Re: [Gnumed-devel] medical calculators

[Karsten Hilbert]

On Sun, Jun 15, 2008 at 09:05:17AM +0200, Hilbert, Sebastian wrote:

> Oscar has a list of webbased medical calculators. We could set those up at 
> gnumed.de with access from within GNUmed or might set them up as a local 
> webpage. I do think however the wxwidgets based web"browser" lacks javascript
> 
> http://www.oscarcanada.org/oscar-users/emr-resource/eform/eform-examples/calculators

I believe there's three places in our workflow where medical
"calculators" should come into play in a well-integrated GP
type system:

Tightly integrated

- a select few algorithms along the lines of BMI only
- there shouldn't even be a need to explicitely request it
  being calculated, simply entering the required data
  should calculate and display the score in an appropriate
  location

- integrate into GNUmed via dedicated code

integrated via external decision support tool

- a wide range of algorithms
- range of tests can change
- tightly quality controlled
- DSS gets patient data
- DSS calculates / generates suggestions according
  to its own internal rules and knowledge
- DSS delivers results to GNUmed for display
- user doesn't even need to know of the existence
  of a test/algorithm beforehand
- say, CHADS2, Wells, ...

- integrate into GNUmed via standard API (think EGADSS)

integrated as a spreadsheet-like form

- a medium range of tests
- think of MMS, Barthel index, Karnofsky index
- needed less often than, say, BMI but not
  need not easy to detect via external DSS
  (until archetypes take over data)

Accessible via external tool or web interface

- a wide range of algorithms
- range of tests can change
- may lack tightness of quality control
- may link more agile to external relevant resources
- to be accessed explicitely by the user
- less well integrated with GNUmed patient data:
  relevant input must be entered manually

- integrate via launching external browser from within GNUmed

The Oscar list can well inform of any known tests and should
be linked from the Clinical Organizing and Workflow topic.

Karsten
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