yehster wrote on Monday, November 05, 2012:
The goal of this project is to provide numeric percentile data for measures of growth and qualitative BMI status on the vitals summary on patient demographic screen, the vitals entry screen and the vitals review screen.
Although the current growth charts provide related information, the results must be interpreted by visual inspection of the graphs. When presenting pediatric vitals, the summary screen displays “See Growth-Chart” rather than providing an interpretation of BMI status based on percentile ranges indicating, underweight(<5), healthy weight(5-85), overweight(85-95), obsese (>95). This is because the percentile score for each growth measure can only be determined by human estimation using the location of each data point relative to the percentile curves on the growth charts.
The approach I am proposing is to determine the numeric percentile values using the LMS(lambda,mu, sigma) data tables provided by the CDC and WHO http://www.cdc.gov/growthcharts/data_tables.htm http://www.cdc.gov/growthcharts/who_charts.htm to compute z-scores, and then using numerical estimation techniques of the cumulative distribution function to compute percentile.
There are three general piece to this.
1. Import the LMS data from the CDC/WHO into OpenEMR
2. Implement the numeric algorithms to compute percentile values for a given patient from the population statistics
3. Update the OpenEMR user interface to display percentile values and BMI status.
This is the set of data to be handled.
WHO growth data to be processed. Age 0-2
1. Weight-for-length
2. Head Circumference for age
3. Length for age
4. Weight for age
CDC Growth data to be processed Age 2-20
1. Weight for age
2. Stature for age
3. BMI for age
and
CDC Weight-for-stature (older patients) 77cm-121.5cm
This is a project which requires significant technical expertise to implement. While it is only an incremental change, I hope that there are enough pediatricians using OpenEMR who see the potential benefit that I can garner financial support for this project to make it worth my while.
-Kevin Yeh, MD
kevin.y@integralemr.com