Hello!
I need help changing the algorithm we have for our 0-24 month patients. Currently the form translates the CDC percentiles. This is incorrect for our 0-24 month patients and is causing a fit with our nutritionist, parents, and providers. The form that we use originated from the open source GE vitals form. Can anyone share their WHO percentile form? Or did anyone successfully edit the open source form to calculate WHO percentiles?
I have tried to attached our current 0-24 Vitals form, but this site keeps giving me an error despite its small file size.
Thanks for any help; the vitals form is very complex and I can't seem to read these hieroglyphics.
I don't have one, but I can tell you what it takes to fix it -
In the client folder go to Clinical Content/peds_growth_data, find the readme.txt file and read it. It explains the file format. The male and female folders contain the data to calculate the percentiles, the number in the name of the files represents an age in months, so there are 4 files for patients 0-24 months. The numbers you are looking for can be found on the world health organization website. You have to read carefully on the website to figure out which set of numbers you actually need. If you get all of the numbers working, then you just need to copy out the new files to every workstation/terminal server. No changes need to be made to the form. Its a ton of work, but it can be done.
Thank you. This sounds much easier than dissecting this form.
<3
Tosh
One note of caution on this approach - the internal Growth Charts used by the EMR are CDC growth charts, not WHO growth charts. As a result the charts will be inaccurate. As there is no workaround possible for this issue at this time, I would recommend that all that desire this functionality submit an enhancement request to GE to permit the selection of the chart type. The more that request it, the more likely GE will understand the importance and need for it, escalating the request to a higher tier. Note that it has been a decade since the WHO charts and data points have been released and that GE has not incorporated it yet, implying that few have asked for it...
Be certain to include this link in your request:
http://www.cdc.gov/growthcharts/who_charts.htm
Though I don't know if it was a service pack or version upgrade, I'm pretty sure GE is using the WHO percentiles for the 24 month and under. They may not have updated the help though.
I would not assume that it would graph correctly given that GE had not updated the array files in the peds_growth_data folder, especially since the code used, for example, in the CCC vitals form, would need to be adjusted so that it does not ignore <24 months old for some percentiles (unless they adjusted that with a recent update - not certain - haven't looked).
Growth Charts are handled by JBoss. Here's some code from the config.xml in the Growth Charts folder. You can see the WHO references. Also the graphs actually say WHO. But it is doubtful they updated the non-JBoss Growth Chart info for forms:
<ViewGroup name="Infant" minAgeInMonths="0">
<View title="Length vs. Age (0-24 mos.)"
id="Infant_HtVsAge"
view-src="svg/views/Infant_HtVsAge_View_WHO.xml"
data-stylesheet-src="xsl/HtVsAge.xsl"
allowShiftForPremies="true"
>
</View>
<View title="Weight vs. Age (0-24 mos.)"
id="Infant_WtVsAge"
view-src="svg/views/Infant_WtVsAge_View_WHO.xml"
data-stylesheet-src="xsl/WtVsAge.xsl"
allowShiftForPremies="true"
>
</View>
<View title="Weight vs. Length (0-36 mos.)"
id="Infant_WtVsLength"
view-src="svg/views/Infant_WtVsLength_View_WHO.xml"
data-stylesheet-src="xsl/WtVsHeight.xsl"
allowShiftForPremies="false"
/>
<View title="Head Circ. vs. Age (0-24 mos.)"
id="Infant_HCVsAge"
view-src="svg/views/Infant_HcVsAge_View_WHO.xml"
data-stylesheet-src="xsl/HcVsAge.xsl"
allowShiftForPremies="true"
>
</View>
</ViewGroup>
I went to the CDC WHO website
https://www.cdc.gov/growthcharts/percentile_data_files.htm
and the data tables I found are the same as what we have currently.
In the article, it says "These data remain unchanged from the initial release on May 30, 2000 of the growth charts."
Does any one have a link to the WHO updated data files for children 0-36 months?
Thanks,
Tosh
i think i found it: http://www.who.int/childgrowth/standards/en/
Update.
Editing the text file seems to be working so far on my test with the female head circumference.
1|33.8787|0.03496|0,1|35.3211|0.03248|0.5,1|37.4411|33.754|1.5,1|38.9244|0.03153|2.5,1|40.063|0.03129|3.5,1|41.0115|0.03111|4.5,1|41.8346|0.03095|5.5,1|42.5093|0.03081|6.5,1|43.1034|0.03069|7.5,1|43.5961|0.03058|8.5,1|44.0357|0.03048|9.5,1|44.4069|0.03039|10.5,1|44.7447|0.03031|11.5,1|45.0353|0.03023|12.5,1|45.2965|0.03016|13.5,1|45.5408|0.03009|14.5,1|45.7567|0.03003|15.5,1|45.9627|0.02996|16.5,1|46.1485|0.0299|17.5,1|46.3294|0.02985|18.5,1|46.4957|0.02979|19.5,1|46.655|0.02974|20.5,1|46.8135|0.02969|21.5,1|46.9617|0.02964|22.5,1|47.1099|0.0296|23.5,1|47.2486|0.02955|24.5,1|47.387|0.02951|25.5,1|47.5158|0.02947|26.5,1|47.6436|0.02943|27.5,1|47.762|0.02939|28.5,1|47.8753|0.02935|29.5,1|47.9869|0.02931|30.5,1|48.0901|0.02928|31.5,1|48.1919|0.02924|32.5,1|48.2861|0.02921|33.5,1|48.3793|0.02917|34.5,1|48.4659|0.02914|35.5,1|48.5099|0.02912|36
is giving me a match every time so far.
This will take a lot of testing, but thought i would let everyone know.
Be certain to keep a copy of your edits (and maybe post them in the marketplace). Unless GE produces their own versions as a factory set, your files may be overwritten during a service pack/version upgrade. If they are, you will need to push your files back out to your client machines post update.
Thanks for the heads up about the version overwrite. I will check them any time we do an update/upgrade.
What a great idea, I will post to Marketplace when I have finished testing.
Tosh
Alright, I finally posted it.
I edited Length vs. Age 0-24mo, Weight vs. Age 0-24 mo, Head circ 0-24 mo, and the whole file for weight vs length (infant file)
https://marketplace.centricityusers.com/#/my-account/preview/531
I have checked the numbers thrice, everything has been within 5% so far
Thanks,
Tosh
Quick question. What do you do with the preemie kids? Are their tables based of the gestational age?