Apply v27 Changes

[brynrhodes]

Specifically for Recommendation 11:

Previous versions of the source diagram (in the pptx) incorrectly indicated prescribing both opioid and benzodiazepine; the logic is correctly implemented as an or, verify the functional description and diagram are correct as well.

Specifically for Recommendation 12:

Recommendation #12 Clinicians should offer or arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone in combination with behavioral therapies) for patients with opioid use disorder ** (recommendation category: A, evidence type: 2)

Current functional description, diagram, and logic allow for "medication-assisted treatment" or "behavioral therapies", where the intent of the recommendation is "medication-assisted treatment" and "behavioral therapies"

Update functional description and logic to reflect this change.

[brynrhodes]

Additional comments on changes in this version of the pptx:

In the recommendation 5 diagram a branch running from the condition “MME >=50?” to “stop” was removed

In the recommendation 5 table a legacy row for “Order for opioid analgesics with ambulatory misuse potential?” was removed

In the recommendation 11 table the “and” gate (green box) for the concurrent conditions “Order for opioid analgesics with ambulatory misuse potential?” and “Order for benzodiazepine medications?” was changed to an “or” gate

In the recommendation 12 table the “or” gate (green box) for the concurrent conditions “Order for buprenorphine or methadone medications in the past 90 days?” and “Order for or performance of substance misuse behavioral counseling?” was changed to an “and” gate

You will also find that as a product of our discussion this afternoon Floyd has made two more updates:

In the recommendation 12 diagram speckling representing configurability has been added around the green box “and” gate (“Do both conditions conclude true?”)

In the recommendation 12 table, a note has been added explaining that the “and” gate is configurable to allow flexibility in accommodating local implementation contexts.

[sliver007]

PowerPoint deck (v27): Recommendations ALL Slide Deck_v27.pptx

[brynrhodes]

Review this to see if it is still applicable

[c-schuler]

Confirmed logic and diagram for rec12 doesn't reflect the intent of the recommendation. Additionally, rec11 diagram also doesn't reflect the intent of the recommendation but the logic does.