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Exact Dx synthetic data · demonstration
Exact Dx · Before you sign · P24 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

All notes

P24 man, 70 · outpatient visit Clinician-typed

Open in the chart

Not assessable Could not check kidney function: limb amputation is on record, and the filtering-rate equation is not reliable then.

The note unsigned draft · Wed Nov 11, 2026 12:00 PM

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The results

The note is compared with the patient's own measurements, in both directions. Kidney filtering rate (eGFR) is estimated from creatinine, age and sex.

Kidney function over time Not assessable

  • 2026-04-25 creatinine 0.7 mg/dL · filtering rate 99.1 (G1 range) (not used)
  • 2026-11-11 creatinine 0.75 mg/dL · filtering rate 97.1 (G1 range) (not used)

Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them.

Other measurements checked against published definitions

Each definition is a draft pending clinical and coding review unless marked reviewed. You decide what the note says.

Nothing else needs a look.

Show all (3)

2 more, grouped by what was measured. At most three are shown above at once.

Glucose and HbA1c Not assessable 2

  1. Not assessable Glucose and HbA1c Draft · pending review

    The note says diabetes; it could not be checked against ada2026_diabetes@1.0: HbA1c or glucose values outside the range do not show that a stated condition is absent (for example under treatment).

    Show in the note Show the results

    Published definition and source

    2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026

    ada2026_diabetes@1.0
    Table 2.1: A1C ≥6.5% (≥48 mmol/mol); FPG ≥126 mg/dL (≥7.0 mmol/L); 2-h PG ≥200 mg/dL (≥11.1 mmol/L) during OGTT; random plasma glucose ≥200 mg/dL (≥11.1 mmol/L) with classic symptoms of hyperglycemia or hyperglycemic crisis. In the absence of unequivocal hyperglycemia, diagnosis requires two abnormal results from different tests ... or the same test at two different time points.

    American Diabetes Association Professional Practice Committee · edition 2026 (Diabetes Care 2026;49 Suppl 1:S27-S49, doi:10.2337/dc26-S002) · Table 2.1 Criteria for the diagnosis of diabetes in nonpregnant individuals · opened 2026-11-14 · source

    Categories that count (ada2026_diabetes@1.0): two results at or above the diagnostic thresholds (number of qualifying results ≥ 2); random glucose 200 mg/dL or more with typical symptoms (random glucose ≥ 200 mg/dL and a recorded clinical item); one result at or above a diagnostic threshold (number of qualifying results ≥ 1).

    Draft definition: pending clinical and coding review.

  2. Agrees Glucose and HbA1c (intermediate range) Draft · pending review

    HbA1c 6.1 % on 2026-11-01 09:00: the note states a related topic, so nothing is raised here (ada2026_prediabetes@1.0). Nothing to review.

    Published bodies disagree on these thresholds; another definition may give a different answer.

    The note does not mention this. Show the results

    Published definition and source

    2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026

    ada2026_prediabetes@1.0
    A1C 5.7–6.4% (39–47 mmol/mol); FPG 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L) (IFG); 2-h PG during 75-g OGTT 140 mg/dL (7.8 mmol/L) to 199 mg/dL (11.0 mmol/L) (IGT)

    American Diabetes Association Professional Practice Committee · edition 2026 (Diabetes Care 2026;49 Suppl 1:S27-S49) · Table 2.2 Criteria defining prediabetes in nonpregnant individuals · opened 2026-11-14 · source

    Threshold for this category (ada2026_prediabetes@1.0): HbA1c ≥ 5.7 % and HbA1c < 6.5 % or fasting glucose ≥ 100 mg/dL and fasting glucose < 126 mg/dL or 2-hour glucose ≥ 140 mg/dL and 2-hour glucose < 200 mg/dL.

    Draft definition: pending clinical and coding review.

Library check LRUN-00024 · library_default_set@1.0 · library-engine 1.0 · replay c675658fbd78…

Show the details

Mode: measurements only (no diagnosis is named). The check runs the same way on clinician-typed and AI-drafted notes (as declared by the source system).

Kidney function (eGFR persistence) · kdigo_ckd_2024@1.1

eGFR: Not assessable: the data cannot decide not assessable

Not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering. Nothing to review until the data can decide.

Both directions
Both directions Not assessable: the data cannot decide (reason above). Nothing is flagged either way.
  • not met: Urine ACR >= 30 mg/g on two values at least 90 days apart (needed only when eGFR >= 60) (kdigo_ckd_2024@1.1)
    no urine ACR on file
  • not met: No condition on record that makes the estimating equation unreliable (maintenance dialysis, kidney transplant, pregnancy, limb amputation or another extreme of muscle mass) (kidney_exclusions@1.0)
    limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation) (kdigo_ckd_2024@1.1)
    not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1)
    not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering
  • met: Values used are steady-state (local convention: values from an admission meeting the creatinine-change criteria are excluded) (kdigo_ckd_2024@1.1)
    excluded L-0053, L-0054
    Rows: L-0053, L-0054

Creatinine change during this admission · kdigo_aki_2012@1.1

Creatinine change: Does not apply to this visit

Not assessed: outpatient visit: the creatinine-change check runs on inpatient encounters only.

Try one creatinine value

One value is never a confirmed stage: the persistence rule needs a repeat at least 90 days later.

The record of this check

Run
RUN-00024 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1633
Engine
kidney-engine 2.0
Rule versions
  • ckd_epi_2009@1.0 · Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check)
  • ckd_epi_2021@1.0 · Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation)
  • kdigo_aki_2012@1.1 · KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2)
  • kdigo_ckd_2024@1.1 · KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months)
  • kidney_compare@1.1 · Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update
  • kidney_exclusions@1.0 · KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list
  • lab_units@1.1 · KDIGO 2012 and 2024 guidelines, unit conversion (creatinine 1 mg/dL = 88.4 umol/L; ACR 1 mg/mmol = 8.84 mg/g)
Note reading
word list + model, agreement required · model: ok · kidney function: silent · creatinine change: silent
Agreed statements
none
Provenance
Clinician-typed, as declared by the source system (context only: never an input to the rules)
Results side
measurement replay hash bd50e5d79c73abdf5a68497b33e8a1544e6a83a63c83be7407f132e9bab883e2 (computed from structured values only)
Replay hash
71cfe343504388231e5c4c24a19ca7da6a7e8c77e029b97f1ea77ca8eec3394e
Decisions
none yet
Revisions
KN-P24-1
Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
RowCollectedCreatinineAge 2021Range2009Used
L-00532026-04-25 09:000.7 7099.1G195.6 no: not used: limb amputation on record (the equation is not reliable)
L-00542026-11-11 09:000.75 7097.1G192.9 no: not used: limb amputation on record (the equation is not reliable)