Centile Chart App?...... anyone?..........anyone?

[Marcus Baw]

I'm not sure why this important area of practice seems to have escaped ANY form of App-ification but it's quite inexplicable to me that there is no official WHO/UK/RCPCH/PublicHealthUK/NHSEngland Growth Chart App.

I'm not an app dev but I wouldn't have thought that the mathematics behind working out a centile are that difficult, and I would guess they would be published somewhere (though I am not sure where)

UK health professionals are still plotting this on (gasp) printed card charts. There is a PDF version to download if you like wasting even more of your own time since the PDF is not at all dynamic and works exactly like the card version, except it's on your shitty NHS 14" screen.

Amazingly, the GP clinical systems don't even have centile calculators in them, such as they have for QRisk, BMI etc.

I do believe that the charts are copyrighted FFS which goes against the spirit of sharing and wholesomeness that the WHO implies by its very existence.

http://www.rcpch.ac.uk/growthcharts

So, I ask you, the NHSHackDay community:

1) Does anyone know of any digital versions of the WHO centile charts, perhaps ones I have missed when looking?

2) Is anyone up for developing an app like this unofficially and potentially against copyright in order to shame the buggers into doing a proper official one (much like what was done with the BNF and NICE by NHS Hack Day in the past) ? It would need to have the growth charts and for added bonus points, the centile-adjusted BMI/weight charts.

3) there is no 3.

M

[Damian Roland]

I believe dilshad...@gmail.com and Chris Kelly are working on this. In the first instance all I need from an app is to enter a age and weight and get a centile. 

Future versions could be more funky

Damian

Sent from my iPhone

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[Marcus Baw]

Exactly Roland it should be that simple.

Input: age and (weight or height)

Output: centile for (weight or height) and centile-appropriate BMI.

My wife is a school nurse and we have just been printing out small versions of the PDF Centile charts that she can carry around in her bag.

It surprises me that there is no Centile Wheel,  in the absence of a thoroughly modern App,  the previous default for such things for those old enough to remember was a wheel.

M

[Ian McNicoll]

Hi Marcus,

see SMARTPlatforms http://sandbox-v06.smartplatforms.org/showcase?app=growth...@apps.smartplatforms.org&patients=7777701,7777702,7777703,7777704,7777705

Our Slovenian colleagues, Marand have already implemented this as part of their openEHR hospital paediatric system.

Ian

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Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
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[Marcus Baw]

Thanks Ian, that SMART app looks great & is open source

GitHub: https://github.com/chb/smart_sample_apps/tree/master/static/framework/growth_charts

Still need someone to containerize this for a smartphone or web-browser platform

M

[Wai Keong]

Wow... this is amazing.. Show's the possibilities of freeing data and the use of a modern platform.

Can't see anything like happening in any of the established players anytime soon because of the legacy code etc.

[Marcus Baw]

Dear NHS Hack Day -ers

I’m looking for some help with a project I’ve started in advance of the upcoming NHS Hack Day London.

Last year (see email trail/conversation below) I was looking to find an app/webapp/anything that could calculate growth percentiles for childrens heights, weights and ale calculate other parameters like BMI. There wasn’t anything except a really nice SMART app, unfortunately because UK GP systems have shown next to no interest in SMART apps platform integration, the SMART app isn’t that useful.

What’s the problem? Doctors and other HCPs use these centiles to guide decisions about when childrens' height/weight is outside “normal”. This helps in the detection of lots of serious conditions, and was initially mainly used to detect underweight children, (although these days we are finding the opposite problem!). Currently the ‘gold standard’ is to work the centile out from a cardboard chart.

I contacted the MRC (Medical research Council) who own the copyright for the "UK90 LMS Tables”, which is the name of the dataset that is used to calculate the centiles. They have granted me (well, openGPSoC CIC) a free license to use this data in a publicly available webapp, smartphone app, and API so that doctors, nurses, Health Visitors, Midwives etc will be able to get the best use of the data. [Incidentally the data is on a public facing website (http://www.healthforallchildren.com/?product=lmsgrowth) but downloaded from there it is under a very restrictive license.] Our openGPSoC-MRC license specifically allows us to make an open source web app (note that only our code can be open source, the UK90 LMS tables remain MRC copyright…. I’m working on them open sourcing it ;-) )

What have we done so far? Myself and Paul Rubenstein (a biomedical statistician of my recent acquaintance) have written a Python script that takes <height> <weight> <age> and <sex> as input and outputs the <height centile> <weight centile> and <BMI>. All the clever stats stuff is done inside this script and it works. Tactix4 (Rob Dyke) have already provisioned webspace for the web app to run on.

What I need advice and help with is - how best to go about further containerizing this inside some framework that will allow a responsive web-app front end, also API calls to be made for the purposes of native Android/iOS apps and possibly even systems suppliers integrating this functionality into their EHRs etc.

I’m reasonably familiar with Ruby on Rails, and am aware that this could be done using RoR, however since it’s not a particularly database-driven application I wondered if RoR is more than is needed. There are similar MVC frameworks in Python which might be more sensible since our algorithm is in Python, however I suspect it doesn’t really matter. I don’t want to start any holy wars.

The main requirements are that it should be: a) simple b) working c) reasonably scalable

Advice and assistance from anyone interested would be wonderful. 

Marcus

[Damian Roland]

I'm afraid I have no technical knowledge in this regard. 

I can only re-emphasise what I have always said about this:

the person who is able to create an app which allows me to simply plug in a weight and date of birth and get a centile will save child morbity and maybe save a life. 

Its the one thing everyone fails to do because of the hassle of finding a growth chart but it is so important.

I can only say please someone do this!!!

Damian

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine

#HSJRisingStar 2014 (recognising collaboration with colleagues rather than me)

@damian_roland

www.rolobotrambles.wordpress.com

damian...@me.com

For more options, visit https://groups.google.com/d/optout.

[anne.marie...@gmail.com]

Sorry if this has came up before but surely a single point has no value? The child should have a record which you can access and has an on going growth record. 

AM

Sent from my HTC

----- Reply message -----
From: "Damian Roland" <damian...@me.com>
To: <nhsha...@googlegroups.com>
Subject: [nhshackday] Centile Chart App?...... anyone?..........anyone?
Date: Tue, Apr 29, 2014 14:46

I'm afraid I have no technical knowledge in this regard. 

I can only re-emphasise what I have always said about this:

the person who is able to create an app which allows me to simply plug in a weight and date of birth and get a centile will save child morbity and maybe save a life. 

Its the one thing everyone fails to do because of the hassle of finding a growth chart but it is so important.

I can only say please someone do this!!!

Damian

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine
#HSJRisingStar 2014 (recognising collaboration with colleagues rather than me)

@damian_roland
www.rolobotrambles.wordpress.com
damian...@me.com



On 29 Apr 2014, at 14:05, Marcus Baw <marc...@gmail.com

> wrote:

> Dear NHS Hack Day -ers
> 
> I'm looking for some help with a project I've started in advance of the upcoming NHS Hack Day London.
> 
> Last year (see email trail/conversation below) I was looking to find an app/webapp/anything that could calculate growth percentiles for childrens heights, weights and ale calculate other parameters like BMI. There wasn't anything except a really nice SMART app, unfortunately because UK GP systems have shown next to no interest in SMART apps platform integration, the SMART app isn't that useful.
> 
> What's the problem? Doctors and other HCPs use these centiles to guide decisions about when childrens' height/weight is outside "normal". This helps in the detection of lots of serious conditions, and was initially mainly used to detect underweight children, (although these days we are finding the opposite problem!). Currently the 'gold standard' is to work the centile out from a cardboard chart.
> 
> I contacted the MRC (Medical research Council) who own the copyright for the "UK90 LMS Tables", which is the name of the dataset that is used to calculate the centiles. They have granted me (well, openGPSoC CIC) a free license to use this data in a publicly available webapp, smartphone app, and API so that doctors, nurses, Health Visitors, Midwives etc will be able to get the best use of the data. [Incidentally the data is on a public facing website (http://www.healthforallchildren.com/?product=lmsgrowth) but downloaded from there it is under a very restrictive license.] Our openGPSoC-MRC license specifically allows us to make an open source web app (note that only our code can be open source, the UK90 LMS tables remain MRC copyright.... I'm working on them open sourcing it ;-) )
> 
> What have we done so far? Myself and Paul Rubenstein (a biomedical statistician of my recent acquaintance) have written a Python script that takes <height> <weight> <age> and <sex> as input and outputs the <height centile> <weight centile> and <BMI>. All the clever stats stuff is done inside this script and it works. Tactix4 (Rob Dyke) have already provisioned webspace for the web app to run on.
> 
> What I need advice and help with is - how best to go about further containerizing this inside some framework that will allow a responsive web-app front end, also API calls to be made for the purposes of native Android/iOS apps and possibly even systems suppliers integrating this functionality into their EHRs etc.
> 
> I'm reasonably familiar with Ruby on Rails, and am aware that this could be done using RoR, however since it's not a particularly database-driven application I wondered if RoR is more than is needed. There are similar MVC frameworks in Python which might be more sensible since our algorithm is in Python, however I suspect it doesn't really matter. I don't want to start any holy wars.
> 
> The main requirements are that it should be: a) simple b) working c) reasonably scalable
> 
> Advice and assistance from anyone interested would be wonderful. 
> 
> Marcus
> 
> 
> 
> On 10 Sep 2013, at 20:56, Wai Keong <wongwa...@gmail.com> wrote:
> 
>> Wow... this is amazing.. Show's the possibilities of freeing data and the use of a modern platform.
>> 
>> Can't see anything like happening in any of the established players anytime soon because of the legacy code etc.
>> 
>> 
>> 
>> 
>> On 10 September 2013 17:18, Marcus Baw <marc...@gmail.com> wrote:
>> Thanks Ian, that SMART app looks great & is open source
>> 
>> GitHub: https://github.com/chb/smart_sample_apps/tree/master/static/framework/growth_charts

[Damian Roland]

I see why you say that however:

 - After the age on one parents rarely have their red books with them

- any child who is having their weights regularly plotted to look at weight is probably getting enough medical input. 

- in the urgent and emergency care situation (outside of regularly GP who may know the child very well and maybe in the hands of someone without lots of paediatric experience) recognising that a child is below the 2nd centile is important. It might be obvious to you but people can miss this. 

- plotting a weight centile should really be part of many paediatric histories but it simple fails to happen because of the effort involved. 

D

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine

#HSJRisingStar 2014 

@damian_roland

www.rolobotrambles.wordpress.com

damian...@me.com

[anne.marie...@gmail.com]

 No I did not know that being below 2nd percentile at a single point was important.

[Wai Keong Wong]

Amazing points Damian and well made!!

I also want to add my support for this app/ program/ service. 

[Joseph Dal Molin]

Marcus have you looked at SMART recently... they have embraced FHIR
after pivoting a couple of times to address the stick in the mud vendor
behaviour. The growth app has been made to run with the new framework
from what I have seen.

J.

Joseph Dal Molin
President, E-cology Corp.
Tel: +1.416.232.1206
Skype: dalmolin

On 14-04-29 09:05 AM, Marcus Baw wrote:
> Dear NHS Hack Day -ers
>
> I’m looking for some help with a project I’ve started in advance of
> the upcoming NHS Hack Day London.
>
> Last year (see email trail/conversation below) I was looking to find
> an app/webapp/anything that could calculate growth percentiles for
> childrens heights, weights and ale calculate other parameters like
> BMI. There wasn’t anything except a really nice SMART app,
> unfortunately because UK GP systems have shown next to no interest in
> SMART apps platform integration, the SMART app isn’t that useful.
>

> *What’s the problem?* Doctors and other HCPs use these centiles to

> guide decisions about when childrens' height/weight is outside
> “normal”. This helps in the detection of lots of serious conditions,
> and was initially mainly used to detect underweight children,
> (although these days we are finding the opposite problem!). Currently

> the ‘gold standard’ is to work the centile out from a *cardboard chart*.

>
> I contacted the MRC (Medical research Council) who own the copyright
> for the "UK90 LMS Tables”, which is the name of the dataset that is
> used to calculate the centiles. They have granted me (well, openGPSoC

> CIC) a *free license* to use this data in a publicly available webapp,

> smartphone app, and API so that doctors, nurses, Health Visitors,
> Midwives etc will be able to get the best use of the data.
> [Incidentally the data is on a public facing website
> (http://www.healthforallchildren.com/?product=lmsgrowth) but
> downloaded from there it is under a very restrictive license.] Our
> openGPSoC-MRC license specifically allows us to make an open source

> web app (note that only *our code* can be open source, the UK90 LMS

> tables remain MRC copyright…. I’m working on them open sourcing it ;-) )
>

> *What have we done so far? *Myself and Paul Rubenstein (a biomedical

> statistician of my recent acquaintance) have written a Python script
> that takes <height> <weight> <age> and <sex> as input and outputs the
> <height centile> <weight centile> and <BMI>. All the clever stats
> stuff is done inside this script and it works. Tactix4 (Rob Dyke) have
> already provisioned webspace for the web app to run on.
>

> *What I need advice and help with is - how best to go about further

> containerizing this inside some framework that will allow a responsive
> web-app front end, also API calls to be made for the purposes of
> native Android/iOS apps and possibly even systems suppliers

> integrating this functionality into their EHRs etc.*

>
> I’m reasonably familiar with Ruby on Rails, and am aware that this
> could be done using RoR, however since it’s not a particularly
> database-driven application I wondered if RoR is more than is needed.
> There are similar MVC frameworks in Python which might be more
> sensible since our algorithm is in Python, however I suspect it
> doesn’t really matter. I don’t want to start any holy wars.
>
> The main requirements are that it should be: a) simple b) working c)
> reasonably scalable
>
> Advice and assistance from anyone interested would be wonderful.
>
> Marcus
>
>
>
> On 10 Sep 2013, at 20:56, Wai Keong <wongwa...@gmail.com

> <mailto:wongwa...@gmail.com>> wrote:
>
>> Wow... this is amazing.. Show's the possibilities of freeing data and
>> the use of a modern platform.
>>
>> Can't see anything like happening in any of the established players
>> anytime soon because of the legacy code etc.
>>
>>
>>
>>
>> On 10 September 2013 17:18, Marcus Baw <marc...@gmail.com

>> <mailto:marc...@gmail.com>> wrote:
>>
>> Thanks Ian, that SMART app looks great & is open source
>>
>> GitHub:
>> https://github.com/chb/smart_sample_apps/tree/master/static/framework/growth_charts
>>
>> Still need someone to containerize this for a smartphone or
>> web-browser platform
>>
>> M
>>
>>
>> On 10 September 2013 12:13, Ian McNicoll
>> <Ian.Mc...@oceaninformatics.com

>> <mailto:Ian.Mc...@oceaninformatics.com>> wrote:
>>
>> Hi Marcus,
>>
>> see SMARTPlatforms
>> http://sandbox-v06.smartplatforms.org/showcase?app=growth...@apps.smartplatforms.org&patients=7777701,7777702,7777703,7777704,7777705
>>
>> Our Slovenian colleagues, Marand have already implemented
>> this as part of their openEHR hospital paediatric system.
>>
>> Ian
>>
>>
>> On 10 September 2013 10:34, Marcus Baw <marc...@gmail.com

>> <mailto:marc...@gmail.com>> wrote:
>>
>> I'm not sure why this important area of practice seems to
>> have escaped ANY form of App-ification but it's quite
>> inexplicable to me that there is no official
>> WHO/UK/RCPCH/PublicHealthUK/NHSEngland Growth Chart App.
>>
>> I'm not an app dev but I wouldn't have thought that the
>> mathematics behind working out a centile are that
>> difficult, and I would guess they would be published
>> somewhere (though I am not sure where)
>>
>> UK health professionals are still plotting this on

>> (gasp)*printed card * charts. There is a PDF version to

>> download if you like wasting even more of your own time
>> since the PDF is not at all dynamic and works exactly
>> like the card version, except it's on your shitty NHS 14"
>> screen.
>>
>> Amazingly, the GP clinical systems don't even have
>> centile calculators in them, such as they have for QRisk,
>> BMI etc.
>>

>> I do believe that the charts are *copyrighted* FFS which

>> goes against the spirit of sharing and wholesomeness that
>> the WHO implies by its very existence.
>>
>> http://www.rcpch.ac.uk/growthcharts
>>
>> So, I ask you, the NHSHackDay community:
>>
>> 1) Does anyone know of any digital versions of the WHO
>> centile charts, perhaps ones I have missed when looking?
>>
>> 2) Is anyone up for developing an app like this

>> *unofficially* and potentially *against copyright* in
>> order to shame the buggers into doing a proper *official*

>> one (much like what was done with the BNF and NICE by NHS
>> Hack Day in the past) ? It would need to have the growth
>> charts and for added bonus points, the centile-adjusted
>> BMI/weight charts.
>>
>> 3) there is no 3.
>>
>> M
>>
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>>
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>> <http://www.openehr.org/knowledge>

>> Honorary Senior Research Associate, CHIME, UCL
>> SCIMP Working Group, NHS Scotland

>> BCS Primary Health Care www.phcsg.org <http://www.phcsg.org/>

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[VJ]

Growth chart works off my phone.

https://apps.fhir.me/#/ui/patient-selected/1482713

Username&password are both lowercase:

demo

Best,
VJ

 tables remain MRC copyright.... I'm working on them open sourcing it ;-) )

[Ian McNicoll]

Hi Joseph,

I agree that the SMART-on-FHIR approach seems to be getting momentum
but I am not sure how mature it is yet, though certainly the growth
chart does work. I am not sure this actually helps Marcus however,
since he wants a much simpler calculator / UI which does not rely on
an existing datasource.

Ian

>> tables remain MRC copyright.... I'm working on them open sourcing it ;-) )

> To unsubscribe from this group and stop receiving emails from it, send an email to nhshackday+...@googlegroups.com.

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office +44 (0)1536 414 994

fax +44 (0)1536 516317

mobile +44 (0)775 209 7859

skype ianmcnicoll

ian.mc...@oceaninformatics.com

Clinical Modelling Consultant, Ocean Informatics, UK
Director openEHR Foundation www.openehr.org/knowledge

[Damian Roland]

Think probably best to clarify: I'm not saying that clinical decisions should ever be taken in isolation on a single weight but that children who worrying symptoms AND who are low weight deserve this to be taken into consideration. Knowing a child has a low weight for age is not always obvious.

All the best

Damian

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine

#HSJRisingStar 2014 

@damian_roland

www.rolobotrambles.wordpress.com

damian...@me.com

[Neville Dastur]

Happy to write the app if the Marcus you can sort out the backend API server part.

ASAIK if is fairly straight forward to create HTTP servers in python which as you say would fit nicely with the current scripts. Give me a RESTful API and I’ll make Damian’s app.

Neville

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[Joseph Dal Molin]

Good points... realized my previous post was written too quickly...
let's park SMART in the incubator for a while as it wasn't what I
intended to focus on. Would it be technically unfeasible to take the
growth chart app which works with SMART and make it work without
SMART... it is open source and on GitHub... runs on all sorts of
devices.... and has won several awards for its design. IMHO it would be
a shame not to leverage all that good work.... caveat: I'm not a
programmer so don't have the same sorts of urges programmers have ;-)
and I am prone occasional fits of blind optimism when it comes to
reusability.

Joseph

[Marcus Baw]

Glad to see some interest and discussion about this. Thanks for all your comments.

I know of the SMART app but it's too complex to implement and I can't see any GP suppliers bothering to put in SMART app containers anytime soon.

We have got a working script that accepts height, weight, age and sex and outputs centiles for height, weight and also a BMI. It's quite simple but it does everything needed.

All we need is advice about how best to platform it so there will be a REST API,  on top of which we can build responsive web apps, mobile apps etc. In the absence of any strong persuasive advice about how to platform it, I'll be doing it in Ruby on Rails or something slightly more lightweight like Sinatra. Speak now Ruby haters or forever hold your peace!

Anne Marie: good point you make about longitudinal measurement over time as opposed to a single measurement. This is one of the main reasons I want to do this app - because the paper/PDF centiles charts are so difficult to use in a paperless workflow over multiple visits. If you calculate a centiles on paper at the first visit, then scan the paper in, then at subsequent visits you are going to have to print out the scanned chart, add new observations, and scan it in again. Madness!

Much better to be able to record centiles in coded form in the record, serially.

M

[Chris Casey]

I am getting a little confused here.

There seems to be several viewpoints here and they are overlapping/conflicting.

Just trying to get it clear in my head so not trying to offend anyone.

One requirement is for anonymous call inputting age/weight/height and getting centile.

(Just as an aside there is more than one UK chart - my Daughter has achondroplasia and need a different chart [try and find that one!] so maybe more questions needed.)

Another is to be able to track this over time therefore not anonymous and needs to be part of a PHR or equivalent.

There seems to be some conflict over whether this can be general and open to all or able to be linked to GP tool providers?

There is also some questions about platform but not sure at what level this is being asked as there seems to be some confusion between wanting rest vs api.

Any modern platform should be able to support REST so really unsure what is being asked.

I have built my aboutMyHospital system using ewd.js (node) which provides both transactional history (if required - as I have used for VistA) and UI's that work on browser or mobile as well as exposing rest interfaces.

Why does anyone need a 'mobile app' to perform a simple function when it can just be a very simple web page that works on mobile or PC?

Regardless of the above - exposing rest interfaces should be easy enough so that others can then use those to build whatever interfaces they need.

Chris

>>>>         http://sandbox-v06.smartplatforms.org/showcase?app=growth_charts@apps.smartplatforms.org&patients=7777701,7777702,7777703,7777704,7777705

>>>> <mailto:nhshackday+unsub...@googlegroups.com>.

>>>> For more options, visit https://groups.google.com/groups/opt_out.
>>> --
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[Marcus Baw]

Hi Chris,

Getting different viewpoints is exactly why I asked the list! ;-)

I am planning a very simple implementation - anonymous client can request a centile if they supply a height, weight, age and sex. What the user does with this afterwards is their business.

There will be no persistence of the queries in the server.

My question as to what platform I should use was really to avoid me setting off in a direction that I would regret later. The tech guys on here would know how best to set up a REST API without tying myself to a technology stack that would hold us back and maybe cause a replatforming later on. But so far there have been no strong voices on that part of the topic.

I agree that a simple HTML responsive web app will be fine viewed on mobile devices so a native app would only have an advantage if I could get the MRC to license the LMS tables for use in a mobile app as well (currently I have a license for just the web app, although I’m hoping with a good web app as a proof-of-concept behind us we will be able to make a good case for extension of the license terms)

M

[David Miller]

> What I need advice and help with is - how best to go about further containerizing this inside some framework that will allow a responsive web-app front end, also API
>

> I wondered if RoR is more than is needed.

Yes. It is more magic than you require ;)

> There are similar MVC frameworks in Python

Also more than you require.

> which might be more sensible since our algorithm is in Python

Plausible.
I can show you how to put an api/web front end on it in a couple hours w. the pythons & the internetings.

Happy to do so at NHSHD London.

> I suspect it doesn’t really matter.

Quite.
Also trivial w. The rubies if you're more comfortable there.

HTH

[Dilshad Marikar]

Dear Marcus

Thanks for putting up the LMS data - I was trying to get this this via the RCPCH growth chart email contacts but did not have any luck!

Speaking in terms of my needs of as paediatric trainee working in A+E just wanted to say

1)a web app is great but a mobile app would be even better given problems with connectivity!

2) If for a date of birth/age we could derive weight centiles and Head circumference centiles (v important in the infant in terms of potential 1st sign of hydrocephalus/tumour)  i'd be happy (but bmi and height centiles would be nice too) 

This blood pressure centile calculator just sticks all its LMS data in a javascript array in the HTML

http://medcalc3000.com/BloodPressurePercentBoys.htm

Not sure how feasible that would be with the amount of growth chart LMS data, but it would make a simple local HTML app

Dilshad

[Dilshad Marikar]

This implementation is for premature infants and sadly a bit buggy, but if something with output along these lines existed it would be a great help 

http://www.paediatrics.co.uk/nicu/growth-charts

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[Marcus Baw]

Thanks Dilshad and David. Some very useful input.

I like the idea of this all being done in Javascript as per the Medcalc example , that would make things a bit simpler although we would need to rewrite the Python script in Javascript (shouldn't be too hard).

It would reduce latency as it would all be client side, and should allow the app to reside in a mobile device and work without a data connection.

Excellent food for thought.

David thanks for offer of help, I will be taking you up on this! See you at NHSHD

M

On 1 May 2014 02:05, "Dilshad Marikar" <dilshad...@gmail.com> wrote:

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[VJ]

Hi Dilshad,

 

In terms of a standalone offline app, I did a quick search on the Play Store and can see about ten appropriate results for “growth chart”. Most are free.  Would you be able to comment on what the shortcomings are of the currently available solutions?

 

Best,

VJ

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[Dilshad Marikar]

hi Marcus
D

Thanks Marcus I feel this is an app I'd be using pretty much daily.  I'd be glad to help you test it

I have some other related projects for the future, which I think will be of immediate use in acute paediatrics.  

I note that the zip file you link to also has an LMS blood pressure centile data derived from UK children data - that would be very useful too!

There was a publication in the lancet that used pooled data to derive heart rate and respiratory rate centiles for kids.  This is useful as cut offs above (or potentially below) the centile extremes could identify potentially seriously I'll kids.  In my mind even more interesting is a dutch study that derived temperature, heart rate and resp rate centiles for children with fever (identifying a child who has a heart rate out of proportion to his fever - could be v sick).  if authors could persuaded to part with their data, these would be some damn useful apps - and could be incorporated into a electronic paediatric early warning score

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[Chris]

Most of the growth charts I have seen on the Apple store are not UK.
The centile charts will vary by country.

Chris

[Dilshad Marikar]

Hi VJ

I've tried 4 of these apps, sadly they use WHO chart data rather than the UK-WHO growth chart data, (which I understand does some mixing and matching with WHO and UK data)

Regards

Dilshad

[Omer Moghraby]

Dear all 

I think this is an excellent idea - I thought i did have one that used UK data set but I cant find it (as phone recently died). 

there was a program on palm (which i have had to temporarily revert to) called ABase which apparently did use this. 

Is it possible to get access to latest UK data set this would be helpful/important especially given there are PH reports of shifts to the right in the weights for the centiles. 

finally BMI is useful but what I find more helpful is the weight for height data (especially for low weight 8-14 year olds) but I have only seen this on an excel sheet (attached). If this could be incorporated it woudl certainly be a killer app from mental health perspective! 

 

bw

Omer

                         

Dr Omer Moghraby
Consultant Child & Adolescent Psychiatrist (in Lewisham)
South London & the Maudsley NHS Foundation trust (SLaM)

www.myhealthlocker.nhs.uk  follow @myhealthlocker 

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www.wnmcp.org.uk   follow @wnmcp

(+44) 7968775698
@moghraby

[Omer Moghraby]

sorry ...also would there be a way of exporting this data? (emailing to ourselves or perhaps later integrating to patient records directly(!)), especially if it could turn into a database of particular patients ...if you have a secure device of course. 

bw

omer

[Chris Casey]

If you were to rewrite this in javascript I could put it up on node sooooo easily for a bootstrap front end,
I could then add an optional persistence layer as well.

This would also by default be rest enabled so could be used by mobile clients.

All the best of every world

[Rob Dyke]

Fork it.
:-)
Rob

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[Dilshad Marikar]

Actually one of the 'future projects' has already been implemented by madox.org (heart and resp rate centiles):

madox.org/webapp/184

Nice and simple and can be used locally!

Dilshad

[Omer Moghraby]

wow ...how about blood pressures -anyone? (chart attached)

                         

Dr Omer Moghraby

Consultant Child & Adolescent Psychiatrist (in Lewisham)
South London & the Maudsley NHS Foundation trust (SLaM)

www.myhealthlocker.nhs.uk  follow @myhealthlocker 

[Damian Roland]

As an aside to point 2 I'm going to take this to Hilary Cass (current president of RCPCH) - she very much has a seek forgiveness rather than ask permission mentality and might endorse such an approach...

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine

#HSJRisingStar 2014 

@damian_roland

www.rolobotrambles.wordpress.com

damian...@me.com

On 10 Sep 2013, at 10:34, Marcus Baw <marc...@gmail.com> wrote:

I'm not sure why this important area of practice seems to have escaped ANY form of App-ification but it's quite inexplicable to me that there is no official WHO/UK/RCPCH/PublicHealthUK/NHSEngland Growth Chart App.

I'm not an app dev but I wouldn't have thought that the mathematics behind working out a centile are that difficult, and I would guess they would be published somewhere (though I am not sure where)

UK health professionals are still plotting this on (gasp) printed card charts. There is a PDF version to download if you like wasting even more of your own time since the PDF is not at all dynamic and works exactly like the card version, except it's on your shitty NHS 14" screen.

Amazingly, the GP clinical systems don't even have centile calculators in them, such as they have for QRisk, BMI etc.

I do believe that the charts are copyrighted FFS which goes against the spirit of sharing and wholesomeness that the WHO implies by its very existence.

http://www.rcpch.ac.uk/growthcharts

So, I ask you, the NHSHackDay community:

1) Does anyone know of any digital versions of the WHO centile charts, perhaps ones I have missed when looking?

2) Is anyone up for developing an app like this unofficially and potentially against copyright in order to shame the buggers into doing a proper official one (much like what was done with the BNF and NICE by NHS Hack Day in the past) ? It would need to have the growth charts and for added bonus points, the centile-adjusted BMI/weight charts.

3) there is no 3.

M

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[Damian Roland]

Just to clarify some of the things the centile chart 'app' may be able to do. 

1) A stand alone single centile calculation - age/weight (+/- height) inputted and centile delivered - useful for urgent/emergency care and growth chart not available or difficult to find

2) number (1) but with some recording function that allows serial measurements to be tracked. Probably more useful for parents maybe as exporting this information to current paper based red books or other health records maybe difficult. Potentially could combine with current GP systems to allow electronic tracking but I suppose this already occurs to some degree in the GPs own clinical notes.

3) An enhanced version of (2) designed to match local or national charts and potentially has possibility to print of graphs into the red book and also link with current electronic health records. 

While the red book remains a paper based health record the recording of serial measurements over time remains a pain in the ass...

(and Ideally for UK use these should be UK based charts...)

Damian

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine

#HSJRisingStar 2014 

@damian_roland

www.rolobotrambles.wordpress.com

damian...@me.com

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[Ian McNicoll]

For anyone interested in (2) or (3), I hope to be able to demonstrate
something on this at the next Hackday based on a SMARTPlatforms chart
modified to include UK LMS data but should allow the patient to be
persisted. See

https://dev.ehrscape.com/ehrscape/demosmart1.html

Ian

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[Marcus Baw]

Ian, the SMART app is utterly beautiful. It does do a lot of what we would need, as long as we can get it into a full screen web app container that isn’t a ‘demo’, and accept input from <input> boxes not just from the underlying EHR (which isn’t there). openGPSOC is up for working with you on this. 

To all of you showing interest and commenting thanks for your support

The feature requests are all being noted and we will add them ASAP - BUT please let’s KEEP IT SIMPLE so it will get done and it will work.

I accept the need for data to be persisted AT SOME FUTURE POINT but can we just keep this simple for now and let a GP/paed/HV/school nurse enter  H/W/A/S and get their centiles. 

For maximum benefit to hospital docs I am going to try and make the app work offline. Doing the whole thing in .js with the data downloaded to device in an array might work and I think we would get away with it from UK90 MRC licensing POV, since the data are already publicly available from other places on the Interwebs, you accept the license as a condition of download, so I’ll do the same. 

M

[Dilshad Marikar]

I apologise if this is going over ground you know already:

1) Infants 37-42 weeks are considered term and plotted at 0 weeks on the chart

2) What is the plan for preterms?  I think its reasonable if a decision is made not to include this data to reduce complexity. 

3)However... we do come across ex-preterm infants who have been discharged. It would be nice to do gestational age correction to get the correct centile.  (This just involves subtracting back for the number of weeks premature).

Reference:

http://www.rcpch.ac.uk/sites/default/files/asset_library/Research/Growth%20Charts/Education%20Materials%2001092010/4%20Term%20and%20preterm%20infants.ppt

Dilshad

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[Dilshad Marikar]

From the RCPCH teaching material gestational age correction should be continued till one year for infants born 32-36 weeks and up to 2 years for infants born before 32 weeks

This is the only instance of correction that needs to apply to growth charts from my experience

In terms of implementing this - perhaps an optional 'gestational correction needed' and if selected select a preterm gestation?  Not enabled by default

Regards

Dilshad

On 1 May 2014 02:05, Dilshad Marikar <dilshad...@gmail.com> wrote:

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[Marcus Baw]

the EHRscape people have published their source for their beautiful HTML5 SMART App Growth Chart.

github: https://github.com/ehrscape/examples

demo: https://dev.ehrscape.com/ehrscape/demosmart1.html

I don’t understand SMART technology but I think it requires connection to a SMART server/container in order to take input (in terms of age/sex/height/weight) - but here it is for anyone interested. Maybe we can make use of it in some way.

M

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[Omer Moghraby]

This SMART app/web tool is really beautiful (to endorse previous descriptions). 

Keeping it simple in the first instance is probably a good idea from usage point of view. 

Are you still considering weight for height? /centile-linked BMI?

BTW - the Redbook does have a MS Healthvault endorsed e-version but only as a trial at the moment and only in certain places. Have people used it? Perhaps it could link directly?   

http://www.eredbook.org.uk/

bw

Omer

[Jonathan Kay]

Thanks for pointing that out: does anyone need more information on this?

Jonathan

Prof Jonathan Kay

Clinical Informatics Director

NHS England

Email: jonath...@nhs.net

[Marcus Baw]

Does Microsoft Health Vault haz an open source version? Does it publish its data model so we can interoperate?

I can’t find it on GitHub ;-)

M

[Ian McNicoll]

The data model is published

https://developer.healthvault.com/pages/types/types.aspx

not open source and may not be exposed by eRedBook

Ian

[Marcus Baw]

cool thx Ian

[Neville Dastur]

Sorry Marcus but this made me chuckle …

Using Microsoft along with open source I think is a oxymoron and further chuckles from the idea that MS would put code on GitHub!!

Neville

[Neville Dastur]

A slightly more serious reply is that MS have their own GitHub type affair called codeplex http://www.codeplex.com/ you might have more luck looking there.

On 8 May 2014, at 13:47, Marcus Baw <marc...@gmail.com> wrote:

[Marcus Baw]

I was being a little facetious…

M

[Rob Dyke]

and here be linkage to MS on github with repos supporting using opensource along with windows

https://github.com/msopentech

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---

From: "Neville Dastur" <neville...@gmail.com>
To: nhsha...@googlegroups.com
Sent: Thursday, 8 May, 2014 1:58:37 PM

Subject: Re: [nhshackday] Centile Chart App?...... anyone?..........anyone?

[Jonathan Kay]

On 2 May 2014, at 09:20, Damian Roland <damian...@me.com> wrote:

> 2) number (1) but with some recording function that allows serial measurements to be tracked. Probably more useful for parents maybe as exporting this information to current paper based red books or other health records maybe difficult. Potentially could combine with current GP systems to allow electronic tracking but I suppose this already occurs to some degree in the GPs own clinical notes.

I haven't read all the posts but could someone tell me the use case for this app if it doesn't join up with GP records? Or possibly Child Health records as well but I don't know much about those, except in National Screening Programmes.

Thanks

Jonathan

[Rob Dyke]

Groundwork.
When GPSoC-R funded/mandated APIs materialize then app could be hooked up....

[Marcus Baw]

There are lots of professionals that would want to be able to put in Height, Weight, Age and Sex and get the Centile. Not all are GPs.

Who would use it? Hospital: Paediatricians, nurses, midwives; Community: Paeds, midwives, Health Visitors, School Nurses, Social Care, Parents, Patients themselves, GPs, Practice Nurses, HCAs doing Child Measurement.

It would be lovely if it linked with GP records but not everything is about data linking with everything else. And once this 

At present the gold standard is a fucking piece of card or even worse a PDF for Christ’s sake. Why hasn’t that been moved on by ANYONE yet?

An Informatician colleague told me yesterday that computed centiles were a requested feature on EHRs back in 1995 but it was ‘only’ nurses asking for it so nothing got done. I am stunned that despite the 'telephone-number’amounts of money that has been poured into NHS IT in the last few years NOBODY has done this simple thing that could be so helpful. (and I am doing it, unfunded)

Perhaps NHS England would want to throw £3K at openGPSoC - that should EASILY cover the costs of finishing this app and probably some future developments - like linking it to GP records.

And perhaps simple but desperately needed functions like this - free for all users that might need it - should have been thought of when the eRedBook was commissioned and presumably paid for by NHS England or Public Health England.

M

[Damian Roland]

Although I am not sure I would use the same language as Marcus my emotions are the same.

This SMART app thing is very pretty. I don't want pretty I want functional.

I want to enter a weight and a age and to be given a centile from a UK chart. period.

I can't believe I am the only clinician in the UK who feels this would be useful.. (but maybe I will have to survey people to prove it)

Damian

Dr. Damian Roland

Consultant and Lecturer in Paediatric Emergency Medicine

#HSJRisingStar 2014 

@damian_roland

www.rolobotrambles.wordpress.com

damian...@me.com

[Marcus Baw]

I was hoping to be able to forgo the Survey this time around, but perhaps not Damian…. ;-)

Apologies for the parliamentary language but as you might guess I am somewhat vexed at present.

M

[Chris]

Absolutely agree with the sentiments here.
Should be simple as pie.
Real problem is restrictive copyright prevents open use.

Chris

[Marcus Baw]

The copyright issue might be one we can change.

Once I have this proof of concept up and running I will try to get the MRC to see that they are not gaining anything by NOT releasing this as Open Data. They might come round to it - after all they did license it to me for free as long as I made an open source app and did not use it for financial gain (e.g. having Google AdSense on the page etc) - all quite reasonable.

I’m not entirely sure why it isn’t Open Data already though, given it was almost certainly generated with 100% taxpayer funding (NHS/MRC etc).

I think they’ll be amenable to discussion especially once there is a proof of concept app.

M

[Rob Dyke]

How so? Marcus is proving that although copywrited (a legal construct /all/ open source projects depend on) there are permissive licensees available for the datatables.

[Chris]

I suspect there is no particular resistance to the concept of opening it up but an decision making inertia that will action it.
There is a lot of rhetoric on opening data out, and now we are beginning to see action, but it is glacially slow.
I have been waiting 8 months for a reply on a request for commercial use of mortality data, and still waiting.....

Chris

[Chris]

Oh! Have I missed something here?
Where are the permissive licenses?
Do you have a link?

Chris

[Chris Casey]

This is getting crazy.

Someone tell me where the data/calculations are available and I will have a public service up and running by tomorrow! 

[Rob Dyke]

A read of this thread will link you to what you need....

--
Rob Dyke

---

From: "Chris Casey" <boroc...@gmail.com>
To: nhsha...@googlegroups.com
Cc: ch...@carsmartin.net
Sent: Thursday, 8 May, 2014 4:21:39 PM

Subject: Re: [nhshackday] Centile Chart App?...... anyone?..........anyone?

[Chris Casey]

Rob,

I have gone back through it several times and while I can find links to the pdf charts I can't seem to find a link to the actual data and calculations so if you know where in this huge thread they are I would appreciate a fresh link saving me a lot of time that I could be spending doing other things

chris

[Rob Dyke]

https://github.com/openGPSoC/the_centile_app ?

--
Rob Dyke

---

From: "Chris Casey" <boroc...@gmail.com>
To: nhsha...@googlegroups.com
Cc: ch...@carsmartin.net

Sent: Thursday, 8 May, 2014 4:39:37 PM

Subject: Re: [nhshackday] Centile Chart App?...... anyone?..........anyone?

[Marcus Baw]

Chris, perhaps we should speak to discuss because I could really use your help.

I’ll contact you off list.

M

[Omer Moghraby]

Completely agree with these sentiments. 

Can I add Child Psychiatrists and some CAMHS workers - especially (but not exclusively) in ADHD where we are currently doing this all the time. 

there is a fairly rudimentary wt/ht in our own EPR but its not great and I generally use that excel sheet that I circulated earlier. 

bw

omer

                         

Dr Omer Moghraby

Consultant Child & Adolescent Psychiatrist (in Lewisham)
South London & the Maudsley NHS Foundation trust (SLaM)

www.myhealthlocker.nhs.uk  follow @myhealthlocker 

[Chris Casey]

Who needed tomorrow!!

 

I am sure it is buggy as I just finished coding it but public rest service up and running.

I have even provided a standard rest interface to test it out.

Try it out

Just don't call me just yet if you find any problems as I am going to sleep. 

Chris

[Kevin Mayfield]

Confused!!

As for a RESTful API, it was answered quite early on in the thread (several times before the question I think)

The SMART App uses a standard RESTful API using the HL7 FHIR standard. So the SMART App will work on an EPR that conforms to the same standard. [I'd presume the API returns an atom feed of HL7 FHIR Observation Resources]

I'll have a look at what we are doing internally (on the app side). Data layer isn't presented as FHIR yet, I've avoided an OCD spasm at the moment but it's on the hit list. 

[Ian McNicoll]

Hi Kevin,

I think the FHIR data layer is still 'in-development' and the growth
charts may still work with the current SMART data API. I am pretty
sure that EHRSscape works with the SMART APIs though FHIR support is
in-hand.

Ian

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[Marcus Baw]

"So the SMART App will work on an EPR that conforms to the same standard”

trouble is, none of the GP systems conform yet. Or do they?

M

[Marcus Baw]

CENTILE CALCULATING REST API NOW LIVE AT

http://ec2-54-237-33-114.compute-1.amazonaws.com:8080/ewd/swagger/index3.html

you can play with it at the URL above using the Swagger GUI

PLEASE ALL FEEL FREE TO SPEND THE WEEKEND WRITING CLIENTS FOR IT… ;-)

• we need a web client (can be more than one) and are working on one of our own
• feel free to embed centile functions into your own projects - say for example you own TPP, EMIS or INPS
• Native Android and iOS clients would be nice
• or responsive multi platform HTML5-foo

Please note that the license terms state we can’t make money out of providing this, so a paid app or one with advertising on it won’t fly...

contact me if you require any help although the API is fairly self explanatory

M

[Damian Roland]

Brilliant - thank you to everyone involved in putting this together!

Damian 

Sent from my iPhone

[Christopher Kelly]

Hi everyone,

I also had a go at this earlier in the year after an email from Dilshad and Damian, but got sidetracked by paediatrics exams...now passed :)

I was 90% finished with it - sorry for the duplication... Will upload my efforts too so you can have a peek!

Cheers,
Chris

[Marcus Baw]

great - it would be interesting to see. is it on github?

M

[Christopher Kelly]

No I'm afraid not - but it was all in JavaScript. Just on my way back
from holiday, so will post it when I'm back!

Cheers,
Chris

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[Kevin Mayfield]

I've been looking at FHIR and for most UK uses I'd class it as stable. The unstable parts tend to be around more advanced uses of EPR which in most cases are a bit beyond uk at mo.

FHIR interfaces are very simple to do (I'm averaging one resource every day at mo or less) and easy to pick up (compared to hl7v2, CDA, nhs, bespoke, etc).

Point is you do this using FHIR now and no spend time creating and documenting another standard, which will likely have to be replaced in a year or so with FHIR

[Kevin Mayfield]

Some sample FHIR examples returning BMI and weights.

http://www.hl7.org/implement/standards/fhir/observation-examples.html

Specific data types would be returned via search parameters (you would search for the patient and the codes you wish returned, this matches structure of GP and EPR systems)

[Rik Smithies]

Just to add that there is a FHIR hack day 20th May in Bristol. Anyone interested can contact me for details.

Rik

tcc...@hl7.org.uk

[Christopher Kelly]

Hi everyone,

Six months later...I've finally had a go at making the growth charts app from UK-WHO data - it's gone live this morning at:

iPhone:

https://itunes.apple.com/us/app/growth-charts-uk-who/id916579608

Android:

https://play.google.com/store/apps/details?id=com.incubate.growthcharts

Would be amazing if anyone fancied trying it out, and seeing if they can break it!

Sorry it's taken so long - ended up being a surprisingly tricky app to make given that it's just a single button. There are so many subtle nuances to growth charts! I've been testing various iterations for a couple of months during my job, and am happy with it now.

There are a couple of other minor things I've spotted this morning, which I will fix (chart says "preterm" even if it's not, and I should really hide the gestation input if the child's age is >2 years). Also would be nice to add trend recording for the future.... but hopefully it's a decent first step.

Any feedback very much appreciated!

Cheers,

Chris

[Marcus Baw]

Top work Chris. I'll check it out immediately.

Are you free on 26th November to come to the NHS open source open day? I'm going up there to talk about Centiles, would be great to co-present the work with yours.

PS: did you get a licence from the MRC for the data or from somewhere else?

M

[Christopher Kelly]

Hi Marcus,

Thanks! I think I am free on 26th Nov - sounds fun.

Good point about the licensing - I'm not sure I have signed a specific agreement about apps (I got the original dataset from the RCPCH in 2012). I will get in contact now...eek.

Cheers,

Chris

[Marcus Baw]

Lets take this off list Chris to avoid cluttering NHSHD list. I don't think you'll have a problem getting a licence from MRC. I wonder if we could make the case that this SHOULD be open data, and to that end involve the ODI etc and take the argument to Prof Tim Cook who is the original author of the UK95 LMS data.

[Wai Keong Wong]

Chris. This is great work!

Will attempt to break it...

[Jonathan Kay]

Well done.

Any thoughts about an outgoing HL7 message?

Does anyone know the data standards behind Apple HealthKit?

Jonathan

On 7 Oct 2014, at 12:09, Christopher Kelly <ch...@incubate.co.uk> wrote:

Hi everyone,

Six months later...I've finally had a go at making the growth charts app from UK-WHO data - it's gone live this morning at:

iPhone:

https://itunes.apple.com/us/app/growth-charts-uk-who/id916579608

Android:

https://play.google.com/store/apps/details?id=com.incubate.growthcharts

Would be amazing if anyone fancied trying it out, and seeing if they can break it!

Sorry it's taken so long - ended up being a surprisingly tricky app to make given that it's just a single button. There are so many subtle nuances to growth charts! I've been testing various iterations for a couple of months during my job, and am happy with it now.

There are a couple of other minor things I've spotted this morning, which I will fix (chart says "preterm" even if it's not, and I should really hide the gestation input if the child's age is >2 years). Also would be nice to add trend recording for the future.... but hopefully it's a decent first step.

[Christopher Kelly]

Thanks everyone! 

It would be neat to output the data to HealthKit for iOS... Only really appropriate for your own children though, which might be better done within the app I guess.

Although looking at the "Body Measurements" section of the Apple Health app, there is height/weight/bmi, which I suppose could be used as a data store. The app could then calculate centiles for a range of values re-imported from there to build a trend...?

Cheers,
Chris

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[Chris Casey]

Chris,

I assume that you are aware of the Rest Centile functionality implemented quite a while ago and described in this list.

Have you used these functions as part of your app or re-implemented from scratch?

Chris

[Christopher Kelly]

Hi Chris,

Thanks - I do remember discussions about a Rest API from earlier in the year, but as I wanted it all to run offline in a bunker in A&E, I'm assuming that wouldn't have been suitable for this?

It's been all written from scratch... might not have been the best approach with hindsight...but equally it means I do know exactly how it's calculating everything!

Cheers,

Chris

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[Marcus Baw]

I can understand your need for it to work offline, and I was working on a HTML5 mobile version of the app which did not need the API that Chris Casey built for me.

The API remains useful though since it allows EHR vendors to easily, safely and quickly incorporate the Centile functionality without having to to the stats themselves. (Not that there's been ANY interest from the GP EHR vendors - with a captive market, who needs continuous product improvment?)

M

[Adhiraj Joglekar]

Is there an update to this thread? 

Like Dr Omer Moghraby, as a CAMHS Psychiatrist who deals with eating disorder cases I am keen on an open API that delivers on weight for height other than the weight and height centiles separately - as per the excel sheet that Dr Omer Moghraby kindly posted. 

I am working with a developer who could create the interface but I am not sure I can give him the bio-stat know how.

All help appreciated in advance. 

BW

[Chris]

Unfortunately, I won't be at the Hackday this time around (again), but I recently obtained the Health Survey for England 2012 data, and fitted distributions to various variables including body mass index (BMI or Quetelet index).

My intention is to generate percentile charts or lookups for them and make them generally available, but so far I have only got the BMI up.

https://www.crystallise.com/home/BMI+percentile+charts

I can supply spreadsheets with the distributions for BMI, height, weight, systolic blood pressure, HbA1c, cigarettes per day in smokers, total cholesterol to HDL ratio and would be very interested using an api.

I will do a follow up post with a link to the spreadsheets.

One word of caution about the use in eating disorders, I presume that the zone of interest here is arond and below the 1st percentile. This is where the tables will be most inaccurate due to low numbers.

Let me know if you need anything else.

Chris

[Keith Grimes]

Not read whole thread, but doesn't http://www.statcoder.com/ do this already? Appreciate US/WHO data

Keith

On Tuesday, 10 September 2013 10:34:33 UTC+1, Marcus Baw wrote:

I'm not sure why this important area of practice seems to have escaped ANY form of App-ification but it's quite inexplicable to me that there is no official WHO/UK/RCPCH/PublicHealthUK/NHSEngland Growth Chart App.

I'm not an app dev but I wouldn't have thought that the mathematics behind working out a centile are that difficult, and I would guess they would be published somewhere (though I am not sure where)

UK health professionals are still plotting this on (gasp) printed card charts. There is a PDF version to download if you like wasting even more of your own time since the PDF is not at all dynamic and works exactly like the card version, except it's on your shitty NHS 14" screen.

Amazingly, the GP clinical systems don't even have centile calculators in them, such as they have for QRisk, BMI etc.

I do believe that the charts are copyrighted FFS which goes against the spirit of sharing and wholesomeness that the WHO implies by its very existence.

http://www.rcpch.ac.uk/growthcharts

So, I ask you, the NHSHackDay community:

1) Does anyone know of any digital versions of the WHO centile charts, perhaps ones I have missed when looking?

2) Is anyone up for developing an app like this unofficially and potentially against copyright in order to shame the buggers into doing a proper official one (much like what was done with the BNF and NICE by NHS Hack Day in the past) ? It would need to have the growth charts and for added bonus points, the centile-adjusted BMI/weight charts.

3) there is no 3.

M

[Chris]

I could find a US Apple app, but nothing for the UK or Android.

Chris

--

[Chris]

You can download the spreadsheet from here.

Applied an MIT license so it can be disseminated and developed freely.

https://www.crystallise.com/RiskFactorDistributions_View.xlsx

Chris

[Keith Grimes]

Admittedly this would be a simple app and easy win for a hackday

K

[Chris]

Here is the documentation of the methods of fitting the distributions.

http://www.crystallise.com/Derivation%20of%20baseline%20risk%20factor%20distributions%20Formatted.pdf

Chris

--

[Omer Moghraby]

we could probably get uptodate UK figures (as you might imagine there are differences in weight centiles) from the MRC or RCPCH & api to that (huge dataset). An old SHO of mine developed something similar for blood pressure when working in my service:

danjoyce.shinyapps.io/adhd_project 

(this version uses CDC dataset but a UK version is due out soon). 

--

                         

Dr Omer Moghraby
Lead Consultant Child & Adolescent Psychiatrist (in Lewisham)
South London & the Maudsley NHS Foundation trust (SLaM)

Office: 020 7138 1456
Mobile: (+44) 7968775698  
Twitter: @moghraby

Finance Officer, Informatics Committee, RCPsych
http://www.rcpsych.ac.uk/college/specialinterestgroups/mentalhealthinformatics.aspx
via @RCPsych

Chairman, WNMCP
www.wnmcp.org.uk   follow @wnmcp

[Chris]

This is for 2012 England figures in adults.

If you are after more recent children's percentiles, you can find them here:

http://www.hscic.gov.uk/searchcatalogue?productid=19585&q=health+survey+for+england&sort=Relevance&size=10&page=1#top

Chris

https://www.crystallise.com/RiskFactorDistributions_View.xlsx

Chris

[Marcus Baw]

I'm at a different hack day and don't have time for a full reply, but I have done extensive work on Centiles for Height, Weight, BMI and also open data about obesity and know my way around the data tables, the licensing and all the other bits.

I'll be at NHSHD at the weekend if anyone wants to talk about this more.

Marcus

[Omer Moghraby]

sounds like a plan Marcus. would be very helpful in terms of children. (methodology at least)