[Oscillating algorithm in medical diagnosis : alternation of flow-charts and diary programs]

26 programs of paraclinical tests for inpatients were written in diary form. Conditions of use were clearly defined with emphasis on optimal utilization of the first two or three days of the stay. Nine diaries are presented as examples. In order to reconcile various clinical, logical and economic requirements, the algorithm should oscillate between the flow-chart and the diary. For clinical evaluation, the flow-chart, completed by a health questionnaire, is satisfactory. But, for prescription of the first paraclinical tests, the diary appears more efficient under the specified conditions of use. The next step should then be a flow-chart, and so on. Flow-charts and diaries may be provided separately, each clinician having the possibility of alternating from one to the other, according to findings and local conditions.