Clinical guidelines as part of a concept for total quality management. Analysis of heterogeneous treatment concepts of sepsis in various clinics withcomputer assisted generation, logical testing and complexity assessment ofclinical algorithms

Generation. local tailoring, implementation and evaluation of clinical guid elines is an integral part of quality management. Clinical guidelines are i ntimately related to the independency of physicians' decisions. By this the physicians should be responsible for guideline development and guarantee t he use of adequate methods of total quality management and outcome assessme nt. Formal consensus finding and transparency of evidence are necessary to guarantee the use of guidelines. Clinical algorithms are highly formalized and they are well suited for generation and analysis by the software ALGO. Determination of complexity and comparison of the clinical contents of algo rithms is done by the scores CASA (Clinical Algorithm Structural Analysis) and CAPA (Clinical Algorithm Patient Abstraction). In a study of 22 clinica l departments on treatment management concepts in sepsis following anastomo tic insufficiency in colorectal carcinoma a considerable heterogeneity was shown using this program.