A database was constructed that facilitated the development of multiple interfaces for varying professionals. Content management is streamlined from a centralized location, also ensuring consistency of guidelines between medical practitioners and case managers and claims adjustors. DISCUSSION (CONCLUSION): This study demonstrates that delivery of treatment guideline recommendations in a decision support system is an effective dissemination strategy that can be tailored to the needs of users not necessarily trained in the interpretation and use of medical evidence. Combining this with an interface for physicians provides a mechanism that can improve the alignment between physician clinical decision-making and that of insurance professionals. TARGET AUDIENCE(S): 1. Guideline developer 2. Guideline implementer 3. Developer of guideline-based products 4. Health care policy analyst/policy-maker 5. Health insurance payers and purchasers

The case describes an 82-year-old right-handed Hispanic male with multiple chronic comorbidities complaining of upper and lower extremity weakness as well as paresthesias that had been worsening over the last two weeks. He had bilateral upper and lower extremity weakness that was worse on the right and he complained of not being able to walk on his own with several falls preceding admission because of this. There were no overt signs of spinal cord compression or cauda equina syndrome. Laboratory work-up was unremarkable with exception to mildly elevated acute phase reactants. Computed tomography (CT) and magnetic resonance (MR) imaging later showed critical cervical compressive myelopathy at the C3-C4 level and multiple parenchymal and extra-axial enhancing lesions in the frontal lobes with associated calcifications suspicious for neurocysticercosis. Antihelminthic therapy was started and the patient underwent spinal fusion surgery with neurosurgery with an uncomplicated postoperative course-also lacking seizure activity of any kind.