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[Gnumed-devel] Re: clin_health_issue - some thoughts

From: Ian Haywood
Subject: [Gnumed-devel] Re: clin_health_issue - some thoughts
Date: Sun, 21 Nov 2004 20:14:51 +1100

Jim Busser wrote:
> I am not sure how we would handle (assess/input) 
> a continuous variable.
You don't, it's calculated from the notes using a defined algorithm
(which we need to discuss, I'll formulate a proposal if this idea reaches 

> with the naming assigned to the issues. For example I find it helpful 
> to sort "adjacent" a patient's angina, status-post MI and post-CABG, 
> heart failure and renal failure, it certainly helps when reviewing 
> the rationale for a current drug regimen.
I think under our model you would have an overarching health issue
"cardiovascular disease" under which to group these diagnoses.

Just thinking aloud, is the disease<->health issue relationship reasonably 
predictable, that is, could the disease codes directory
store a "default" health issue for each diagnosis, so they can be grouped 
automatically. (of course the user should be able to re-arrange them manually 
if desired)

Carlos Moro wrote:
> I've been playing around with the multi-split based SOAP inpuut
> approach. It's commited in cfmoro's test-area. It's basically a
> very first try of customizing wxpython multisash. It's completely
> open for advice/review/discussion/changes/improvements (thanks a
This is good work, I would like to propose a modification based on Karsten's 
suggestion on IRC: instead of a TreeCtrl on the right, just have a listbox with 
health issues numbered, then a single soap control,
the notes can be tagged to a health issue by adding the number, so
with this contrived example:

S: 1. SOB on exertion, while walking up stairs.
2. blurred vision
O: 1. mild bibasal crackles, JVP +2cm, mild pitting oedema to mid-calf
2. fundoscopy: some haemorrhages
A: 1. increasing CCF
2. retinopathy

The health issues are
1. congestive cardiac failure 
2. diabetes

The numbered list can change over time, as health issues are ordered by 
importance. New issues can be generated implicitly by referring to a new number.

This actually merges nicely with Richard's design: the list of health issues 
becomes one of the tabs in the "pick list" notebook in the top-right (along 
with medications, waiting room, inbox, etc.), leaving space bottom-right for 
Recalls/Warnings and the scratch-pad. 

Ian Haywood 

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