I am not ashamed to say that I love algorithms. They say a picture is worth a thousand words, well an algorithm must be worth at least that.

Medical algorithms, flow diagrams, decision trees—whatever you choose to call them—are useful tools that can be used to support clinical decision making. They can be used to guide a range of clinical conundrums, such as diagnosis, assessment of risk, or the selection of appropriate treatments. Most healthcare professionals simply do not have time to read every piece of evidence, or every page of every clinical guideline (let alone whimsical editorials like this one), which is why algorithms can be so useful. Many guidelines include algorithms that summarise the key recommendations in a simple, quick, and easy-to-use format. This issue of Guidelines in Practice includes a number of algorithms designed to support clinical decisions.

The most recent update to the British guideline on the management of asthma, developed by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN), was published in July 2019. Dr Sinan Eccles discusses the revisions that are most relevant to primary care. The article covers how to conduct an in-depth review of a person’s asthma, indicators that can help to predict a patient’s risk of a future asthma attack, and updated recommendations about the pharmacological and non‑pharmacological management of asthma. Three useful algorithms from the BTS/SIGN guideline are included—a diagnostic algorithm, and algorithms that summarise the pharmacological management of asthma in adults and children. There is also a set of multiple-choice questions to test your knowledge after reading the article. 

I am sometimes tempted to create and use algorithms to guide challenging real-life decisions: what to have for tea, what to wear, and maybe even who to vote for. What do you think of algorithms? Do you find them a useful adjunct to clinical guidelines, or do you feel they risk oversimplifying important clinical decisions? I also love tables, but I’ll save that for another editorial.

Gemma Lambert, Editor