clinical-guideline-navigator

Clinical Practice Guideline Navigator

Search, navigate, and apply clinical practice guidelines from major professional organizations including AHA, ACC, ACP, IDSA, ADA, ACOG, and dozens more. This skill provides evidence-graded recommendations for common clinical scenarios, translating dense guideline documents into concise, actionable decision points at the point of care.

Quick Install

npx skills add Open-Medica/open-medical-skills --skill clinical-guideline-navigator

What It Does

• Multi-organization guideline search: Queries guidelines from AHA/ACC (cardiology), IDSA (infectious disease), ADA (diabetes), ACOG (obstetrics), ATS/IDSA (pulmonology), USPSTF (preventive), and other specialty societies through a unified interface
• Evidence grade surfacing: Displays the recommendation class (I, IIa, IIb, III) and level of evidence (A, B-R, B-NR, C-LD, C-EO) alongside each recommendation so clinicians can assess the strength of the underlying data
• Scenario-based retrieval: Accepts a clinical scenario description (e.g., "new diagnosis of HFrEF, EF 30%, NYHA Class III") and returns the relevant guideline recommendations without requiring the user to know which document to search
• Guideline comparison: When multiple societies have published guidelines on the same topic (e.g., hypertension management per AHA/ACC vs. ESC), highlights where recommendations converge and diverge
• Update tracking: Flags when guidelines have been superseded by newer publications or when focused updates have modified prior recommendations

Clinical Use Cases

• Hypertension treatment initiation: An internist evaluates a 52-year-old with newly diagnosed stage 1 hypertension and 10-year ASCVD risk of 12%. The skill retrieves 2017 ACC/AHA guidelines recommending pharmacotherapy for stage 1 HTN when 10-year risk exceeds 10%, and suggests thiazide diuretic, ACE inhibitor, ARB, or CCB as first-line options
• Antibiotic selection for CAP: An emergency physician admits a patient with community-acquired pneumonia. The skill pulls ATS/IDSA 2019 guidelines stratified by severity (outpatient vs. inpatient non-ICU vs. ICU) and MRSA/Pseudomonas risk factors to recommend the appropriate empiric regimen
• Diabetes management escalation: A primary care physician managing a patient whose A1C remains above target on metformin monotherapy receives guideline-concordant second-line agent recommendations from the ADA Standards of Care, stratified by comorbidities (established ASCVD, CKD, heart failure)
• Cancer screening intervals: A family physician queries age-appropriate cancer screening recommendations across USPSTF, ACS, and specialty society guidelines to build a personalized preventive care plan

Safety & Evidence

• Safety Classification: Safe — The skill surfaces published guideline recommendations without modification. It does not generate novel treatment advice or override clinical judgment. All recommendations are attributed to their source organization and publication date.
• Evidence Level: High — Content is derived directly from peer-reviewed clinical practice guidelines developed through systematic evidence review processes by recognized professional organizations. The skill preserves original evidence grading and recommendation classes.

Example Usage

Scenario-based guideline query:

Patient: 68-year-old with newly diagnosed heart failure, LVEF 25%, NYHA Class II
Currently on no cardiac medications
What does the guideline-directed medical therapy recommend?

AHA/ACC/HFSA 2022 Guideline Recommendations for HFrEF:

• ACEi/ARB/ARNI (Class I, LOE A): Initiate sacubitril/valsartan (preferred over ACEi/ARB in eligible patients) to reduce morbidity and mortality
• Beta-blocker (Class I, LOE A): Initiate carvedilol, metoprolol succinate, or bisoprolol once euvolemic
• Mineralocorticoid receptor antagonist (Class I, LOE A): Add spironolactone or eplerenone if eGFR >30 and K+ <5.0
• SGLT2 inhibitor (Class I, LOE A): Add dapagliflozin or empagliflozin regardless of diabetes status
• Titration: Uptitrate each agent to target dose as tolerated before adding the next pillar

Source: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure, J Am Coll Cardiol. 2022;79(17):e263-e421.

Guideline comparison:

Compare AHA/ACC and ESC recommendations for statin therapy
in primary prevention for patients aged 40-75 with LDL 130 mg/dL

AHA/ACC 2018: Calculate 10-year ASCVD risk. If 7.5-19.9% (borderline-intermediate), consider moderate-intensity statin; if >=20%, recommend high-intensity statin. Coronary artery calcium score can reclassify if uncertain (Class IIa). ESC 2021: Uses SCORE2 risk calculation. For moderate-risk patients (SCORE2 2.5-7.5% for age <50), target LDL <100 mg/dL. For high-risk patients, target LDL <70 mg/dL. Key divergence: AHA/ACC uses statin intensity categories while ESC uses LDL target-based approach. Both agree on the benefit of statin therapy in intermediate-to-high risk primary prevention.

Technical Details

• Category: Clinical Research Summarizing
• Author: OMS Contributors
• License: MIT
• Version: 1.0.0
• Specialty: All Specialties

References

• 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2022;79(17):e263-e421.
• 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension. 2018;71(6):e13-e115.
• Metlay JP, et al. "Diagnosis and Treatment of Adults with Community-Acquired Pneumonia: ATS/IDSA 2019." Am J Respir Crit Care Med. 2019;200(7):e45-e67.
• American Diabetes Association. Standards of Care in Diabetes (current year). Diabetes Care.
• USPSTF Recommendation Statements — uspreventiveservicestaskforce.org

---

This skill is part of Open Medical Skills, a curated marketplace of medical AI skills maintained by physicians for physicians and the healthcare industry.