Re: [Gnumed-devel] Turtorials

[Eric MAEKER]

Le 4 juil. 2010 à 20:50, Karsten Hilbert <address@hidden> a  
écrit :

> On Sat, Jul 03, 2010 at 12:12:14PM +0200, Hilbert, Sebastian wrote:
>
> > > so we can start to think on How Tos for these issues.
> > Good idea. While one would think that the concept is trivial its
> > implementation in GNUmed *might* need a how-to description.
>
> I really like the idea of clinical how to's. If those were
> video that'd be perfect   *evil grin*
>
> > > - second this facilitates the job of doctors while browsing the  
> > > EMR -
> > > besides, acute diagnostics generally aren´t supposed to be that  
> > > precise ...
> > Hmm. Isn't a diagnosis always precise. It might be uncertain or  
> > wrong but
> > always precise. Everything else is findings instead of diagnosis I  
> > guess.
>
> While it is correct that a diagnosis is precise by
> definition we (in primary care) do not actually find the
> diagnosis of the current complaint in many patients (also,
> many times there will not really be one as the chief
> complaint is a Befindlichkeitsstörung rather than true
> illness).
>
> What Rogerio is likely referring to is what we already
> formalized as
>
> A "Sign"
> B "Cluster of signs"
> C "Syndromic diagnosis"
> D "Scientific diagnosis"

SOAP is the key ! It is fully i18n and understand by all practitioner.
S subjective
O objective
A assessment
P plan

> IOW, we don't just realize that we don't know. We even let
> the GP formalize their level of confidence. That's riding
> the edge of primary care research.
>
> Rogerio's point was the acute afflictions are far more
> likely to be A or B while chronic conditions should really
> be sought be become D.
>
> This is also what Jim previously suggested as a database
> report suitable for raising clinical excellence: Find
> chronic (in today's GNUmed terms: clin.health_issue.active =
> True and clin.health_issue.known_since = <quite_long>) which
> are clin.health_issue.diagnostic_certainty in (ABC).
>
> Karsten
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