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This is not surprising. An algorithm essentially describes a 'central tendency' and is therefore irreversible in nature. It is impossible to apply an algorithm to individuals. All the EGFR algorithms suffer from this undisputable fallacy. In addition it separates the physician from the patient - diagnosis becomes a number. Aesculapius<https://en.wikipedia.org/wiki/Asclepius> and Hippocrates<https://en.wikipedia.org/wiki/Hippocrates> would turn in their tombs if he knew what is going on in the Queen's England! Anders Kallner, MD, PhD (R) Dept Clin Chem Karolinska University Hospital SE 176 71 Stockholm, SWEDEN Phone: +46 8 51774943 [log in to unmask] ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/