The Best Website You're Not Going To

You know how midway through the new TV season the critics start their articles about the “best shows you’re not watching,” in some cases making a desperate plea for people to watch and increase the ratings for shows that really deserve to stay on the air? Well, a website by the name of Medal.org is one of the best medical Web resources most of you are not using. It’s kind of like TiVo: you may not really know it exists or exactly what it does, but once you have it for a week you don’t know how you ever lived without it.

What’s so Great About It?

It is an ongoing effort to create software implementations of useful healthcare algorithms, include documentation and references, and make both easily available to all interested. It saves people from going to numerous textbooks that they in all likelihood would not refer to as often as they should. The algorithms here have been collected from the peer-reviewed biomedical literature, including research journals and textbooks. The amount of work involved is mind boggling. The authors have stated their intention to create CDs and books based on the material from the website combined with additional material in the near future.

The website is the brain child of John Richard Svirbely, MD, and M. Sriram Iyengar, PhD. They came up with the idea when they were both working in medical informatics at Ohio Informatics. The site has 95,000 registered users, which means a lot of you are not aware of or already using the site. Registration is free, but until you register, you are limited to exploring one or two Algorithms.

So what exactly is there? Every medical algorithm and patient assessment form that isn’t copyrighted. As if that weren’t enough, you can download them as is or in Excel format so that you can manipulate them as you please or even incorporate them into your practice management software. Many of the algorithms can be taken online and scored as well.

Right now the site gets about 21,000 hits per day with 2,000 unique sessions. It is grossly underutilized for what it is offering. The honest truth is I wouldn’t have found it myself if I wasn’t embarking on a very large research project that required me to look up various scales. Medal.org comes up as number one on Google searches with numerous key words; they do not pay any money to Google, nor do they advertise.

The 400 online calculators are broken down by specialty and include things like coma scales, metal status exams, stroke assessment, adult respiratory distress syndrome following trauma, PRISM scores, iron deficiency and related anemia scales, myelodysplastic syndromes scales, febrile seizures in children, and on and on. Scales from every single specialty: 400 of them! When you click on one, you can read it, download the Excel sheet, click on the “online algorithm,” which allows it to be scored right there as well, then click “reference source.” On the “contents by specialty” side, you click and every specialty is listed, even specialties such as dentistry, pharmacology, and toxicology. When you click on your specialty, you will see diagnostic scales broken down by diagnosis as well as numerous formulas. For example, under “hematology formulas” for differentiating iron deficiency from thalessemia minor, to name just a few.

The site makes it very clear that the material at their website “is intended only for the educational and personal use of healthcare students and professionals. It is not intended for persons who have not received appropriate medical training, and should not be used for making clinical decisions pertaining to patient diagnosis, care, or management. Algorithms predicting outcomes use data based on the original articles. Outcomes may vary between institutions and are impacted by newer developments in diagnostics and therapeutics. These should be validated prior to use.” This project is entirely self-funded.

Their very ambitious goal is:

• to ensure accurate and reliable equations and algorithms,
• to provide adequate documentation with references to the original sources,
• to standardize data elements, to enable automation of input and output, and
• to index and link for quick access and retrieval.

Svirbely and Iyengar formed the Institute for Algorithmic Medicine (IAM), which is a non-profit corporation created to help carry out the goals of the Medical Algorithms Project. IAM owns the website and all its contents.

Some Background on its Founders

Svirbely is a physician board-certified in anatomic and clinical pathology who went on to do a fellowship in medical informatics. His partner, Iyengar, has a PhD in computer sciencs and a Masters degree in Statistics and Electrical Engineering.

Aside from their impressive credentials, they happen to be very nice and incredibly smart individuals who are still after all this time extremely enthusiastic about their project and are constantly looking for new ways to improve it. In the short time I spoke with them, they were extremely helpful in pointing me down the right path for my research project, and I know I will be visiting their site often, as well as telling everyone I know about it.

Now I am telling YOU. You really must go see what you have been missing.