The Clinical Usefulness of an Algorithm for the Interpretation of Biochemical Profiles with Hypercalcemia

Open Access
Publisher Website
Google Scholar
Abstract
A logical, systematic approach to the interpretation of diagnostic biochemical profiles in patients with hypercalcemia has been attempted through the use of algorithms (decision trees). A tentative algorithm (ALG-I) and an expanded and modified version (ALG-II) were compared for effectiveness in tests of 80 patients with hypercalcemia at Charity Hospital in New Orleans: The overwhelming majority (69%) of these patients had malignant disease. Comparative performance indicated that the modified algorithm (ALG-II) assigned the correct diagnostic categories in 66% of cases, compared with 53% for ALG-I, but the clinical performance of ALG-I improved (agreement rate of 60%) when it was assumed that patients with malignancy could have coexisting hyperparathyroidism or pseudohypoparathyroidism. The clinical trial indicated that both algorithms were fairly comparable and that their primary use would'be as teaching aids for medical students and residents to suggest various diagnostic possibilities for hypercalcemia in patients.