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Exact Dx synthetic data · demonstration
Exact Dx · Before you sign · P13 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

All notes

P13 man, 65 · outpatient visit Clinician-typed

Open in the chart

Needs a look The two filtering-rate equations give different answers for these results (2021 equation: threshold not met; 2009 equation: threshold met, G3a). The tool does not choose.

The note unsigned draft · Thu Nov 12, 2026 03:00 PM

Follow-up.
S: No complaints.
O: BP 126/78.
A/P:
1. Prediabetes: diet and exercise, recheck A1c in 6 months.
2. Hyperlipidemia: continue statin.
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 Needs a look

  • 2026-07-15 creatinine 1.28 mg/dL · filtering rate 62.1 (G2 range)
  • 2026-11-12 creatinine 1.3 mg/dL · filtering rate 61.0 (G2 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.

Nothing else needs a look.

Show all (4)

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

Glucose and HbA1c Agrees 2

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

    The note says Prediabetes, and HbA1c 6 % on 2026-11-12 13:05 meets the published definition's criteria for the category “intermediate range (HbA1c 5.7 to 6.4%, fasting glucose 100 to 125 mg/dL, or 2-hour glucose 140 to 199 mg/dL)” (ada2026_prediabetes@1.0).

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

    Show in the note 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.

  2. Agrees Glucose and HbA1c Draft · pending review

    HbA1c 6 % on 2026-11-12 13:05: in the category “None” of ada2026_diabetes@1.0; the note doesn't mention this. Nothing to review.

    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_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.

Cholesterol Agrees

  1. Agrees LDL cholesterol Draft · pending review

    The note says Hyperlipidemia, and LDL 204 mg/dL on 2026-11-12 13:05 meets the published definition's criteria for the category “LDL 190 mg/dL or more” (aha2018_severe_hypercholesterolaemia@1.0).

    Another published definition (atp3_ldl@1.0) gives the category “LDL 190 mg/dL or more ('very high')”.

    Show in the note Show the results

    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

    Threshold for this category (aha2018_severe_hypercholesterolaemia@1.0): LDL ≥ 190 mg/dL.

    Draft definition: pending clinical and coding review.

Library check LRUN-00013 · library_default_set@1.0 · library-engine 1.0 · replay 6affe6074e8e…

Show the details

Your decision: Kidney function (eGFR persistence)

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: Definitions disagree; the tool does not choose criteria met under 1 of 2 eGFR equations (2021 race-free, 2009)

eGFR 61.0 on 2026-11-12 (lab row L-0027); eGFR 62.1 on 2026-07-15 (lab row L-0026). KDIGO persistence: not met (two values of 60 or more 120 days apart, none below 60 after them). 2009 eGFR equation (drift check): persistence met, GFR category G3a. The two equations lead to different results; the tool does not choose.

From the encounter diagnosis list: CKD stage 3a (from an outside lab report)

Both directions
What the labs show that the note doesn't say Criteria not met; nothing unstated
What the note says that the labs don't support Statement met under one definition only (both shown)
  • 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)
    1.3 / 1.28 = 1.02x
    Rows: L-0026, L-0027
  • 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-0026 (58.3, 2026-07-15) and L-0027 (57.3, 2026-11-12), 120 days apart; persistent category G3a (the range both values meet)
    Rows: L-0026, L-0027
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1)
    not met: two values of 60 or more 120 days apart, none below 60 after them
    Rows: L-0026, L-0027
  • 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-00013 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1589
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
Encounter list: CKD stage 3a (from an outside lab report)
Provenance
Clinician-typed, as declared by the source system (context only: never an input to the rules)
Results side
measurement replay hash ba1854022ea29cc75c3e8826a61722aefa464211b30e183da69d6e653cd58b12 (computed from structured values only)
Replay hash
72c0007565e54f49a482b671052c3628b41ea9f2f605f94105ff413f52124064
Decisions
none yet
Revisions
KN-P13-1
Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
RowCollectedCreatinineAge 2021Range2009Used
L-00262026-07-15 09:001.28 6562.1G258.3 yes
L-00272026-11-12 13:001.3 6561.0G257.3 yes