Website Review |
The Medical Algorithms Project
www.medal.org
So what is an algorithm? Quite simply, it is a step-by-step method for solving a problem. And so this, the website of The Medical Algorithms Project, is a repository for >6000 medical algorithms which are ‘any step-by-step procedure, computation, formula, survey, or look-up table useful in healthcare’.
Entirely self-funded, it is managed by the Institute for Algorithmic Medicine, a ‘non-profit corporation’ created by J. Svirbely (MD), a clinical pathologist and M. G. Sriram (PhD), a health information scientist, both in the USA. From their brief curriculum vitae, also available on the site, it is clear that they have a special interest in computer science and medical informatics. The Project has a ‘Board of Advisers’ (including Prof. John Fox of Cancer Research UK) and ‘contributors and friends’, mostly from the USA but not exclusively; all are either doctors or scientists and educators in the field of medical/health informatics.
Access is free and straightforward, though you have to register (also free) for a user ID and password, which gives it and you security. Protection of your personal information is assured at registration. You also need Internet Explorer 4.1+ or Netscape 7.1+ and Windows 98 or later versions.
The >6000 algorithms, which have been collected from the peer-reviewed biomedical literature, including research journals and text books, are organized into 45 chapters (the ‘Table of Contents’ gives you the full list), on topics ranging from ‘Body Dimensions & Blood Values’ through all the major medical specialities to ‘Pharmacy Practice’ and even ‘Dental & Oral Medicine’. Of interest to the reader will be the two chapters on ‘Environmental Health’ and ‘Occupational Medicine & Disability Assessment’. I found the section on ‘Malingering’ (references include a general overview, The Emory Inconsistency Profile and Munchhausen Syndrome) particularly interesting. The algorithms are available as spreadsheets, which you can download, save and then use away from the site with data from individual patients or from groups in trend analysis or surveys. Forty algorithms are available as web-based forms. (The ones on pain and disability assessments would be particularly useful.)
Once registered and you open the chapter on ‘Occupational Medicine & Disability Assessment’, for example, you face a list of sub-headings on various topics arranged in a column on the left-hand side of the page (for example Hand-arm vibration syndrome, Low back injury and Spinal disorders), with various algorithms linked to each section in the right-hand column (such as Sensorineural stages in the hand-arm vibration syndrome or The Oswestry low back pain disability questionnaire.) If an algorithm appears as a link, click on it and run the corresponding spreadsheet. After running the spreadsheet if you click ‘Save’, it will save on your computer to be used again. Just when you thought this was enough, you find you get more. If you click on the ‘Info’ icon in the middle column you get ‘Algorithm References’, which is where the sources/references for the algorithms are to be found. These are short notes on the topic under consideration and would be a very useful revision tool for any practising occupational physician but, more importantly, for trainees just before an exam! As this is a US-based site many of the algorithms are American (the American Medical Association dominates), but not all. The downside? There are just too many algorithms to choose from (try disability assessment as a topic), though the one for occupational asthma, reactive airways disease syndrome as well as many others are very usable.
Under the ‘Terms of Use’ the creators clearly state that the ‘material is intended only for the educational and personal use of healthcare students and professionals’, and also that it ‘should not be used for making clinical decisions, but should be compared with and tempered by personal clinical knowledge’ of the patient. The site has ‘Discussion’ and ‘E-mail Us’ sections where new ideas, and comments on what is currently available, can be sent.
Would I use it? Yes, though probably not all that frequently (perhaps for a difficult case to try and quantify the clinical assessment). The site would be a useful source of questionnaires for group analysis and surveys. Plus there is a lot of useful revision material.
Overall score 3–4.
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