Assessment and treatment algorithm for overweight and obesity

A medical algorithm is any

computation Computation is any type of arithmetic or non-arithmetic calculation that follows a well-defined model (e.g., an algorithm). Mechanical or electronic devices (or, historically, people) that perform computations are known as ''computers''. An es ...

formula In science, a formula is a concise way of expressing information symbolically, as in a mathematical formula or a ''chemical formula''. The informal use of the term ''formula'' in science refers to the general construct of a relationship betwee ...

statistical survey Survey methodology is "the study of survey methods". As a field of applied statistics concentrating on human-research surveys, survey methodology studies the sampling of individual units from a population and associated techniques of survey da ...

nomogram A nomogram (from Greek , "law" and , "line"), also called a nomograph, alignment chart, or abac, is a graphical calculating device, a two-dimensional diagram designed to allow the approximate graphical computation of a mathematical function. ...

, or look-up table, useful in

healthcare Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...

Medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...

algorithm In mathematics and computer science, an algorithm () is a finite sequence of rigorous instructions, typically used to solve a class of specific Computational problem, problems or to perform a computation. Algorithms are used as specificat ...

s include

decision tree A decision tree is a decision support tool that uses a tree-like model of decisions and their possible consequences, including chance event outcomes, resource costs, and utility. It is one way to display an algorithm that only contains condit ...

approaches to healthcare treatment (e.g., if

symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...

s A, B, and C are evident, then use treatment X) and also less clear-cut tools aimed at reducing or defining uncertainty. A

medical prescription A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historica ...

is also a type of medical algorithm.

Scope

Medical algorithms are part of a broader field which is usually fit under the aims of

medical informatics Health informatics is the field of science and engineering that aims at developing methods and technologies for the acquisition, processing, and study of patient data, which can come from different sources and modalities, such as electronic hea ...

and medical

decision-making In psychology, decision-making (also spelled decision making and decisionmaking) is regarded as the Cognition, cognitive process resulting in the selection of a belief or a course of action among several possible alternative options. It could be ...

. Medical decisions occur in several areas of medical activity including medical test selection,

diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...

, therapy and

prognosis Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stabl ...

, and

automatic control Automation describes a wide range of technologies that reduce human intervention in processes, namely by predetermining decision criteria, subprocess relationships, and related actions, as well as embodying those predeterminations in machines ...

medical equipment A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...

. In relation to

logic Logic is the study of correct reasoning. It includes both formal and informal logic. Formal logic is the science of deductively valid inferences or of logical truths. It is a formal science investigating how conclusions follow from premises ...

-based and

artificial neural network Artificial neural networks (ANNs), usually simply called neural networks (NNs) or neural nets, are computing systems inspired by the biological neural networks that constitute animal brains. An ANN is based on a collection of connected unit ...

-based

clinical decision support system A clinical decision support system (CDSS) is a health information technology, provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, to help health and health care. CDSS encompasses a variety of ...

s, which are also computer applications used in 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

calculation A calculation is a deliberate mathematical process that transforms one or more inputs into one or more outputs or ''results''. The term is used in a variety of senses, from the very definite arithmetical calculation of using an algorithm, to th ...

s to complex outcome

prediction A prediction (Latin ''præ-'', "before," and ''dicere'', "to say"), or forecast, is a statement about a future event or data. They are often, but not always, based upon experience or knowledge. There is no universal agreement about the exact ...

s. Most

clinician A clinician is a health care professional typically employed at a skilled nursing facility or clinic. Clinicians work directly with patients rather than in a laboratory or as a researcher. A clinician may diagnose, treat, and otherwise care for pa ...

s use only a small subset routinely. Examples of medical algorithms are: *

Calculators An electronic calculator is typically a portable electronic device used to perform calculations, ranging from basic arithmetic to complex mathematics. The first solid-state electronic calculator was created in the early 1960s. Pocket-size ...

, e.g. an on-line or stand-alone calculator for

body mass index Body mass index (BMI) is a value derived from the mass (weight) and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is expressed in units of kg/m2, resulting from mass in kilograms and he ...

(BMI) when stature and body weight are given; *

Flowcharts A flowchart is a type of diagram that represents a workflow or process. A flowchart can also be defined as a diagrammatic representation of an algorithm, a step-by-step approach to solving a task. The flowchart shows the steps as boxes of va ...

and drakon-charts, e.g. a binary

for deciding what is the

etiology Etiology (pronounced ; alternatively: aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek (''aitiología'') "giving a reason for" (, ''aitía'', "cause"); and ('' -logía''). More completely, e ...

chest pain Chest pain is pain or discomfort in the chest, typically the front of the chest. It may be described as sharp, dull, pressure, heaviness or squeezing. Associated symptoms may include pain in the shoulder, arm, upper abdomen, or jaw, along with n ...

* Look-up tables, e.g. for looking up

food energy Food energy is chemical energy that animals (including humans) derive from their food to sustain their metabolism, including their muscle, muscular activity. Most animals derive most of their energy from aerobic respiration, namely combining the ...

and nutritional contents of foodstuffs *

Nomogram A nomogram (from Greek , "law" and , "line"), also called a nomograph, alignment chart, or abac, is a graphical calculating device, a two-dimensional diagram designed to allow the approximate graphical computation of a mathematical function. ...

s, 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 The Texas Medication Algorithm Project (TMAP) 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 doct ...

or otherwise working on their production. A grammar—the

Arden syntax Arden syntax is a markup language used for representing and sharing medical knowledge. This clinical and scientific knowledge language is used in an executable format by clinical decision support systems to generate alerts, interpretations, and to ...

—exists for describing algorithms in terms of

medical logic module A medical logic module (MLM) 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. Possible usage is with an event monitor prog ...

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 decisions made in the delivery of

medical care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profess ...

. Medical algorithms assist in standardizing selection and application of treatment regimens, with algorithm

automation Automation describes a wide range of technologies that reduce human intervention in processes, namely by predetermining decision criteria, subprocess relationships, and related actions, as well as embodying those predeterminations in machines ...

intended to reduce potential introduction of errors. Some attempt to predict the outcome, for example critical care scoring systems. Computerized health diagnostics algorithms can provide timely clinical decision support, improve adherence to

evidence-based Evidence-based practice (EBP) is the idea that occupational practices ought to be based on scientific evidence. While seemingly obviously desirable, the proposal has been controversial, with some arguing that results may not specialize to indivi ...

guidelines A guideline is a statement by which to determine a course of action. A guideline aims to streamline particular processes according to a set routine or sound practice. Guidelines may be issued by and used by any organization (governmental or pri ...

, 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 Protocol may refer to: Sociology and politics * Protocol (politics), a formal agreement between nation states * Protocol (diplomacy), the etiquette of diplomacy and affairs of state * Etiquette, a code of personal behavior Science and technolog ...

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 is any type of arithmetic or non-arithmetic calculation that follows a well-defined model (e.g., an algorithm). Mechanical or electronic devices (or, historically, people) that perform computations are known as ''computers''. An es ...

s obtained from medical algorithms should be compared with, and tempered by, clinical knowledge and

physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

judgment.

Scope

Examples

Purpose

Cautions

See also

Further reading