On Wednesday 01 September 2004 22:39, Stephen wrote:
> Having started this a few months ago we're rather regretting it although
> perhaps things will settle down. The machine (machine and strips
> provided by the PCT) we have in the surgery consistently reports INR
> levels of 0.5-1 points below the hospital lab reading on the same
> sample, resulting in patients who were previously stable for months
> having dosage changes and weekly recalls.
It seems vanishingly likely that there has been a change in the patient, so I
would have thought this is part of your calibration of the test-system
against the gilt standard the lab provides.
Once you know the calibration curve of the system, you can read the truer INR
off a graph or chart and substitute that into whatever you use.
I tend to make changes in dose on the close order of 1 mg per week, which
makes me wonder how often there would be any point in recalling people after
so little time as a week - having had one mg more or less than they would
before the change.
I suggest that the time to retest is not before they have had say 10mg more or
less than they would have if no change had been made.
I have some code of my own that I don't like enough to use, and just use a
template in the database to make admin easier - if there was an Open Source
tracking system that interfaced with our master patient index I probably
would use it. I don't care to use two separate patient indexes though.
--
Adrian Midgley Open Source software is better
GP, Exeter http://www.defoam.net/
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