Re: [Gnumed-devel] measurement tooltip

[Karsten Hilbert]

> > Say:
> >
> > normal range = 9.5-10
> >
> > Result = 11
> >
> > - result is 1.1 times the upper limit
> > - result deviates by 2 times the normal range
> 
> I like the concept of "times" the upper limit (or % of lower limit)  
> (maybe % of mid-reference range)

I would argue for % of lower limit because if it *was* the lower limit
we'd be saying it is within normal range, in extension "% of lower limit"
means "% of what is considered normal".

> I have only ever seen *clinical* reference made to "times the upper  
> limit".
We can calculate and display references to both standard normal and
clinical limits because we allow tracking both on each measurement.

> I have never come upon a reference guideline clinical value for  
> "deviates" as in the "delta"... clinically,

Well, consider the above example. While it is only 1.1 times the upper
limit the deviation is by 2 times the *bandwidth* of the normal range.
1.1 may not sound like much but the deviation from the upper limit is
200% of the variation of the value in the normal population ! This
provides some measure in cases of high absolute values of a very narrow
normal range, say, 110-113 is normal. 117 isn't that much higher but
it deviates much more than the normal variation would allow for.

> 1. Suggest leaving out "of normal" and simply say "upper limiti  
> since, in some cases, we are talking a (therapeutic) "reference  
> range" or (in patients in whom we have customized the values) we have  
> set a "target range"
Well, we support both at the same time :-)   Hence 
both calculations and thus precise wording.

> 2. I would omit "deviates <x> times" unless it is made clearer
I am open to suggestions on clearer wording.
 
> a deviation (delta) in your calculation, as you seem to be taking the  
> midpoint (9.75) and expressing the elevated result (11) to be one and  
> a fraction "times" the normal range
ah, no, it's times the upper limit (1.1 times 10 is 11)

BTW, I chanced upon this idea when I did the very same calculation
by hand two days ago on a certain patient's data - including the
bandwidth deviation.

Karsten
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