✎ Clinician-typed
This draft, as declared by the source system
1 to look at before you sign · 2 checked
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● Needs a look
Kidney function over time
Two kidney results 180 days apart are in the G4 range (filtering rate 25.6 on 2026-05-14 and 23.4 on 2026-11-10); the note doesn't mention kidney function.
¶ Where in the note?
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1 more, grouped by what was measured. At most three are shown above at once.
Lung function and oxygen
◆ Needs your clinical judgement
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◆ Needs your clinical judgement
Lung function after bronchodilator
Draft · pending review
The note says COPD
. FEV1/FVC 0.58 on 2026-09-11 10:00; FEV1 % predicted 62 % on 2026-09-11 10:00: the record shows these values; this needs your clinical judgement (gold2026_copd_airflow@1.0 uses them as one part of a wider clinical picture, category “FEV1/FVC below 0.7 with FEV1 50 to below 80% predicted (grade 2)”).
Published bodies disagree on these thresholds; another definition may give a different answer.
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Published definition and source
Global Strategy for Prevention, Diagnosis and Management of COPD: 2026 Report — Pocket Guide
gold2026_copd_airflow@1.0
In patients with COPD (FEV1/FVC < 0.7): GOLD 1: Mild FEV1 ≥ 80% predicted; GOLD 2: Moderate 50% ≤ FEV1 < 80% predicted; GOLD 3: Severe 30% ≤ FEV1 < 50% predicted; GOLD 4: Very Severe FEV1 < 30% predicted
Global Initiative for Chronic Obstructive Lung Disease (GOLD) · edition 2026 (pocket guide v1.1, 20 Nov 2025) · Figure 2.10 (PDF page 20); key points (PDF page 11) · opened 2026-11-14
· source
Threshold for this category (gold2026_copd_airflow@1.0): FEV1/FVC < 0.7 and FEV1 % predicted ≥ 50 % and FEV1 % predicted < 80 %.
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) · sourceckd_epi_2021@1.0
Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation) · sourcekdigo_aki_2012@1.1
KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2) · sourcekdigo_ckd_2024@1.1
KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months) · sourcekidney_compare@1.1
Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update · sourcekidney_exclusions@1.0
KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list · sourcelab_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) · sourcegold2026_copd_airflow@1.0
draft, pending review · source
Record
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