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Complex Operational and Organizational Problems


Project Metadata Keywords
Label Name Other Year DurationYrs
Client International Psychopharmacology Algorithms Project (IPAP) none NonProfit
Dates 1996 18
Employer DOE Oak Ridge Facilities
Employer Hartley Consulting
Partner N/A
Pubs "Psychopharmacology Algorithm Development," Psychiatric Annals, Vol 35, No 11, Nov 2005 co-author 2005
Pubs Data Acquisition Instruments: Psychopharmacology, Y/DSRD-2097 author 1998
Pubs "Psychiatrist Prescribes O.R.," ORMS Today. Vol 34, No1, Feb 2007 co-author 2007
Team Matthew J. Friedman, Kenneth O. Jobson
Configuration management
Decision analysis
Legal issues
Psychopharmacology algorithms
Science, Math and Medicine
Software issues

The word "algorithm" can also be used to describe certain medical procedures. In this context, the algorithm is similar to a recipe, with ingredients and processes; however, it is the kind of recipe that specifies what to do under alternative conditions, e.g., cooking recipes that contain alternatives for high altitude cooking or ingredient substitutions. A medical algorithm may be used to describe a procedure or to prescribe a procedure. The algorithm may have a deterministic or a stochastic orientation, that is, emphasizing cause and effect or emphasizing the probabilities of various possible results or coincident conditions. An algorithm may also be presented as a time oriented flow or as an time- isolated procedure. Regardless of the variations in purpose or orientation, an algorithm is a succinct expression of the elements of the procedure and its language of expression should support the communication of the algorithm's meaning.

IPAP Algorithms

From 1993 to 1997 the International Psychopharmacology Algorithm Project (IPAP) worked to create a number of algorithms for the treatment of psychiatric disorders. The initial algorithms were created using versions of the Delphi method to elicit expert opinions to avoid any bias that might be created by dominant personalities or reputations. This approach was successful, but slow. In 1997, IPAP experimented with a web-based conference to create two algorithms, hoping to speed up the process. Although the overall results were positive, analysis of the process yielded a number of suggestions, which were reported in the literature (see 1998, Publications - External Review). Additionally, several improvements to algorithm presentation were suggested (1999, Publications - External Review). A version of these suggestions are on the webpage, The Language of Algorithms.

During the time from 1998 to 2002, IPAP held conferences or participated in conferences in several countries, notably in China and Japan. Both China and Japan decided to create national Psychopharmacology Algorithm Projects, CPAP and JPAP, respectively.

One of the flaws observed in the web conference was the difficulty making the connection of the algorithm to the best medical evidence. IPAP resolved to restructure the process, creating evidence-based algorithms, rather than expert-based algorithms. During 2004 and 2005, IPAP enlisted two groups of prominent psychiatrists to create flowchart algorithms for Schizophrenia and Post Traumatic Syndrome Disease (PTSD) (see 2005, Publications - External Review). Figures 1 and 2 illustrate these algorithms. The complete algorithms on the IPAP website include copious notes for each of the nodes and additional reference material, for the education of physicians.

Figure 1. Flowchart for the IPAP Schizophrenia algorithm

Figure 2. Flowchart for the IPAP PTSD algorithm

During 2006, IPAP has begun the process of creating a third evidence-based algorithm. This algorithm deals with Generalized Anxiety Disorder (GAD).

Figure 3. Flowchart for the IPAP GAD algorithm

The complete algorithm on the IPAP website include copious notes for each of the nodes and additional reference material, for the education of physicians.

In 2008, IPAP worked to create algorithms for addictions. The results are algorithms for Alcohol Dependency, Cocaine Dependency, Nicotine Dependency, and Opioid Dependency.

Figure 4. Flowchart for the IPAP Alcohol Dependency algorithm

Figure 5. Flowchart for the IPAP Cocaine Dependency algorithm

Figure 6. Flowchart for the IPAP Nicotine Dependency algorithm

Figure 7. Flowchart for the IPAP Opioid Dependency algorithm

The complete algorithms on the IPAP website include copious notes for each of the nodes and additional reference material, for the education of physicians.


These algorithms represent an ongoing effort by the psychiatric profession to improve the communication of knowledge regarding the treatment of mental disorders. The schizophrenia faculty is currently addressing new research to determine what, if any, impact it has on the schizophrenia algorithm. This effort is an indication that IPAP intends to maintain the currency of its algorithms.

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