FAQ

01. Is it necessary to introduce algorithms for diagnosis and treatment into medical practice? Until recently, innovations and discoveries in the medical field were progressively assimilated into practice through building up individual and collective experience. The rapid changes in the theory, procedures and technologies do no longer leave time for the new knowledge to settle and be assimilated progressively. We are often in the position to use new drugs, methods and technologies before having a clear idea or experience regarding older ones, which we have to abandon. The plethora of diagnostic and therapeutic options force the clinician to make choices, and these prove to be extremely difficult sometimes. Moreover, the advent of cutting-edge technologies in medicine have raised the costs of health care, imposing the rational use of resources available. These are only a few arguments in favour of the standardization of diagnostic and therapeutic practices, based on the medical evidence published in literature. Evidence-based medicine has become an essential concept for maximum efficiency of health care and its costs, correlated with the human, technological and financial resources available. 02. Is it worth reinventing the wheel? Would it not be easier to use algorithms already developed by others, more experienced than ourselves? Even if the development of algorithms starts from internationally accepted medical practice standards, practice guidelines must be in agreement with current medical practice in our cultural and geographical area, with its particular human, technological and financial resources, and must be validated by the users. In addition, the information in the database will represent and starting point of discussion and therefore will become a learning space for all factors involved, authors and users. 03. Will the algorithms developed here become mandatory for practice if validated by practitioners, the College of Physicians and the Health Insurance Houses? Our answer is no. Each algorithm represents the opinion of the expert or the team who elaborated it, a starting point and a reference for discussion and improvement. The dynamic nature of the Internet will make the database sensitive to the "market", therefore the algorithms will be modified according to the feedback from the medical practice and the evolutions in medical research. 04. What are the conditions required to make the introduction of diagnostic and therapeutic algorithms into my practice efficient? You are invited to explore this question yourselves, by answering the questions formulated by D.L. Sackett, W.S. Richardson, W. Rosenberg and R.B. Haines in Evidence-Based Medicine, Churchill-Livingstone, New York, 1997. - Are the recommendations in this guideline / algorithm valid? Were all important decision options and outcomes clearly specified? Was the evidence relevant to each decision option identified, validated and combined in a sensible and explicit way? Are the relative preferences that key stakeholders attach to the outcomes of decisions (including benefits, risks and costs) identified and explicitly considered? Is the guideline resistant to clinically sensible variations in practice? - Is this valid guideline or strategy potentially useful? Does this guideline offer an opportunity for significant improvement in the quality of health practice? Is there a large variation in current practice? Does the guideline contain new evidence (or old evidence not yet acted upon) that could have an important impact on management? Would the guideline affect the management of so many people, or concern individuals at such high risk, or involve such high costs that even small changes in practice could have major impacts on health outcomes or resources (including opportunity costs)? - Should this guideline or strategy be applied in your practice? What barriers exist to its implementation? Can they be overcome? Can you enlist the collaboration of key colleagues? Can you meet the educational, administrative and economic conditions that are likely to determine the success or failure of implementing the strategy? Credible synthesis of the evidence by a respected body Respected, influential local exemplars already implementing the strategy Consistent information from all relevant sources Opportunity for individual discussions about the strategy with an authority User-friendly format for guidelines Implementable within target group of clinicians (without the need for extensive collaboration) Freedom from conflict with economic incentives, administrative incentives, patient expectations and community expectations. 05. Can I also participate in the elaboration of algorithms / guidelines? Med-online is a database open to all collaborations. The only conditions required are: To have a university degree, Faculty or University of Medicine, or other health-care related specialties. To comply with the standards and formats of the Med-Online database as explained in the Instructions to authors (http://www.med-online.ro/eng/instructions.php). Please request the inclusion among the project participants by emailing the Project Coordinator or Secretary http://www.med-online.ro/eng/contact.php and attaching your CV. After acceptance you will receive a web-mail address on Med-Online.ro and the necessary space for your personal page.