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August 13, 1982

Action-Oriented Decisions in Ambulatory Medicine

JAMA. 1982;248(6):759. doi:10.1001/jama.1982.03330060083048

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In this era of computerized everything, numerous attempts have been made to organize the procedures of medical diagnosis and treatment into rational patterns variously called "protocols," "rules," or "algorithms." This book summarizes a five-year effort to do this for some relatively simple outpatient practices. According to the preface, the author's original purpose was to develop rules by which a computer could audit a medical record system to detect patient conditions that needed corrective actions and to ensure that all patients received exactly the care that was intended by the physician responsible. Thus, the book is about medical decision rules and practices.

In an introductory 14-page chapter and two appendices, there is discussion of decision theory as it applies to medical practice, but the other 300 pages of the book offer specific diagnostic and treatment algorithms dealing with such topics as the use of digitalis or antiarrhythmic drugs, testing for occult