Exact Dx · Before you sign · P01 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

P01 man, 72 · outpatient visit Clinician-typed

Agrees The note says CKD stage 3b and two results 200 days apart agree (G3b range, filtering rate 37.0 on 2026-04-26 and 34.8 on 2026-11-12).

The note unsigned draft · Thu Nov 12, 2026 11:00 AM

Clinic follow-up.
S: Feels well. No new complaints. Walking 20 minutes a day.
O: BP 132/78, HR 70. No edema.
Labs today reviewed.
A/P:
1. CKD stage 3b, stable. Avoid NSAIDs. Repeat labs in 6 months.
2. Hyperlipidemia: continue atorvastatin.

Edit note

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 Agrees

2026-04-26 creatinine 1.9 mg/dL · filtering rate 37.0 (G3b range)
2026-11-12 creatinine 2.0 mg/dL · filtering rate 34.8 (G3b range)

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.

Needs a look Blood pressure readings Draft · pending review

Blood pressure 132/78 mmHg on 2026-11-12 10:05 meets the published definition's criteria for the category “stage 1 range (130 to 139 systolic, or 80 to 89 diastolic)” (nhlbi_bp_categories@1.0). The note doesn't mention this.

Another published definition (esc2024_office_bp@1.0) gives the category “office 120 to 139 systolic or 70 to 89 diastolic”.

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

High Blood Pressure — Diagnosis
nhlbi_bp_categories@1.0

Normal: Less than 120 systolic AND Less than 80 diastolic; Elevated: 120 to 129 AND Less than 80; Stage 1: 130 to 139 OR 80 to 89; Stage 2: 140 or higher OR 90 or higher; Hypertensive Crisis: Higher than 180 OR Higher than 120

National Heart, Lung, and Blood Institute (U.S. National Institutes of Health) · edition page last updated June 26, 2025 · Blood pressure categories table · opened 2026-11-14 · source

Threshold for this category (nhlbi_bp_categories@1.0): systolic ≥ 130 mmHg and systolic < 140 mmHg or diastolic ≥ 80 mmHg and diastolic < 90 mmHg.

Draft definition: pending clinical and coding review.

Dismiss with a reason

Reason in your words (needed for "Other")

Show all (3)

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

Cholesterol Not assessable

Not assessable LDL cholesterol Draft · pending review

The note says Hyperlipidemia; it could not be checked against aha2018_severe_hypercholesterolaemia@1.0: there is no LDL cholesterol result in the last 730 days.

Another published definition (atp3_ldl@1.0) cannot decide: there is no usable LDL cholesterol result.

Show in the note

Published definition and source

2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol
aha2018_severe_hypercholesterolaemia@1.0

Severe Hypercholesterolemia (LDL-C ≥190 mg/dL [≥4.9 mmol/L])

American Heart Association / American College of Cardiology and partner societies · edition 2018 (Circulation 2019;139:e1082-e1143, author manuscript PMC7403606) · Section 4.2 heading; Top 10 Take-Home Message 4 · opened 2026-11-14 · source

Categories that count (aha2018_severe_hypercholesterolaemia@1.0): LDL 190 mg/dL or more (LDL ≥ 190 mg/dL).

Draft definition: pending clinical and coding review.

Library check LRUN-00001 · library_default_set@1.0 · library-engine 1.0 · replay 7e1a90ec93ec…

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: Note and criteria agree criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

eGFR 34.8 on 2026-11-12 (lab row L-0002) and eGFR 37.0 on 2026-04-26 (lab row L-0001), 200 days apart, no value >= 60 between. KDIGO persistence: met. Persistent GFR category G3b (the range both values meet). Note: the kidney-function statement (quoted below) agrees with the persistent GFR category.

From the draft note: CKD stage 3b

Both directions
What the labs show that the note doesn't say	Criteria met; the note has a statement
What the note says that the labs don't support	Statement present; criteria met

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
met: Latest creatinine below 1.5x the lowest value in the previous 365 days (otherwise: possible acute change; repeat needed) (kdigo_ckd_2024@1.1)
2.0 / 1.9 = 1.05x
Rows: L-0001, L-0002
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)
none on record for this encounter date
met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation) (kdigo_ckd_2024@1.1)
pair L-0001 (34.5, 2026-04-26) and L-0002 (32.4, 2026-11-12), 200 days apart; persistent category G3b (the range both values meet)
Rows: L-0001, L-0002
met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1)
pair L-0001 (37.0, 2026-04-26) and L-0002 (34.8, 2026-11-12), 200 days apart; persistent category G3b (the range both values meet)
Rows: L-0001, L-0002
met: Values used are steady-state (local convention: values from an admission meeting the creatinine-change criteria are excluded) (kdigo_ckd_2024@1.1)
no values excluded

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-00001 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1541

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: stated · creatinine change: silent

Agreed statements

CKD stage 3b (characters 138-150)

Provenance

Clinician-typed, as declared by the source system (context only: never an input to the rules)

Results side

measurement replay hash 62d2a372d6e6be7bfcbeb55e8a5aa6a3c9125316163b7d802b43c5beaa845fc2 (computed from structured values only)

Replay hash

3d4f2d2ebcc56b011349776ca4dc259fae72911e113750940954a43510232a04

Decisions

none yet

Revisions

KN-P01-1

Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
Row	Collected	Creatinine	Age	2021	Range	2009	Used
`L-0001`	2026-04-26 09:00	1.9	72	37.0	G3b	34.5	yes
`L-0002`	2026-11-12 08:30	2.0	72	34.8	G3b	32.4	yes

P01 man, 72 · outpatient visit ✎ Clinician-typed