Re: [Gnumed-devel] measurement tooltip

[Jim Busser]

On 20-Jun-09, at 9:33 AM, Karsten Hilbert wrote:

Say:

normal range = 9.5-10

Result = 11

- result is 1.1 times the upper limit

- result deviates by 2 times the normal range

I like the concept of "times" the upper limit (or % of lower limit) (maybe % of mid-reference range) 

I have only ever seen *clinical* reference made to "times the upper limit".

I have never come upon a reference guideline clinical value for "deviates" as in the "delta"... clinically, I have only seen "times", for example with the assessment of incidentally elevated liver transaminases (AST, ALT), which some guidelines say should need to be sustained > 3 months at > 1.5x upper limit of normal to warrant chronic hepatitis testing:

http://www.bcguidelines.ca/gpac/guideline_liver.html#recommendation6

Postscripts:

1. Suggest leaving out "of normal" and simply say "upper limiti since, in some cases, we are talking a (therapeutic) "reference range" or (in patients in whom we have customized the values) we have set a "target range" (for example goal INR or, as the world gets obese or anorexic we may set a goal weight).

2. I would omit "deviates <x> times" unless it is made clearer and (ideally) some utility is referenced. I also suspect you are needing a deviation (delta) in your calculation, as you seem to be taking the midpoint (9.75) and expressing the elevated result (11) to be one and a fraction "times" the normal range and somehow concluding a "deviation" of ~ 1 + 1 = 2 times the normal range. You need a deviation (delta) in the calculation... and I think it will clutter the tooltip... but I do like "x upper limit" and agree it should be kept in.