Medical algorithm
Encyclopedia
A medical algorithm is any computation
, formula
, statistical survey
, nomogram
, or look-up table, useful in healthcare. Medical algorithm
s include decision tree
approaches to healthcare treatment (i.e., if symptom
s A, B, and C are evident, then use treatment X) and also less clear-cut tools aimed at reducing or defining uncertainty.
, therapy and prognosis
, and automatic control
of medical equipment
.
In relation to logic
-based and artificial neural network
-based clinical decision support system
, which are also computer applications to the medical decision making field, algorithms are less complex in architecture, data structure and user interface. Medical algorithms are not necessarily implemented using digital computers. In fact, many of them can be represented on paper, in the form of diagrams, nomographs, etc.
s to complex outcome prediction
s. Most clinicians use only a small subset routinely.
Examples of medical algorithms are:
A common class of algorithms are embedded in guidelines on the choice of treatments produced by many national, state, financial and local healthcare organisations and provided as knowledge resources for day to day use and for induction of new physicians. A field which has gained particular attention is the choice of medications for psychiatric conditions. In the United Kingdom guidelines or algorithms for this have been produced by most of the circa 500 primary care trusts, substantially all of the circa 100 secondary care psychiatric units and many of the circa 10 000 general practices. In the US there is a national (federal) initiative to provide them for all states, and by 2005 six states were adapting the approach of the Texas Medication Algorithm Project
or otherwise working on their production.
A grammar - the Arden syntax
- exists for describing algorithms in terms of medical logic module
s. An approach such as this should allow exchange of MLMs between doctors and establishments, and enrichment of the common stock of tools.
made in the delivery of medical care. Medical algorithms assist in standardizing selection and application of treatment regimens, with algorithm automation
intended to reduce potential introduction of errors. Some attempt to predict the outcome, for example critical care scoring systems
.
Computerized algorithms can provide timely clinical decision support, improve adherence to evidence-based
guidelines
, and be a resource for education and research.
Medical algorithms based on best practice can assist everyone involved in delivery of standardized treatment via a wide range of clinical care providers. Many are presented as protocol
s and it is a key task in training to ensure people step outside the protocol when necessary. In our present state of knowledge, generating hints and producing guidelines may be less satisfying to the authors, but more appropriate.
Computation
s obtained from medical algorithms should be compared with, and tempered by, clinical knowledge and physician
judgment.
Computation
Computation is defined as any type of calculation. Also defined as use of computer technology in Information processing.Computation is a process following a well-defined model understood and expressed in an algorithm, protocol, network topology, etc...
, formula
Formula
In mathematics, a formula is an entity constructed using the symbols and formation rules of a given logical language....
, statistical survey
Statistical survey
Survey methodology is the field that studies surveys, that is, the sample of individuals from a population with a view towards making statistical inferences about the population using the sample. Polls about public opinion, such as political beliefs, are reported in the news media in democracies....
, nomogram
Nomogram
A nomogram, nomograph, or abac is a graphical calculating device developed by P.E. Elyasberg, a two-dimensional diagram designed to allow the approximate graphical computation of a function: it uses a coordinate system other than Cartesian coordinates...
, or look-up table, useful in healthcare. Medical algorithm
Algorithm
In mathematics and computer science, an algorithm is an effective method expressed as a finite list of well-defined instructions for calculating a function. Algorithms are used for calculation, data processing, and automated reasoning...
s include decision tree
Decision tree
A decision tree is a decision support tool that uses a tree-like graph or model of decisions and their possible consequences, including chance event outcomes, resource costs, and utility. It is one way to display an algorithm. Decision trees are commonly used in operations research, specifically...
approaches to healthcare treatment (i.e., if symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s A, B, and C are evident, then use treatment X) and also less clear-cut tools aimed at reducing or defining uncertainty.
Scope
Medical algorithms are part of a broader field which is usually fit under the aims of medical informatics and medical decision making. Medical decisions occur in several areas of medical activity including medical test selection, diagnosisDiagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, therapy and prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
, and automatic control
Automatic control
Automatic control is the application of concepts derived from the research area of modern control theory. Automatic control is also a technology for application of control strategies. The implementing requires prior of analyzing and modeling of the subject to be controlled...
of medical equipment
Medical equipment
Medical equipment is designed to aid in the diagnosis, monitoring or treatment of medical conditions.-Types:There are several basic types:* Diagnostic equipment includes medical imaging machines, used to aid in diagnosis...
.
In relation to logic
Logic
In philosophy, Logic is the formal systematic study of the principles of valid inference and correct reasoning. Logic is used in most intellectual activities, but is studied primarily in the disciplines of philosophy, mathematics, semantics, and computer science...
-based and artificial neural network
Artificial neural network
An artificial neural network , usually called neural network , is a mathematical model or computational model that is inspired by the structure and/or functional aspects of biological neural networks. A neural network consists of an interconnected group of artificial neurons, and it processes...
-based clinical decision support system
Clinical decision support system
Clinical decision support system is an interactive decision support system Computer Software, which is designed to assist physicians and other health professionals with decision making tasks, as determining diagnosis of patient data. A working definition has been proposed by Dr...
, which are also computer applications to the medical decision making field, algorithms are less complex in architecture, data structure and user interface. Medical algorithms are not necessarily implemented using digital computers. In fact, many of them can be represented on paper, in the form of diagrams, nomographs, etc.
Examples
A wealth of medical information exists in the form of published medical algorithms. These algorithms range from simple calculationCalculation
A calculation is a deliberate process for transforming one or more inputs into one or more results, with variable change.The term is used in a variety of senses, from the very definite arithmetical calculation of using an algorithm to the vague heuristics of calculating a strategy in a competition...
s to complex outcome prediction
Prediction
A prediction or forecast is a statement about the way things will happen in the future, often but not always based on experience or knowledge...
s. Most clinicians use only a small subset routinely.
Examples of medical algorithms are:
- Calculators,. e.g., an on-line or stand-alone calculator for body mass indexBody mass indexThe body mass index , or Quetelet index, is a heuristic proxy for human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing...
(BMI) when stature and body weight are given; - Flowcharts, e.g., a binary decision treeDecision treeA decision tree is a decision support tool that uses a tree-like graph or model of decisions and their possible consequences, including chance event outcomes, resource costs, and utility. It is one way to display an algorithm. Decision trees are commonly used in operations research, specifically...
for deciding what is the etiologyEtiologyEtiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
of chest painChest painChest pain may be a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the pain is non-cardiac in origin, this is often a diagnosis of exclusion made after ruling out more serious causes of the pain.-Differential... - Look-up tables, e.g., for looking up food energyFood energyFood energy is the amount of energy obtained from food that is available through cellular respiration.Food energy is expressed in food calories or kilojoules...
and nutritional contents of foodstuffs - Nomographs, e.g., a moving circular slide to calculate body surface area or drug dosages.
A common class of algorithms are embedded in guidelines on the choice of treatments produced by many national, state, financial and local healthcare organisations and provided as knowledge resources for day to day use and for induction of new physicians. A field which has gained particular attention is the choice of medications for psychiatric conditions. In the United Kingdom guidelines or algorithms for this have been produced by most of the circa 500 primary care trusts, substantially all of the circa 100 secondary care psychiatric units and many of the circa 10 000 general practices. In the US there is a national (federal) initiative to provide them for all states, and by 2005 six states were adapting the approach of the Texas Medication Algorithm Project
Texas Medication Algorithm Project
The Texas Medication Algorithm Project is a decision-tree medical algorithm, the design of which was based on the expert opinions of mental health specialists. It has provided and rolled out a set of psychiatric management guidelines for doctors treating certain mental disorders within Texas'...
or otherwise working on their production.
A grammar - the Arden syntax
Arden Syntax
The Arden syntax is an artificial intelligence frame-based grammar for representing and processing medical conditions and recommendations as "Medical Logic Modules ", used in Medical algorithms....
- exists for describing algorithms in terms of medical logic module
Medical Logic Module
A medical logic module is an independent unit in a healthcare knowledge base that represents the knowledge published on a requirement for treating a patient according to a single medical decision....
s. An approach such as this should allow exchange of MLMs between doctors and establishments, and enrichment of the common stock of tools.
Purpose
The intended purpose of medical algorithms is to improve and standardize decisionsDecision making
Decision making can be regarded as the mental processes resulting in the selection of a course of action among several alternative scenarios. Every decision making process produces a final choice. The output can be an action or an opinion of choice.- Overview :Human performance in decision terms...
made in the delivery of medical care. Medical algorithms assist in standardizing selection and application of treatment regimens, with algorithm automation
Automation
Automation is the use of control systems and information technologies to reduce the need for human work in the production of goods and services. In the scope of industrialization, automation is a step beyond mechanization...
intended to reduce potential introduction of errors. Some attempt to predict the outcome, for example critical care scoring systems
ICU scoring systems
-Adult scoring systems:* APACHE II was designed to provide a morbidity score for a patient. It is useful to decide what kind of treatment or medicine is given...
.
Computerized algorithms can provide timely clinical decision support, improve adherence to evidence-based
Evidence-based medicine
Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...
guidelines
Guideline (medical)
A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare...
, and be a resource for education and research.
Medical algorithms based on best practice can assist everyone involved in delivery of standardized treatment via a wide range of clinical care providers. Many are presented as protocol
Clinical trial protocol
A clinical trial protocol is a document that describes the objective, design, methodology, statistical considerations, and organization of a clinical trial...
s and it is a key task in training to ensure people step outside the protocol when necessary. In our present state of knowledge, generating hints and producing guidelines may be less satisfying to the authors, but more appropriate.
Cautions
In common with most science and medicine, algorithms whose contents are not wholly available for scrutiny and open to improvement should be regarded with suspicion.Computation
Computation
Computation is defined as any type of calculation. Also defined as use of computer technology in Information processing.Computation is a process following a well-defined model understood and expressed in an algorithm, protocol, network topology, etc...
s obtained from medical algorithms should be compared with, and tempered by, clinical knowledge and physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
judgment.
See also
- Consensus (medical)Consensus (medical)Medical consensus is a public statement on a particular aspect of medical knowledge available at the time it was written, and that is generally agreed upon as the evidence-based, state-of-the-art knowledge by a representative group of experts in that area...
- Evidence-based medicineEvidence-based medicineEvidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...
- Guideline (medical)Guideline (medical)A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare...
- Journal ClubJournal clubA journal club is a group of individuals who meet regularly to critically evaluate recent articles in scientific literature. Journal clubs are usually organized around a defined subject in basic or applied research. For example, the application of evidence-based medicine to some area of medical...
- Medical decision making
- Medical informatics
- Odds algorithmOdds algorithmThe odds-algorithm is a mathematical method for computing optimalstrategies for a class of problems that belong to the domain of optimal stopping problems. Their solution follows from the odds-strategy, and the importance of the...
- Treatment Guidelines from The Medical LetterTreatment Guidelines from The Medical LetterTreatment Guidelines from The Medical Letter is published monthly by the non-profit organization The Medical Letter, Inc., which also publishes The Medical Letter on Drugs and Therapeutics. The journal provides reviews of drug classes for the treatment of most primary care disorders, such as...
External links
- AlternativeMentalHealth.com - 'Alternative Health Medical Evaluation Field Manual', Lorrin M. Koran, MD, Stanford UniversityStanford UniversityThe Leland Stanford Junior University, commonly referred to as Stanford University or Stanford, is a private research university on an campus located near Palo Alto, California. It is situated in the northwestern Santa Clara Valley on the San Francisco Peninsula, approximately northwest of San...
Medical Center (1991) - MedAl.org - 'The Medical Algorithms Project'
- NIH.gov - 'Automated Medical Algorithms: Issues for Medical Errors', Kathy A. Johnson, PhD, John R. Svirbely, MD, M. G. Sriram, PHD, Jack W. Smith, MD, PHD, Gareth Kantor, MD, and Jorge Raul Rodriguez, MD, Journal of the American Medical Informatics AssociationJournal of the American Medical Informatics AssociationThe Journal of the American Medical Informatics Association is a peer-reviewed scientific journal covering research in the field of medical informatics published by the American Medical Informatics Association....
- Regenstrief Institute
- MedFormula - a palm pilot based medical algorithm/calculator