Community Health Toolkit

Plain language clinical diagnostic algorithms for symptoms in those over 5-95

Now years ago I advocated for and co-created a portfolio of plain language clinical diagnostic algorithms for symptomatic patients over the age of 5 years. Female, male, acute, chronic, serious, self-limited. Endorsed by the Nepali Ministry of Health for its 6000 Community Health Assistants, all front-line workers. A 10% convenience sample of all Nepali CHWs showed only a 10-20% diagnostic accuracy when compared to clinical experts’ diagnoses. By contrast, after using the algorithms in preliminary and limited field trials, diagnostic agreement with senior Nepali physicians seeing the same panel of patients on the same day and blinded to what the algorithms diagnosed achieved agreement in over 90% of cases seen.
I have a PDF of an early version, mostly complete diagnostically, for sharing, completion, improvement and necessary adaptation to places outside Nepal where different disease spectra require modification of the algorithms to incorporate universal symptoms into specific diagnostic/disease entities.
Barry L Farkas MD MPH FAAFP

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