a case for elsevier’s clinical decision support tools
TRANSCRIPT
• CaseStudy–ExpertPath
• February2016
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
Dr.XimenaAlvira,MD,PhD25/05/2018
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
Background • 30 year old female presents to her primary care
physician complaining of mild pain in her right flank of one-week duration.
• No associated history of hematuria or any other systemic symptoms.
• The physical examination reveals a large mass comprising the right lumbar and right hypochondriac region.
• The patient is referred to the nephrologist, who orders an abdominopelvic computed tomography, which reveals a large 14 × 9.5 × 8 cm mass with areas of necrosis over the mid-region and lower pole of the right kidney.
• The patient is admitted for surgery, during which the tumor is seen to invade the whole kidney.
• A left radical nephrectomy is performed, and the specimen is sent for histopathological analysis.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
Macroscopic features The kidney weighed 458 grams after removal of perinephric adipose tissue. The upper portion of the kidney contained a 10 x 9 x 9 cm rubbery mass with smooth-walled cysts and mucoid degeneration. Areas of necrosis and hemorrhage were noted. The adrenal gland was grossly normal.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• I log into ExpertPath, type some of the terms from the gross features to obtain diagnostic suggestions, and click on text to obtain a description of the cases and compare between possible diagnoses.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• In the results panel, I select the eligible items to compare.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• I click Compare to review the images and characteristics of the diagnoses.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• I compare the Images of the selected diagnoses.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• And also review the comparative accompanying texts.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• I start typing “Synovial sarcoma” to obtain diagnostic suggestions.
Now that I’m confident about the diagnosis, I log into ImmunoQuery to chose the antibody panel that will best support my clinical decision.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• I select the diagnosis I am looking for. • Click on Build Panel.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• Immediately, I have access to information on the antibodies’ percentage of positiveness, and the number of cases where they have been described/tested.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• However, to discard the other diagnosis suggested, I decide to compare antibody panels between both diagnoses.
• Click on Build Panel.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• I click on Suggested Panel to obtain the antibodies that yield the best information to differentiate between the two diagnoses.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
• And I also click on Suggested Panel to review the complete panel of all the antibodies, their percentage of positivity, the number of cases where they have been described/tested, and how well they differentiate one or the other diagnosis.
A Case for Elsevier’s Clinical Decision Support tools ExpertPath™ and ImmunoQuery®
With the support of and
I was able to confidently reach a diagnosis and provide enough information for the management of the patient’s disease.
Thank you