CLINICAL ALGORITHMS IN SEPSIS TRIALS - DISCUSSION

Algorithms have frequently been mistaken for the graphic format in whi ch they are presented. However, an algorithm is neither a flow chart n or a list of instructions; it is a step-by-step approach to solving a problem. Likewise, a clinical algorithm (CA) is a step-by-step approac h to solving a clinical problem. CAs are deterministic, which does not mean that they are rigid. They are practical rather than mathematical algorithms, that can be used only with clinical judgement, and must b e tailored to each patient. There are a number of types of, or uses fo r, CAs that can improve sepsis management, including: diagnostic or se verity score CAs; a management CA for managing sepsis, constructed acc ording to recently published standards for use in teaching; research p rotocol algorithms that must be used to collect data or guide implemen tation of a clinical trial aimed at validating one or more decisions i n the management CA; and finally, protocol-style CAs drawn from the ma nagement CA that should be validated using matching outcome studies.