Greta Greywood · Notes · Demo Health Record (demonstration)

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Demo Health Record Riverbend Community Hospital (fictional) synthetic data · demonstration

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Annual visit

Unsigned draft

Type: Clinic visit
Date: 2026-11-11 11:00
Author: Dr. Imogen Vale
Status: Unsigned draft
Drafted by: Clinician-typed

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Annual visit. S: Occasional dizziness on standing. O: BP 128/70 seated, 118/68 standing. A/P: 1. Orthostatic symptoms: hydration, rise slowly. 2. Osteoporosis: continue alendronate. 3. Health maintenance: vaccines updated.

Visit diagnoses (as entered by the clinician)

Age-related osteoporosis without current pathological fracture

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Clinician-typed This draft, as declared by the source system

1 to look at before you sign · 2 checked

Needs a look Kidney function over time

Two kidney results 150 days apart are in the G3b range (filtering rate 43.1 on 2026-06-14 and 39.5 on 2026-11-11); the note doesn't mention kidney function.

Where in the note? Show the results

Show all (2)

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

Bone density Agrees

Agrees Bone density T-score Draft · pending review

The note says Osteoporosis, and T-score -2.8 on 2026-04-25 09:00 meets the published definition's criteria for the category “T-score -2.5 or lower band” (who1994_osteoporosis@1.0).

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

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Published definition and source

Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO Study Group (WHO Technical Report Series 843)
who1994_osteoporosis@1.0

Normal. A value for BMD or BMC within 1 SD of the young adult reference mean. Low bone mass (osteopenia). ... more than 1 SD below the young adult mean but less than 2.5 SD below this value. Osteoporosis. ... 2.5 SD or more below the young adult mean.

World Health Organization · edition 1994 · Section 2.1 Definitions, printed pages 5-6 (PDF pages 11-12) · opened 2026-11-14 · source

Threshold for this category (who1994_osteoporosis@1.0): T-score ≤ -2.5 SD.

Draft definition: pending clinical and coding review.

Details

Thresholds

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

Rules and published sources

ckd_epi_2009@1.0 Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check) · source
ckd_epi_2021@1.0 Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation) · source
kdigo_aki_2012@1.1 KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2) · source
kdigo_ckd_2024@1.1 KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months) · source
kidney_compare@1.1 Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update · source
kidney_exclusions@1.0 KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list · source
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) · source
who1994_osteoporosis@1.0 draft, pending review · source

Record

Check RUN-00006 · kidney-engine 2.0 · replay 9295148decb7…. Data for this sidebar (JSON).

Library check LRUN-00006 · library_default_set@1.0 · library-engine 1.0 · replay 4a820d8cd837….

Decision support only: you decide and you write the note. Exact Dx 1.0.0 · data as of Fri Nov 13, 2026 04:55 PM