What it is and does...
STATworkUP
is medical software for computer assisted problem assessment. It is designed to support the diagnostic process. Because its features parallel customary
methods of learned clinical investigation, its operation is intuitive for
health care providers.
The
application's features help explore and integrate data to facilitate fast and
comprehensive problem assessment.
Cross-reference and evaluation profiles relate observations to
associated disorders and suggest appropriate studies. As assessment proceeds, the program adjusts the differential
to fit selected findings.
Sophisticated
processing power and an elegant user interface combine for rapid information
acquisition for refined analysis of each condition encountered. The result is a cost-effective and
in-depth case workup. Additionally, STATworkUP is an excellent
referencing and teaching resource and a good review package. The product can
also be used to create expert systems for other disciplines and can be used
with IatroCom's Constellation Voyager
product for web page publication.
Clinical
medicine is an artistic and philosophic discipline combining scientific skill.
Sound
practices require years of training plus ample experience and insight.
STATworkUP
is a collection of evidence-based facts and associations that can be useful for
quick recall of lots of information to help guide the case workup.
Every
effort has been taken to conform to standard practices and guidelines in both
the medical and computing industries.
The authors include physicians, engineers, mathematicians and
informaticists. Although STATworkUP is not intended to supplant sound medical
judgment, it is another tool for practitioners, easy to understand and use. It
comes with knowledge databases for specialties.
What it does not do...
Although
the program calculates a range of diagnostic possibilities for finding
selections, it does not interpret symptom complexes, nor perform synthesis of
information, based upon quality, magnitude or temporal-spatial relationships. Those special factors and determinations transcend the program's scope at this time. These subtle, but important, considerations require keen medical insight.
For
these reasons STATworkUP is an interactive application, requiring the user's discretion.
Getting Started...
Reading
the document is helpful and that is bundled with the software. To get the full value of STATworkUP we
recommend you read it. Yet, many
want to jump right in and begin exploring. To help you do that here are a few pointers:
New Assessment...
To
begin choose a problem to evaluate from Problem menu. A workup window will appear for the problem selected that
profiles related history, physical and studies plus an array of diagnostic
possibilities on the Analysis menu.
We encourage you to experiment by making finding selections to see what
happens.
Related
information for each finding, study, or diagnosis selection is displayed at the
bottom of the window. Notice that
as findings are selected some studies are signified, with a diamond, indicating
their appropriateness for further evaluation.
More
likely diagnostic possibilities to look at are underlined on the Diagnostic
Array. You can adjust the fit of findings for related diagnosis or
studies. To do that a probability
setting meter is used. That can be opened from Analysis menu. There are also
Prioritize Differential and Cross-Reference items on that menu.
Try the encompassing design of the Cross-Reference Window to view many
relationships. It is rather easy
to grasp how it works to get a fast comparison.
Reports of
the workup can be produced and printed. The evaluation and chart notes can also
be saved as documents in the customary manner.
STATworkUP
databases can also be modified.
However we will discuss that later because it is not something to change
without some degree of expertise.
Problem Workup...
STATworkUP
provides history, physical and studies lists on problem profiles to assist
problem evaluation. Relevant
findings and possible diagnoses are included to workup each problem. These
windows relate to the problems selected from the Problems menu. Potential diagnoses for each problem
are listed on the Analysis menu Diagnostic Array. Clinical manifestations for
each diagnosis are listed as History and Physical findings along with the
studies.
The
problem window title bar shows the name of the condition being evaluated. As each finding or diagnosis is
selected, related information for it is shown below.
The
information for findings and diagnoses widens the perspective, shifting the
focus from the chief complaint to other contributory, yet perhaps less obvious,
problems and diagnoses for further consideration.
Whenever
selected, STATworkUP adds the findings' supportive weight for pertinent diagnoses, and for the indicated studies to help further confirm things.
Possible
diagnoses get underscored on the diagnostic array that can also be prioritized
by selecting the Prioritize Differential item from the Analysis menu.
A
diamond next to a study signifies that it is appropriate for further
investigation.
Corroboration Mode...
The
corroborate mode can be set on or off from the Options menu. When it is on, relevant findings and
studies for each diagnosis are shown when picked from the list. Other findings
and studies on the problem workup profile get dimmed out.
Probability Setting...
A probability adjustment meter is provided to control the
amount of specificity. Higher
settings better relate diagnoses and studies to selected findings. You can access
the meter by choosing the Probability Setting item on the Analysis menu.
Cross-Reference...
The
Cross-Reference window opens by selecting that item from the Analysis menu.
This
robust function correlates History and Physical, Studies, Diagnoses, and Problems. Just choose a button. Build a list. Select an item. Instantly get the linked information. Choose
another button to show relationships to that item. Many combinations are possible. Try it out.
This
window dynamically integrates many viewpoints for rapid problem analysis.
It
also tracks the evolving finding selections by choosing the Findings button.
The
Problems button builds a list of all Problem Workup Profiles that exist. More Workup profiles can be made for any History or Physical item
in the Database.
Selecting
the Workup button after choosing a Problem from the problem list goes to that
evaluation profile to further assess the problem.
Select
the Differential Button to scan a list of potential diagnoses to consider for
findings that have been selected during the problem workup. These are compiled from all diagnostic
arrays in the open data base. They
can be prioritized or shown alphabetically. The differential diagnosis list can be expanded or
constrained by adjusting the specificity of the selected findings. Use the Probability setting meter for
this.
Setting Priorities...
STATworkUP computes the diagnostic differential as evaluation findings are added or removed. To look at more likely diagnostic
possibilities during the problem workup turn on the Prioritize Differential
mode on the Analysis menu.
Diagnoses are then sorted by their weighted-match instead of
alphabetically. The weighted match
is a product of weighted specificity and included findings.
This
is better described in the full operating manual.
Adjusting Specificity...
STATworkUP
lets you vary the number of finding selections that are needed to recommend
specific diagnoses or associated studies for focused consideration. You can set the percent of fit that you
like by using the probability setting meter.
At
low specificity settings the differential diagnosis is expanded, but diagnoses
loosely fit the finding selections.
At high specificity settings the differential is constrained and the fit
of listed diagnoses to finding selections is tighter.
Each
finding has a factored weight for each diagnosis it defines. The total weight of all possible
findings that define a diagnosis in the database defines the BEST FIT VALUE
for that particular diagnosis. The
combined weight of all selected findings determines the ACTUAL VALUE for the
diagnoses. The ratio of ACTUAL to
BEST VALUE is called Weighted Specificity in STATworkUP.
The
default setting for the probability meter when starting a new assessment is
50%. At that setting each
underscored diagnosis on the Problem Workup Diagnostic Array or each diagnosis
on the differential list in the Cross-Reference window is supported by at least
half of its total selected findings attribute weight.
Finding
inclusiveness for each prioritized diagnosis is also factored into the list.
Case Notes...
A
charting area is provided for vital signs and text entry, Open Case Notes from the File
menu. It can be saved along with
the workup.
Saving the
Workup...
The entire evaluation can be saved for future reference. It can also be
encrypted.
Saved
files are represented by a lamp-of-knowledge icon. STATworkUP saves the status of all checked findings and the
case notes made during the encounter.
This
follows standard interface guidelines for saving other files on the Macintosh.
Saved
work can be opened from the File menu by selecting Open Assessment.
Modifying Databases...
Caution! Do not do this unless you know what you are
doing! Read the manual first.
Contacting IatroCom...
This
software has been extensively tested since 1986. IatroCom Enterprises sincerely hopes you enjoy using
STATworkUP and we solicit all comments.
mailto:
ceo@iatrocom.org?subject=STATworkUP
mailto:
ceo@iatrocom.org?subject=Constellation Voyager
