aspirin, clopidogrel and standard fibrinolytic therapy for 28 days, then aspirin monotherapy

IHD or PAD (ICD9 code 4438 & 414) with genuine aspirin intolerance and NO Atrial fibrillation – clopidogrel monotherapy (see notes below for genuine aspirin intolerance)

Atrial Fibrillation (ICD9 code 4273) with IHD, previous ischaemic cerebral infarction, diabetes, hypertension, valve disease or LVF

Drug eluting and other stents (DES) – aspirin and clopidogrel for twelve months, then aspirin monotherapy

Recurrent cerebral infarction (ICD9 code 4379) - In patients with recurrent cerebral infarction or TIA (ICD9 code 435) despite combined treatment with aspirin/dipyridamole, clopidogrel alone may be used on specialist recommendation only; there is little evidence to guide practice in these patients

Plavix ATC code B01AC04

Reference

<guideline title="Plavix Recommendation" evidence="IIb" significance="moderate">

   <conditions>

           <condition type="age" all="45 y - 75 y"/>

           <condition type="dxcodes" any="icd9:4438, icd9:414, icd9:4273, icd9:4379, icd9:435"/>

           <condition type="drugs" not="atc:B01AC04"/>

   </conditions>

   <consequence>

          <warning strength="recommendation">Consider Plavix to reduce ischemic events</warning>

          <warning strength="recommendation">http://new.oscarmanual.org/mydrugref/practice-guidelines/Clopidogrel_Guideline_East_Lancs_Nov_06.pdf/view</warning>

   </consequence>