Re: [Gnumed-devel] Clinicians: indications, again

[Karsten Hilbert]

On Thu, Jun 17, 2010 at 02:12:11PM -0700, Jim Busser wrote:

> > I do appreciate your concern on precision but also maintain
> > that this is "pragmatically correct" in the sense of typical
> > clinical use, no ?
> 
> This argument is not an edge case... I would put it (from the North American 
> perspective) as upside down from what I am accustomed to:
> 
> your indication = what you are trying to prevent
>       vs
> my indication = what pre-existing condition justifies to use/do this
> 
> So while the ASA clinical outcome effects (purpose, end points) include
> 
>       reduce the rate of myocardial infarction
>       reduce the rate of (recurrent) transient ischemic brain attacks
> 
> we do not prescribe ASA for every individual... we may require
> 
>       history of myocardial infarction, TIA or stroke
>       high cardiovascular risk score
> 
> ... and it is the last-named above that I (and many colleagues) think of as 
> the "indication" ... the justification or "approval factor" for why to give 
> it. This is in distinction to  what is achieved as the desired outcome.
> 
> The corollary is the contra-indication. The contra-indication is the 
> pre-existing condition or risk group that makes you want to avoid giving 
> something. A history of egg allergy is a contra-indication. If a person 
> already has natural immunity (from previous infection) to Hepatitis A, they 
> do not have an indication (a justifiable reason) to give Hepatitis A vaccine. 

1) How *would* you name it ?

2) Observe the screenshots. Do they make sense ?

Karsten
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