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— updated 2018-05-31

Herbalists' BootCamp
Beginner Tutorial #6:   CaseQuery

by Roger W. Wicke, Ph.D.
This tutorial series will help you get started using the HerbalThink-TCM software, ensure it is installed correctly, demonstrate how to use important features and modules, and teach you basic principles of Chinese herbology that you can begin applying practically. Successful completion of this series is required for all applicants to the RMHInet brainstorming network and to our professional courses.

Copyright ©2016-2018 by RMH-Publications Trust; all rights reserved. Published by the Rocky Mountain Herbal Institute; c/o PO Box 579; Hot Springs, Montana [59845] USA. Education and software for health professionals:   www.rmhiherbal.org


Jump to another tutorial in this sequence:
#1: Introduction; Download #2: Setup and Documentation #3: Self-Study Reference #4: Herbal Tutor #5: Pulse Simulator #6: CaseQuery #7: AutoSage-TCM #8: Completing member/admission requirements

Subtopics on this page…

 

Tutorial #6:   CaseQuery

Estimated completion time:   12 hours

CaseQuery and AutoSage-TCM together comprise expert-system software for automated pattern recognition of the clinical syndromes constituting traditional Chinese medical (TCM) pathophysiology theory, including quantitative assessment of complex cases characterized by multiple simultaneous syndrome-patterns.

CaseQuery allows users to record detailed case histories of symptom, tongue, and pulse data. Case record files are created in a standardized format that can be read and understood by the AutoSage-TCM analysis software. The user then emails this data file to RMHI, where it is processed using the AutoSage-TCM program, and then a detailed, cross-referenced report is emailed back to the user.

Both CaseQuery and AutoSage-TCM are described in much greater detail in TCHS Vol.6: User's Guide to AutoSage-TCM. Chapter 7 of that text includes instructions for CaseQuery users and a series of screen shots. It may be helpful but not necessary to read any of that material before completing this tutorial.

This tutorial is the most critical one of the BootCamp series. It is extremely important that you learn to create accurate and complete case-history records for your future clients. Without accurate, complete case-history data, all the conclusions you derive from such data will be in doubt.





 

Questionnaire #6 — copy this form

  • Copy and paste the following into a text document using any simple text editor (Mac OS X: TextEdit;   Windows: WordPad, Notepad). You will be filling in your answers (between the [[ ]] marks) during this tutorial and then emailing your completed questionnaire to your assigned tutor.
  • Most questions will require simple, short answers. These questions are designed primarily to ensure that you know how to access the appropriate material within each module and to interpret it correctly.
  • Now you are ready to actually begin the tutorial. Follow the instructions in the remainder of this tutorial, and then fill in your answers to the questionnaire when asked to do so.
  • Please email this tutorial questionnaire to your assigned BootCamp tutor (the person who emailed you the original download instructions — Tutorial #1) and wait for a reply/feedback before continuing with the next tutorial.
============ HERBALTHINK-TCM BEGINNER TUTORIAL #6, QUESTIONNAIRE ==========
                             [updated 2018-05-22]

YOUR FULL NAME:  [[  ]]


--------------- CaseQuery:
A-0: Did you remember to periodically 'Save' your file to avoid 
accidentally losing any of your work?  [[  ]]

A-1: Were you able to find "Instructions for modifiers" and then copy 
and save that information to a text file for convenient reference while you 
were learning to use the '12-SSmod' tab?  [[  ]]

A-2: Does the relationship between all the symptoms/modifiers you selected 
and the encoded SS items that appear in the bottom frame make sense to you?
  [[  ]]

A-3: Did you read/study the supplement to tutorial #6: "CaseQuery 
symptom modifiers explained, with examples" ?  [[  ]]

A-4: When completing tab '17-PULS', did you double-check the accuracy of 
the magnitudes (mild/moderate/severe/extreme) for each specified parameter?
  [[  ]]

A-5: Did you read/study the supplement to tutorial #6: "The CaseQuery 
'PULS' tab, explained" ?

A-6: Did you read tab '18-Review' and follow the instructions there?  [[  ]]

A-7: Did you execute the 'Completeness Review...' command before saving the 
final version of your file?  [[  ]]

A-8: Did you save a copy of the information in 'Completeness Review...' and 
then read it to discover any missing/required data in your case?  [[  ]]

A-9: Did you remember to specify the acute/chronic modifier for all symptoms 
to which that modifier is relevant?  [[  ]]

A-10: Did you double-check (proof-read) each SS item (all symptoms, tongue) 
in the bottom frame to verify that it completely represents the original 
plain-English case report in this tutorial?  [[  ]]


B-0: Attach the CaseQuery output file (#A001) that you created in the 
first part of this tutorial and email it with this completed questionnaire.

=============================== END ======================================



CaseQuery

To run CaseQuery, double-click on one of the following shellscript files within your installed  herbalthinktcm  application folder, appropriate for your operating system (the instructions are otherwise identical to running HerbalThink-TCM, see Help/Documentation):

  • CASEQUERY-linux.sh
  • CASEQUERY-macosx-cmd.cmd
  • CASEQUERY-windows-bat.bat

Of all the tutorials in the Herbalists' BootCamp series, this one will require the most time. If you are quick at figuring out new software, the CaseQuery program is designed to be intuitive, and you should be able to figure out many of its functions by playing around with it for a while. In fact, we strongly recommend that before attempting to complete this tutorial, you simply give yourself time to play around with the various options and controls.

When you are ready to complete this tutorial, it is important to read the step-by-step instructions very carefully, answer the case-history questionnaire as completely as possible, and then when you have finished, save the final results in a case-history data file, which you will send to RMHI as an email attachment.

For this tutorial, you will be entering in a very simple case study that illustrates the mechanics of how symptoms, symptom modifier terms, tongue, and pulse data are entered. You will be emailing the case file as an attachment to Questionnaire #6 for this tutorial, and we will check that you have entered in the data correctly and that it accurately reflects the wording of the original case report. It is important, however, to understand that this case is far from complete and does not come close to the level of detail that you should strive for when you are entering data for a real person.

Following is the test case that you now should transcribe into a data file using the CaseQuery program. Just carefully follow the instructions that appear within CaseQuery on each tab, and complete all the tabs in their natural sequence.
This case includes a small set of symptoms, but these symptoms are examples that will require you to think carefully about how you will code them using the symptom modifier tab ('SSmod').

  • CaseQuery test case #A001. This case is very sketchy and only includes a small number of symptoms. It is for practice only and is assigned to test your ability to accurately transcribe this case record into the CaseQuery format. Typically, a real case report should be MUCH more thorough than this and will include numerous symptoms.
    Important:
        · In transcribing the symptoms, choose the questionnaire entries and modifiers that most closely represent the meaning of the items below.
        · Try using the 'Find' command to quickly find specific symptoms within the symptoms tabs.
        · You will need to learn how to use the symptom-modifiers tab ('12-SSmod') and the various 'Edit' menu options. Be sure to read 'Instructions for @MODIFIERS' within the '12-SSmod' section. Also, see:  CaseQuery symptom modifiers explained, with examples.
     
  • F, age 40
  • Height: 5'8"
  • Weight: 170 lbs.
  • Symptoms. Has been experiencing chronic:

    (For symptoms #1 and #5 below, see especially:
    'By-single-line' mode; 'Duplicate SS LineItem' command in the 'Edit' menu.
    Read 'Instructions for @MODIFIERS' within the '12-SSmod' section, item #5, for how to use this command in such cases.
    Symptoms #1 and #5 will each require two encoded lines.)

    1. Tendency to easily feel too hot generally, but especially severe in late summer
    2. Poor memory
    3. In late summer is easily dehydrated, with dry mouth and frequent thirst
      (Hint: A total of three symptom items in questionnaire must be checked.)
    4. Poor appetite
    5. Aching pain in joints and muscles generally, especially severe in legs and hips;
      the preceding pain, wherever it occurs in the body, is worse with pressure and better with exertion (exercise and movement)
  • Tongue:
    • Tongue tissue is dark red (in color chart: red_d1t ) in all sectors except at the tip (row a), where it is slightly pale (red_p1t).
      See also:   a simple explanation of the HSL hue-saturation-lightness color model
    • Tongue coating color is normal-white all over, and coating is slightly thicker than normal at rows 'd' and 'e' at the root.
  • Pulses (be sure to choose the correct 'severity' value for each parameter):
        mild/slightly   Moderate/DefaultValue   SEVERE/VERY   EXTREME!!
        (For example, if someone says a pulse is "rapid", it is generally assumed that they mean a moderate/default value of rapid =   Rapid  )
        None of the parameters below are 'extreme'. That choice generally should be reserved for values that exceed anything you can simulate using the Pulse Simulator module.
    See also:   The CaseQuery 'PULS' tab, example
    • 71 beats/min.
    • Rhythm:   normal
    • Length/duration:   normal
    • At L1:   floating, slightly strong, and wide.
    • At L2 it is moderately sinking and changes quality abruptly between the 'mid' and 'deep' levels:
      • L2mid:   normal strength, slightly taut, narrow, very distinct
      • L2deep:   strong, very taut, wide, smooth time-profile
    • At L3:   slightly weak, slightly narrow
    • At R1:   slightly wide, fuzzy edged, very smooth time-profile
    • At R2:   wide, fuzzy-edged, smooth time-profile
    • At R3:   sinking, slightly weak, fuzzy-edged


After you are finished, be sure to save your file. You can always open it later and continue to edit, if you cannot complete it in one session.


Important note about the 'MISC' tab:  
The CaseQuery tab labelled '1-MISC' is where data like age, height, weight, and the following categories of miscellaneous health history information may be entered:

  1. Summary of chief complaints
  2. Medical diagnoses, if any provided
  3. History of major illnesses
  4. Misc: medications, environmental and occupational health exposure risks

The preceding 4 categories of miscellaneous information are not evaluated by AutoSage-TCM, but will be of major importance to any humans who will be reading and interpreting the report. This information may also be useful to the AutoSage-TCM developers and programmers whenever questions of interpretation arise. When you use CaseQuery, you should attempt to represent as much of this information as possible by checking the appropriate symptom items within the subsequent questionnaire tabs.


 

Questionnaire — CaseQuery

Before submitting your CaseQuery output file, please answer all of the following questions (Yes/No), which address the most common mistakes, omissions, and oversights that past students have made. If any answer is "NO", go back and re-read the instructions more carefully. Email your assigned tutor if you cannot find the information you need.

  • A-0: Did you remember to periodically 'Save' your file to avoid accidentally losing any of your work?
        Hint:   See tab '0-Intro' for beginning instructions and tips.
  • A-1: Were you able to find "Instructions for modifiers" and then copy and save that information to a text file for convenient reference while you were learning to use the '12-SSmod' tab?
        Hint:   The "Instructions for modifiers" information will appear in the upper right frame of tab '12-SSmod'. You can change the size of the CaseQuery window and each of its component frames by dragging the appropriate controls.
  • A-2: Does the relationship between all the symptoms/modifiers you selected and the encoded SS items that appear in the bottom frame make sense to you?
        Each encoded SSItem (encoded symptom/sign object) may initially seem a bit cryptic, but if you examine them more closely, you will find that each term is merely a compact, abbreviated version of its wordier plain-English equivalent. There is a one-to-one correspondence between the symptom and modifier choices you make and their equivalent encodings.
  • A-3: Did you read/study the supplement to tutorial #6: "CaseQuery symptom modifiers explained, with examples" ?
  • A-4: When completing tab '17-PULS', did you double-check the accuracy of the magnitudes (mild/moderate/severe/extreme) for each specified parameter?
  • A-5: Did you read/study the supplement to tutorial #6: "The CaseQuery 'PULS' tab, explained" ?
  • A-6: Did you read tab '18-Review' and follow the instructions there?
  • A-7: Did you execute the 'Completeness Review...' command before saving the final version of your file?
  • A-8: Did you save a copy of the information in 'Completeness Review...' and then read it to discover any missing/required data in your case?
  • A-9: Did you remember to specify the acute/chronic modifier for all symptoms to which that modifier is relevant?
        Hint:   See the command 'SelectAllSS_toApplyAcuteChronic', which will help you save time if a majority of your symptoms are either acute or chronic.
  • A-10: Did you double-check (proof-read) each SS item (all symptoms, tongue) in the bottom frame to verify that it completely represents the original plain-English case report in this tutorial?

If you answered "YES" to all the preceding questions, submit the preceding questionnaire along with your CaseQuery output file:

  • B-0: Attach the CaseQuery output file that you just now created for case #A001 and email it as an attachment to your emailed questionnaire.



Summary of what you learned in this tutorial

The CaseQuery software utility allows you to create a detailed report of an individual's symptoms and clinical signs, including descriptions of tongue and pulse that are so important in traditional Chinese medicine. Learn to use the '@SSmod' tab effectively — this tool will allow you to specify a symptom's severity, its time-pattern history (chronic/acute), applicable body locations, time of day/month/year, what aggravates/relieves, and other modifiers. By applying these modifiers correctly, you can usually come close to representing the intended meaning of the patient's description in his/her own words.

CaseQuery produces encoded text files that can be interpreted and analyzed by the AutoSage-TCM expert system, which you will be studying in the next tutorial.





Please submit your completed questionnaire for this tutorial, wait to receive feedback from your assigned tutor, then go to  Tutorial #7:   AutoSage-TCM