Re: [Gnumed-devel] Measurement workflows - value colour red , display of � , and gnuplot auto-invocation?

[Busser, Jim]

On 2013-07-13, at 2:32 PM, Karsten Hilbert <address@hidden> wrote:

>> In GNUmed, clinical importance ("relevant") and the
>> numeric or text value are both combined into red characters.
> 
> Apart from preference I fail to see why that is a problem ?

Perhaps it is just me, and perhaps it is just by force of habit (but I doubt 
it) ...

… for any one test, when I visually scan across the line of results, and I see 
changing numeric values, it is easier for me to focus on the numeric 
magnitudes, in other words "how much did these numbers change or fluctuate, and 
in what direction) if the characters are all in the same font and colour.

If normals and abnormals are in different fonts and/or colours, it can become 
too distracting.

In the case of a series of values of a single test, all of which would be (say) 
low, it is easier for me to observe, on the basis of the cell shading, that the 
entire set is low, after which I can mentally "suppress" the background shading 
to better focus on the numbers themselves. For example, to decide whether there 
are trends within the block and then, if the field of view includes the values 
to become normal again, to see whether only marginally or fully normal.

Take the example of a patient who is delirious, and who was not (and still does 
not) eat or drink very well, whose sodium (Natrium, Na) while on intravenous 
fluids had been low, and later after discontinuing intravenous fluid becomes 
highish.

If a series with the most recent value is shown at left, thusly:

        145 <--- 142 <--- 139 <--- 136 <--- 133 <--- 130 <--- 127 <--- 124 <--- 
122 <--- 121

then I personally  find something advantageous in a shaded background, because 
by shading the background of cells (containing values) 133 through 121 the 
abnormal state of sodium is more-effectively communicated to me as (in all 
likelihood) continuously low for that entire block of time, since the shading 
would be contiguous / continuous across all those values.

If, instead, the shading were to be uniform, as is currently the case in 
GNUmed, then it would only be the characters themselves "130" etc which would 
appear "abnormal".

To me, this does not communicate as effectively.

It also, for me, becomes easier to "focus" on "just the numeric values" when 
all of them are of the same font colour. I can then avoid to feel distracted by 
the visual transition from "red" 133 to "black" 136 because even though the 136 
is "normal" and the 145 are "normal", the clinical process does not care about 
such dividing lines.

I am better able to see, when I can better ignore (mentally suppress) the 
shading, that not only has the patient gone from subnormal to normal, but we 
seem to be witnessing a new problem, where the patient is not drinking enough 
free water.

I realize that I am providing an inpatient example and that the focus of GNUmed 
is outpatients however I think the principles of how information communicates 
to us remains the same. I also realize that some clinical systems highlight 
clinically significant changes even within normal ranges, and might therefore 
flag the patient whose sodium changes from 136 to 145 within 3-5 days but that 
is a separate issue.

- Jim