On Tuesday 24 December 2002 01:19, John Gage wrote:
> But then you talk about "searching" in the same breath. To me,
> "searching" implies SQL queries or something very similar.
> Clinicians simply do *not* perform these sorts of data mining
> activities in their practice.
I do.
Either in person or by instructing staff to do it.
> The whole idea of "give me all the
> patients over fifty who chem gum and wear cotton slacks" does not
> exist in clinical medicine. Yes, this sort of thing must be
> accomplished with standard RDBMS tools, but that does not have
> anything to do with clinical medicine.
Give me all the patients who have a diagnosis of Ischemic Heart Disease
ranked by a score dependent upon
how high their BP is and how long ago taken
how high their cholesterol ditto
the inverse of how long since last seen
separate them into patients who are already on this list of drugs
{aspirin, a beta blocker, a statin} and put first those who are not.
That's the order I want to worry about them, and see them.
And yes, I do have some software that reports my current patient database in
something approaching that fashion, and as time goes on I expect to get it
closer.
Think in terms of supporting this sort of thing:-
In a patient who has ischaemic heart disease the notes should contain (taken
in conjunction with standing orders and other references)
A diagnosis of this in the summary or problem list;
records of lipid levels
a comment on family history
records of smoking, and if a smoker, of advice to stop and the offer of
assistance in this
blood pressure recordings, with current ones either in the target range or an
exception excuse
prescriptions of {drugs above} or an excpetion excuse
etc
--
From one of the Linux desktops of Dr Adrian Midgley
http://www.defoam.net/
