The website’s calculator will produce a table of investigations required for a given patient based on certain variables which the user will enter. The variables that determine these are:
1. Age
2. ASA grade (1,2, or 3)
3. Grade of surgery (1,2,3, 4, Cardiovascular, or Neurosurgery)
4. Co-morbidities (Cardiovascular, Renal, Respiratory)
As the ASA grade can be determined by the Co-morbidities, the user will not be required to enter the ASA grade itself. Instead this will be determined from the co-morbidities that the user selects by the calculator.
Step One – Patient details
The user will enter the patients details which will include patient’s name, date of birth, and hospital number. The calculator will calculate age from the patient’s date of birth. Age will be used in the calculator based on a set of ranges such as < 6months, or <40years. The exact ranges needed are detailed in the tables in the pdf file “NICE - Preop Poster”.
Confidential Function
If the user does not want to disclose details of the patient he should be able to click a confidential button which makes the name, date of birth, and hospital number grey so that no details can be entered. Instead, a box in which the user enters the age should appear. The user will then enter an appropriate age for the calculator to use.
Step Two - Comorbidities
The user will select which co-morbidities apply. The choices will include renal, respiratory, or cardiovascular co-morbidities. A patient may have one, two, or all three of these. Hence, the calculator must be able to allow for the user to select multiple co-morbidities. Perhaps this is best done by using a ”tick” radio-button function.
Once the user clicks on a certain co-morbidity he will then have to select the detail that applies to this co-morbidity. For example, if cardiovascular co-morbidity is selected for a patient with ASA grade 2 the user must choose from “Current angina”, “Diabetes”, “Exercise Tolerance”, or “Hypertension”. Table 2.3 summarizes all possible choices for the three co-morbidities.
The ASA grade of the patient will be calculated from the co-morbidity selected by the user. The ASA grades of each co-morbidity is also detailed in Table 2.3 at the end. The ASA grade used will be the highest selected for any co-morbidity. So if a patient scores 2 for a renal comorbidity but 3 for a cardiovascular comorbidity this means that they will need to have an overall ASA grade of 3. If the patient has no co-morbidites selected their ASA grade will be equal to 1.
Step Three – Grade of surgery
Next the user will choose the grade of surgery. As determining the grade of surgery is difficult and not well known amongst healthcare professionals, we will give users two options. If the grade of surgery is known, this can simply be selected as either 1, 2, 3, 4, Neurosurgery, or Cardiovascular. If the user does not know what the grade of surgery is they can instead select what surgery the patient is having. The user will select this by first choosing the specialty of surgery to which the operation may belong (ie. Colorectal). After this is done they will specify the operation by selecting from a narrowed list of surgeries that pertain only to that specialty. Table 1 summarizes a list of possible specialties and their relevant operations. There may be some more operations added later, but the grades of surgery will not change.
Each of the operations in the calculator will correspond to a grade of surgery, and it is this that the calculator will consider in generating the final output. For example, “Endoscopic operations on bronchus” is grade 1.
Step Four - Output
The user clicks submit once all the selections have been made and a table is generated with the results. Please find examples of the calculator input and result screens in the next two pages. The tables in the document “NICE - Preop Poster” specify what tests are indicated for the relevant ASA grades, grades of surgery, ages,
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Hello, I'd like to work with you on this project. Did you maybe forget to attach some file? In the pdf attached there are no choice tables like you describe, but only the final output ones. Please check kindly the private message. Regards, Roman