Clinical Flowcharts

Clinical Flowcharts

Refer to Medicine Today’s flowcharts, listed under topic areas, to help guide the diagnosis, investigation and management of various conditions. Flowcharts should be read in context of the article in which they are published. Access the full text pdf of these articles by clicking on the flowchart, or the article link in red.

Click on the topic areas below to access the flowcharts

Adolescent medicine
STI screening for adolescents and young people aged 15 to 29 years
Recommended steps for diagnostic evaluation of ASD
Andrology
An overview of managing patients with testicular cancer
Algorithm for semen analysis
Cardiovascular medicine
Diagnosis and assessment of lymphoedema
Managing chronic subdural haemorrhage
1. Investigation and management of a patient with suspected heart failure
2. HFrEF management algorithm
1. Diagnostic work up and management of suspected heart failure
2. Management of HFrEF
1. Diagnosis of pulmonary embolism (PE)
2. Diagnosis of deep vein thrombosis (DVT)
3. Choice of anticoagulant for proximal DVT or PE
4. Duration of anticoagulation for proximal VTE or PE
1. Chronic rate control of atrial fibrillation with rapid ventricular response
2. An approach to stroke prevention in atrial fibrillation
Proposed diagnostic algorithm based on risk stratification for women with troponin-negative chest pain
A suggested algorithm for the diagnostic work-up of patients with pulmonary hypertension
Management of giant cell arteritis
Suggested DCM screening pathway for asymptomatic patients with diabetes
Suggested algorithm for cascade testing for familial hypercholesterolaemia
Suggested primary care investigation and treatment of patients with OSA
Duration of anticoagulation for VTE
Management of patients with heart failure and reduced ejection fraction
An approach to diagnosing HFpEF
Angina and coronary artery diseses
Proposed diagnostic algorithm based on risk stratification for women with troponin-negative chest pain
Arrhythmias
1. Chronic rate control of atrial fibrillation with rapid ventricular response
2. An approach to stroke prevention in atrial fibrillation
Heart diseases
Proposed diagnostic algorithm based on risk stratification for women with troponin-negative chest pain
Heart failure and cardiomyopathy
1. Investigation and management of a patient with suspected heart failure
2. HFrEF management algorithm
1. Diagnostic work up and management of suspected heart failure
2. Management of HFrEF
Suggested DCM screening pathway for asymptomatic patients with diabetes
Management of patients with heart failure and reduced ejection fraction
An approach to diagnosing HFpEF
Hypertension
A suggested algorithm for the diagnostic work-up of patients with pulmonary hypertension
Lipid disorders
Suggested algorithm for cascade testing for familial hypercholesterolaemia
Duration of anticoagulation for VTE
Vascular diseases
Diagnosis and assessment of lymphoedema
Managing chronic subdural haemorrhage
1. Diagnosis of pulmonary embolism (PE)
2. Diagnosis of deep vein thrombosis (DVT)
3. Choice of anticoagulant for proximal DVT or PE
4. Duration of anticoagulation for proximal VTE or PE
Management of giant cell arteritis
Duration of anticoagulation for VTE
Clinical case reviews
An approach to management of a woman with missing intrauterine contraceptive (IUC) threads
An approach to investigating liver lesions
Dermatology
Investigating and managing a patient with vitiligo
A diagnostic approach to pruritus
Drug and alcohol medicine
1. Suggested diagnostic algorithm for FASD in patients aged 6 years or older
2. Suggested diagnostic algorithm for FASD in patients aged under 6 years
Suggested management of patients with regular use of over-the-counter (OTC) codeine
A suggested approach to screening all adult primary care patients for unhealthy alcohol use
Three-step brief advice for smoking cessation
Suggested approach to the assessment of nonviral liver disease
Ear, nose and throat medicine
1. Management of acute rhinosinusitis
2. Management of chronic rhinosinusitis
A suggested approach to managing vertigo in general practice
1. Recommended algorithm in the investigation of thyroid nodules in the general practice setting
2. Recommended options for management of thyroid nodule cytopathology in the general practice setting
Management algorithm for a patient presenting with epistaxis
1. Suggested assessment of patients with sudden hearing loss in general practice
2. Suggested management of patients with sudden sensorineural hearing loss
Stepwise approach to assessing and managing patients with unilateral nasal lesions
Emergency medicine
Suggested steps for the treatment of PTSD in emergency service workers
Management algorithm for a patient presenting with epistaxis
Endocrinology and metabolism
Suggested algorithm for the investigation and management of patients with pancreatic cystic lesions
Algorithm for thyroid hormone replacement in adults with subclinical hypothyroidism due to Hashimoto's thyroiditis
An algorithm for the identification and management of adults with iron deficiency
Management algorithm for osteoporosis risk in older people
2. Workup for suspected hypothyroidism in men and nonpregnant women
1. Management algorithm for diagnosis/evaluation of premature ovarian insufficiency (POI)
2. Management algorithm for premature ovarian insufficiency (POI)
Managing a patient with diabetic foot infection
Decision tree for commencing an SGLT-2 inhibitor
Decision tree for weight management and referral
Suggested DCM screening pathway for asymptomatic patients with diabetes
Screening and detection of prediabetes and diabetes
1. Suggested approach to diagnosing gout
2. Suggested approach to chronic gout management
1. Recommended algorithm in the investigation of thyroid nodules in the general practice setting
2. Recommended options for management of thyroid nodule cytopathology in the general practice setting
Suggested algorithm for cascade testing for familial hypercholesterolaemia
Assessment and management of patients with iron deficiency
Algorithm for semen analysis
Suggested approach to the assessment of nonviral liver disease
An approach to primary and secondary fracture prevention
An approach to managing comorbid depression in diabetes
Bone and mineral metabolism disorders
Management algorithm for osteoporosis risk in older people
1. Suggested approach to diagnosing gout
2. Suggested approach to chronic gout management
An approach to primary and secondary fracture prevention
Diabetes
Managing a patient with diabetic foot infection
Decision tree for commencing an SGLT-2 inhibitor
Suggested DCM screening pathway for asymptomatic patients with diabetes
An approach to managing comorbid depression in diabetes
Lipid metabolism disorders
Suggested algorithm for cascade testing for familial hypercholesterolaemia
Obesity
Decision tree for weight management and referral
Screening and detection of prediabetes and diabetes
Reproductive endocrinology
1. Workup for suspected hyperthyroidism in men and nonpregnant women
1. Management algorithm for diagnosis/evaluation of premature ovarian insufficiency (POI)
Algorithm for semen analysis
Thyroid gland disorders
Algorithm for thyroid hormone replacement in adults with subclinical hypothyroidism due to Hashimoto's thyroiditis
1. Workup for suspected hyperthyroidism in men and nonpregnant women
2. Workup for suspected hypothyroidism in men and nonpregnant women
1. Recommended algorithm in the investigation of thyroid nodules in the general practice setting
2. Recommended options for management of thyroid nodule cytopathology in the general practice setting
Gastroenterology
An algorithm for the identification and management of adults with iron deficiency
Management of gallbladder polyps
1. Simplified investigation and treatment algorithm for colonic adenocarcinoma
2. Simplified investigation and treatment algorithm for rectal adenocarcinoma
A suggested approach to diagnosing abdominal pain in a child
An approach to diagnosis, treatment and monitoring of eosinophilic oesophagitis (EoE)
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Follow-up care of patients after hepatitis C treatment with direct-acting antivirals
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Assessing patients with chronic diarrhoea
Assessment and management of unsettled or crying babies
Faecal immunochemical testing in colorectal cancer screening
An approach to the treatment of gastro-oesophageal reflux disease (GORD)
Evaluation and management of infants with GOR(D)
Assessment and management of patients with iron deficiency
Suggested approach to the assessment of nonviral liver disease
Suggested diagnostic pathway for coeliac disease
Key steps for assessing symptoms of dysphagia
Genetics
Suggested algorithm for cascade testing for familial hypercholesterolaemia
A guide to incorporating genetic screening as a part of preconception counselling
1. A proposed pathway for genetic testing for causes of epilepsy
2. An approach to considering whether genetic testing could be helpful
Geriatrics
Managing chronic subdural haemorrhage
Suggested algorithm for managing patients with neuropsychiatric symptoms associated with dementia
Management algorithm for osteoporosis risk in older people
Haematology
An algorithm for the identification and management of adults with iron deficiency
Assessment and management of patients with iron deficiency
Duration of anticoagulation for VTE
Hepatology
An approach to investigating liver lesions
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Follow-up care of patients after hepatitis C treatment with direct-acting antivirals
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Diagnostic approach to liver disorders during pregnancy
Suggested approach to the assessment of nonviral liver disease
Immunology and allergy
Diagnosis and management of mammalian meat allergy
Allergic diseases
Diagnosis and management of mammalian meat allergy
Autoimmune diseases
Algorithm for thyroid hormone replacement in adults with subclinical hypothyroidism due to Hashimoto's thyroiditis
Infectious diseases
Assessment and management of lactating women presenting with breast pain and possible mastitis
Three questions to consider when urethral symptoms persist or return
An approach to antibiotic treatment of acute uncomplicated bacterial cystitis in women
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Follow-up care of patients after hepatitis C treatment with direct-acting antivirals
1. Current postsplenectomy vaccination recommendations for adults with asplenia/hyposplenia not previously vaccinated
2. Current vaccination recommendations for patients after splenic artery embolisation
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Approach to influenza vaccination in patients with a history of Guillain-Barré syndrome
STI screening for adolescents and young people aged 15 to 29 years
Process for diagnosis and treatment of UTI in children
Vaccination
1. Current postsplenectomy vaccination recommendations for adults with asplenia/hyposplenia not previously vaccinated
2. Current vaccination recommendations for patients after splenic artery embolisation
Approach to influenza vaccination in patients with a history of Guillain-Barré syndrome
STI screening for adolescents and young people aged 15 to 29 years
Insect and marine animal bites and stings
Diagnosis and management of mammalian meat allergy
Men’s health
Three questions to consider when urethral symptoms persist or return
Princeton consensus treatment algorithm
Suggested management of men with erectile dysfunction not responsive to phosphodiesterase-5 inhibitor therapy
An overview of managing patients with testicular cancer
A guide to incorporating genetic screening as a part of preconception counselling
Algorithm for semen analysis
Neurology
Access to medicinal cannabis
Managing chronic subdural haemorrhage
Management algorithm for fibromyalgia in primary care
Suggested algorithm for managing patients with neuropsychiatric symptoms associated with dementia
A suggested approach to managing vertigo in general practice
Assessment and management of a child with DCD
Overview of migraine treatment
1. A proposed pathway for genetic testing for causes of epilepsy
2. An approach to considering whether genetic testing could be helpful
Nutrition
An algorithm for the identification and management of adults with iron deficiency
Decision tree for weight management and referral
Evaluation and management of infants with GOR(D)
Obstetrics and gynaecology
1. Suggested diagnostic algorithm for FASD in patients aged 6 years or older
2. Suggested diagnostic algorithm for FASD in patients aged under 6 years
An approach to management of a woman with missing intrauterine contraceptive (IUC) threads
Missed pill rules
Assessment and management of lactating women presenting with breast pain and possible mastitis
An approach to antibiotic treatment of acute uncomplicated bacterial cystitis in women
A suggested algorithm for selecting menopausal hormone therapy for postmenopausal women
1. Missed combined oral contraceptive pill
2. Missed progestogen-only contraceptive pill
Management of a woman with missing IUD threads
1. Management algorithm for diagnosis/evaluation of premature ovarian insufficiency (POI)
2. Management algorithm for premature ovarian insufficiency (POI)
A guide to contraceptive use for women aged 50 years and over
An approach to managing women with asymptomatic ovarian cysts detected on ultrasound
Diagnostic approach to liver disorders during pregnancy
Prescribing testosterone to postmenopausal women with hypoactive sexual desire disorder
The rules for missed combined hormonal and drospirenone-only contraceptive pills
Managing a missed drospirenone 4mg progestogen-only pill
A guide to incorporating genetic screening as a part of preconception counselling
Algorithm for semen analysis
Managing missed estetrol/drospirenone pills
Contraception
An approach to management of a woman with missing intrauterine contraceptive (IUC) threads
Missed pill rules
1. Missed combined oral contraceptive pill
2. Missed progestogen-only contraceptive pill
Management of a woman with missing IUD threads
A guide to contraceptive use for women aged 50 years and over
The rules for missed combined hormonal and drospirenone-only contraceptive pills
Managing a missed drospirenone 4mg progestogen-only pill
Managing missed estetrol/drospirenone pills
Menopause
A suggested algorithm for selecting menopausal hormone therapy for postmenopausal women
1. Management algorithm for diagnosis/evaluation of premature ovarian insufficiency (POI)
2. Management algorithm for premature ovarian insufficiency (POI)
Prescribing testosterone to postmenopausal women with hypoactive sexual desire disorder
Pregnancy
1. Suggested diagnostic algorithm for FASD in patients aged 6 years or older
2. Suggested diagnostic algorithm for FASD in patients aged under 6 years
Assessment and management of lactating women presenting with breast pain and possible mastitis
Diagnostic approach to liver disorders during pregnancy
A guide to incorporating genetic screening as a part of preconception counselling
Algorithm for semen analysis
Reproductive medicine
2. Management algorithm for premature ovarian insufficiency (POI)
A guide to incorporating genetic screening as a part of preconception counselling
Algorithm for semen analysis
Occupational health
Assessment and management of a child with DCD
Oncology
Diagnosis and assessment of lymphoedema
1. Simplified investigation and treatment algorithm for colonic adenocarcinoma
2. Simplified investigation and treatment algorithm for rectal adenocarcinoma
An approach to managing women with asymptomatic ovarian cysts detected on ultrasound
Faecal immunochemical testing in colorectal cancer screening
An overview of managing patients with testicular cancer
Stepwise approach to assessing and managing patients with unilateral nasal lesions
Ophthalmology
Management of giant cell arteritis
Paediatrics
1. Suggested diagnostic algorithm for FASD in patients aged 6 years or older
2. Suggested diagnostic algorithm for FASD in patients aged under 6 years
Assessment and management of lactating women presenting with breast pain and possible mastitis
A suggested approach to diagnosing abdominal pain in a child
Classification of the type and severity of nocturnal enuresis
Assessment and management of unsettled or crying babies
Recommended steps for diagnostic evaluation of ASD
Process for diagnosis and treatment of UTI in children
Assessment and management of a child with DCD
Evaluation and management of infants with GOR(D)
A guide to incorporating genetic screening as a part of preconception counselling
1. A proposed pathway for genetic testing for causes of epilepsy
2. An approach to considering whether genetic testing could be helpful
Pain medicine
Management of acute and chronic low back pain
Suggested management of patients with regular use of over-the-counter (OTC) codeine
Management algorithm for fibromyalgia in primary care
A suggested approach to diagnosing abdominal pain in a child
Management of giant cell arteritis
Assessment and management of unsettled or crying babies
Overview of migraine treatment
Diagnosing new persistent daily headache
Acute pain
Suggested management of patients with regular use of over-the-counter (OTC) codeine
Addiction and dependence
Suggested management of patients with regular use of over-the-counter (OTC) codeine
Chronic noncancer pain
Management algorithm for fibromyalgia in primary care
Headache and migraine
An approach to the diagnostic work up for aneurysmal subarachnoid haemorrhage as a cause of thunderclap headache
Overview of migraine treatment
Diagnosing new persistent daily headache
Paediatric pain management
A suggested approach to diagnosing abdominal pain in a child
Assessment and management of unsettled or crying babies
Pain medication
Management of acute and chronic low back pain
Suggested management of patients with regular use of over-the-counter (OTC) codeine
Overview of migraine treatment
Pharmacology and therapeutics
Access to medicinal cannabis
Management of acute and chronic low back pain
A suggested algorithm for selecting menopausal hormone therapy for postmenopausal women
Suggested management of patients with regular use of over-the-counter (OTC) codeine
Management of a woman with missing IUD threads
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Follow-up care of patients after hepatitis C treatment with direct-acting antivirals
1. Current postsplenectomy vaccination recommendations for adults with asplenia/hyposplenia not previously vaccinated
2. Current vaccination recommendations for patients after splenic artery embolisation
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Decision tree for commencing an SGLT-2 inhibitor
Decision tree for weight management and referral
Overview of migraine treatment
The rules for missed combined hormonal and drospirenone-only contraceptive pills
Managing a missed drospirenone 4mg progestogen-only pill
An approach to primary and secondary fracture prevention
Managing missed estetrol/drospirenone pills
Management of patients with heart failure and reduced ejection fraction
Podiatry
Managing a patient with diabetic foot infection
Psychiatry and psychology
Suggested algorithm for managing patients with neuropsychiatric symptoms associated with dementia
Suggested steps for the treatment of PTSD in emergency service workers
1. Holistic assessment protocol used in interpersonal psychotherapy
2. Interpersonal therapy as modular therapy
Approach to managing a patient in an acutely psychotic state in general practice
Recommended steps for diagnostic evaluation of ASD
An approach to managing comorbid depression in diabetes
Dementia
Suggested algorithm for managing patients with neuropsychiatric symptoms associated with dementia
Depression
1. Holistic assessment protocol used in interpersonal psychotherapy
2. Interpersonal therapy as modular therapy
An approach to managing comorbid depression in diabetes
Psychotic disorders
Approach to managing a patient in an acutely psychotic state in general practice
Public and environmental health
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Follow-up care of patients after hepatitis C treatment with direct-acting antivirals
Pathways to liver fibrosis assessment in primary care for patients with hepatitis C
Faecal immunochemical testing in colorectal cancer screening
Three-step brief advice for smoking cessation
Respiratory medicine
A suggested algorithm for the diagnostic work-up of patients with pulmonary hypertension
1. Management of acute rhinosinusitis
2. Management of chronic rhinosinusitis
1. Management of idiopathic pulmonary fibrosis
Classification of interstitial lung diseases
Suggested primary care investigation and treatment of patients with OSA
Rheumatology
Management of acute and chronic low back pain
Management algorithm for fibromyalgia in primary care
Management algorithm for osteoporosis risk in older people
Management of giant cell arteritis
1. Suggested approach to diagnosing gout
2. Suggested approach to chronic gout management
An approach to primary and secondary fracture prevention
Arthritis
1. Suggested approach to diagnosing gout
2. Suggested approach to chronic gout management
Sexual health
Three questions to consider when urethral symptoms persist or return
Princeton consensus treatment algorithm
Suggested management of men with erectile dysfunction not responsive to phosphodiesterase-5 inhibitor therapy
STI screening for adolescents and young people aged 15 to 29 years
Prescribing testosterone to postmenopausal women with hypoactive sexual desire disorder
Algorithm for semen analysis
Sports medicine
Assessing risk of acute mountain sickness (AMS) in intending travellers
Travel medicine
Assessing risk of acute mountain sickness (AMS) in intending travellers
Urology
Three questions to consider when urethral symptoms persist or return
An approach to antibiotic treatment of acute uncomplicated bacterial cystitis in women
Classification of the type and severity of nocturnal enuresis
Princeton consensus treatment algorithm
Suggested management of men with erectile dysfunction not responsive to phosphodiesterase-5 inhibitor therapy
Process for diagnosis and treatment of UTI in children
An overview of managing patients with testicular cancer
Women’s health
An approach to management of a woman with missing intrauterine contraceptive (IUC) threads
Missed pill rules
Assessment and management of lactating women presenting with breast pain and possible mastitis
An approach to antibiotic treatment of acute uncomplicated bacterial cystitis in women
A suggested algorithm for selecting menopausal hormone therapy for postmenopausal women
1. Missed combined oral contraceptive pill
2. Missed progestogen-only contraceptive pill
Management of a woman with missing IUD threads
1. Management algorithm for diagnosis/evaluation of premature ovarian insufficiency (POI)
2. Management algorithm for premature ovarian insufficiency (POI)
Proposed diagnostic algorithm based on risk stratification for women with troponin-negative chest pain
A guide to contraceptive use for women aged 50 years and over
An approach to managing women with asymptomatic ovarian cysts detected on ultrasound
Diagnostic approach to liver disorders during pregnancy
Prescribing testosterone to postmenopausal women with hypoactive sexual desire disorder
The rules for missed combined hormonal and drospirenone-only contraceptive pills
Managing a missed drospirenone 4mg progestogen-only pill
A guide to incorporating genetic screening as a part of preconception counselling
Managing missed estetrol/drospirenone pills