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Re: [Gnumed-devel] state of test results handling

From: James Busser
Subject: Re: [Gnumed-devel] state of test results handling
Date: Sat, 29 Mar 2008 12:04:20 -0700

Screenshot feedback:

- beneath Kirk's name, there appears a partly-formed rectangular button (?) or am I misinterpreting? (screenshot attached)

Cells and selections and reviewing / signing:

- how did a semi-discontinuous selection of cells get highlighted blue (RBC in the left column, together with all 4 cells in the right column)

- if I correctly interpret that the action of the "Review" widget will be to "set or reset" the values of all items in the table (based on the checkbox selections within the widget), then this may be an unwise implementation, since almost never will *all* displayed items warrant the same attribute. Can the setting / resetting of the item attributes be based on a multiple selection rather than based on the total contents of the table? Under this alternative design, if nothing had gotten selected, nothing would get coded as having been reviewed, suggesting maybe all items in the display should be pre- selected by default.

- would the checkbox "Technically abnormal" within the Review widget serve to let the user overwrite (alter) whatever value had been provided by test_org? If this ability is intended, it changes the usage of this column relative to what is currently-defined in the schema text!

- suggest the "Review" button be relabeled "Review..." since, after it is clicked, it requires additional user decisions and actions

- suggest that next to the Review button be added "Abnormal-only" and "Significant-only" which would filter (subselect) from within the current display... these buttons would ignore whether or not any cells had been highlighted

- in the case where the display contains a large number of items, there won't be enough room for them to be re-displayed inside the Review widget, which then would create a problem, therefore remove this display from inside the widget? I suppose it would no longer then be correct for the prompt to say "... ALL test results listed below", it would have to say "... ALL items currently-selected." If it is easy to implement, a "count" of the number of items currently- selected could be performed, and if it were a single item, *that* one could be represented in the widget, and otherwise the prompt could say "... ALL <n> items currently-selected."

- finally (for now) there is ambiguity in English in the meaning of the word "review" because to review can simply mean "to look at (again)" and may or may not mean to examine critically, and even if critical examination of the results was performed, it is possible to choose not to record this activity. In point of fact, although not everyone would vote in favour, it could be possible for each view to create a row in clin.reviewed_test_results which would capture whoever it was that "reviewed" these results. What we are really talking about is *acknowledging* (and implying the taking of responsibility for) the results. I am OK to leave the name "review" in schema's columns (fields). However I think it advisable that in the user interface we use the word "Sign.." on the button, and in the widget change "This review" to "This signing" (and "the review" to "this signing"). If this is agreed to be a good idea then this revision could be similarly applied to the document signing.

Test naming that is offered in the table [presumably "code" ("name")]

- this could come from the table test_type or potentially from test_type_unified... shall we figure on at least two scenarios...

i) when reviewing as-yet unsigned results, the user is presumably presented with the specific test-type as returned by the test_org from which the result came

ii) is it already possible to see lab results *not* through the inbox, to show/see *all* existing lab results? And a future version will permit a subselection among available results?

iii) would test_type_unified only be used through a different method of user access, for example the user accesses a widget that presents all test_type_unified values within which the user can select one or multiple, and these then become the basis for the test naming in the Test column?

Presentation of the results (suggestions):
sort order (or vertical presentation order) among the results that are to be viewed... many of us are very accustomed to seeing tests presented with both internal relationships (tests within a battery like hematologic tests Hb WBC platelets) appearing together and --- in my case --- above the "chemistry" with immunology and other special testing and microbiology and pathology lower down. Is there some way to establish and manage this? I do notice, within the tooltip or right-click, the fields "Grouped under" and "Type comment" test names in plain text, instead of bold

        right-justify the results, within the cells
        for non-numeric results, present the first 4 characters?
        pad the right end of each result with 3 "space" characters
        3rd space is populated with first character of abnormality_indicator
(dunno if this will get confused by varied indicators, like * or H or h or upward-pointing arrow)
        maybe needs to be monospace font to maintain vertical visual alignment

        make technically abnormal results red

suggest clinically significant results do not affect formatting, but only the filterability

- if it would be possible for a single view to display a mix of already-signed plus unsigned results, is it desired that any distinction be made visually? or just rely on persistence of the unreviewed results line item in the inbox?

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