Medical algorithm

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  • In Europe a medical algorithm implemented in software such as an app is likely if made generally available or marketed to be regarded as a medical device
  • As of 2012 the FDA is consulting on a similar requirement

Contents

General

See also Medical Algorithm at Wikipedia

The Arden syntax is a grammar for expressing medical algorithms which is now part of HL7. Sophies and EMIS protocols in the UK allow GPs to implement and exchange algorithms in addition to any built into clinical record systems. No medical record system is complete without a scripting language and the ability for users to develop new algorithms.

Specific

Anticoagulation

Various look-up tables and at least one properly tested computer algorithm exist for calculating the best dose of Warfarin. The advantage they offer over guessing is that they take into account the individual variation in the particular patient. Improvements in the time in range have been demonstrated from use of a suitable algorithm.

Acute Abdominal Pain

A Health technology assessment was published in 2006. It concluded that "With their significantly greater specificity and lower false-positive rates than doctors, decision tools are potentially useful in confirming a diagnosis of acute appendicitis, but not in ruling it out." [1]

Appendicitis

The Alvarado Appendix Score This is largely unused. In use it had higher predictive power than junior surgeons. After use for some time, juniors' predictive power rose to match it.[1] It has been incorporated with ultrasound imaging[2][2][3][4][5][6]

CV Risk

The Framingham equations for cardiovascular risk overestimate risks in the UK. The reason remains unclear as of 2005. Framingham equations[7] QRISK has been recommended for UK practitioners in a recent editorial.[8]

Myocardial Infarction

The GRACE acute coronary syndrome risk model[9]

DVT

A modified Wells score calculator. These are in use to assist a decision on how to manage a swollen leg when the question of DVT has arisen.

eGFR

Main article: estimated Glomerular Filtration Rate includes links to web based calculaters for eCFR and eCrCl applicable to the U.K. population.

Measles

Algorithm for the public health management of cases and contacts of measles.
Algorithm for the public health management of cases and contacts of measles

Pancreatitis

Modified_Glasgow_score

Use of antivirals in influenza

See the HPA flowchart on when to prescribe oseltamivir for the prevention of influenza via here.

See also

External links

References

  1. Liu JL, Wyatt JC, Deeks JJ, Clamp S, Keen J, Verde P, et al. Systematic reviews of clinical decision tools for acute abdominal pain. Health technology assessment (Winchester, England) 2006;10:1-186.
  2. Adams ID, Chan M, Clifford PC, Cooke WM, Dallos V, de Dombal FT, Edwards MH, Hancock DM, Hewett DJ, McIntyre N, Somerville PG, Spiegelhalter DJ, Wellwood J, Wilson DH. Computer aided diagnosis of acute abdominal pain: a multicentre study. BMJ 1986;293:800-4.
  3. McAdam WAF, Brock BM, Armitage T, Davenport P, de Dombal FT. Twelve years experience of computer-aided diagnosis in a District General Hospital. Ann Roy. Coll. Surg 1990;72: 140-6
  4. Hoffmann J, Rasmussen OO. Aids in the diagnosis of acute appendicitis. British Journal of Surgery 1989;76(8):774-9.
  5. Douglas CD, Macpherson NE, Davidson PM, Gani JS. Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score. BMJ 2000;321:1-6
  6. de Dombal FT, Dallos V, McAdam WAF. Can computer aided teaching packages improve clinical care in patients with acute abdominal pain? BMJ 1991; 302:1495-1497
  7. Brindle P, Emberson J, Lampe F, Walker M, Whincup P, Fahey T et al. Predictive accuracy of the Framingham coronary risk score in British men: prospective cohort study. BMJ 2003;327:1267-70.
  8. Jackson R. Cardiovascular risk prediction: are we there yet? Heart 2008;94(1):1-3
  9. Fox KA, Dabbous OH, Goldberg RJ, Pieper KS, Eagle KA, Van de Werf F, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ (Clinical research ed.) 2006;333:1091. (Direct link – subscription may be required.)
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