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CE mark (developed in compliance with directive 93/42/EEC for class I devices). Made in the United Kingdom

 

Dem DX Clinical Reasoning Support Ref R1 (C) 2015-2021

Diagnosis Guide

Table of Contents

Overview

Dem Dx is a clinical reasoning support tool that is used to provide medics with a simple to use and efficient way of taking a user from a presenting complaint, through associated symptoms, to an incidence ranked list of the most likely differential diagnoses that make up the medical investigation on patients.

The Dem Dx platform is aimed at healthcare professionals and students to help them in their clinical reasoning approach.

 

Sign Up

On signing up to Dem Dx you will receive a complimentary free trial. To do so, from the the main landing page of https://web.demdx.com click on the ‘Sign up for 7 days free’ button:

Login page screenshot

This will take you to the Sign up form. Fill in your user information, agree to the terms and service and click on ‘Sign Up’ to begin using Dem Dx:

 

Signup page screenshot

You will then receive a verification email to verify your email address.


Alternatively you can sign up using an existing apple ID or facebook login:

Signup page screenshot

Clicking on either one will redirect you to their respective sign-in page. 

 

Login


Once signed up, access to the app can be obtained at any time by clicking the ‘Log In’ button on the main landing page: 

Login page screenshot

On the login screen, if previously signed up using an Apple ID or a facebook login, use the appropriate buttons to Sign in:

Signup page screenshot

Else enter your username and password and click ‘Login’ to gain access.

Signup page screenshot

In the event of a forgotten password select ‘Don’t remember your password?’ 

Signup page screenshot

In the following screen, ensure your email address is correct and click ‘Send Email’. An email will be sent to you allowing you to set a new password.

Reset password screenshot

Specialty Pathways

  • Once logged in, click on the ‘Specialty Pathways’ tab on the right panel. This will display the Specialty Pathways page where your first choice is to select a specialty that most appropriately fits a patient’s presentation:

  • From the list of options in each specialty, select the presenting complaint that most accurately fits a patient’s presentation:

  • Once you click on a symptom, the next screen will bring up the most important clarifying symptom questions:

  • The system will continue to ask clarifying questions to help get you to a final diagnosis in the quickest, most efficient way possible. Upon reaching the end of a journey, a pathway summary to the final diagnosis will also be presented:

  • Clicking on the final diagnosis (highlighted in green) will give you a summary of that diagnosis:

Features to assist with clinical reasoning


As you navigate through a journey, the tool has several features to assist you in the process:

 

 

Read More/Less


Symptoms with extensive information on the symptom presented will have an option to ‘Read More’:

This can be clicked on to expand the details of the symptom:

Red flags

 

Urgent or serious conditions are marked with a red flag:

Differentials


Each symptom has a ‘Differentials’ button associated with it. 

Clicking this button will bring up the list of differentials that correspond to the symptoms and signs you have identified so far. It shows the potential diseases and conditions that fit with the symptoms and signs that you have selected at that stage in the patient pathway. 

These differentials are ranked by global incidence. As you follow the prompting of Dem Dx and add additional clinical observations, the number of potential diagnoses will reduce until you reach your presumed diagnosis.


In addition, a descriptive summary of any differential enlisted can be viewed by clicking on it: 

Media


A ‘View Media’ button associated with a symptom:

links through to our collection of media files that demonstrate clinical findings:

These include images (eg. X-rays, CT scans, MRI scans, spirometry traces):

and videos (eg. heart sounds, breath sounds):

Guidelines


A ‘Guidelines’ button associated with a symptom:

Links to a list of national guideline images and external resources pertaining to that symptom:

Clicking on an item within the Guidelines list will expand the evidence based recommendations for viewing:

And clicking on the External resources guideline link will take you to the website of the external resource:

Current Pathway


This gives an overview of the symptoms that have been previously selected and highlights your current position within the journey.

(Note: each selection made during the journey will appear in the Current Pathway column)

For each symptom within the current pathway column, click on the 3dot menu to view more information on the symptom: 

This displays a current presentation screen which includes the symptom information along with several tabs that highlight the different associations to that symptom (ie guidelines, media and differentials):

Additionally the 3 dot menu provides the option to navigate to the symptom page containing the selected symptom:

This allows for flexibility to view previous symptom pages or to change your pathway:

Actions (plan specific)


The ‘Actions’ button associated with a symptom:

when clicked on displays a set of pre-defined medical actions to be taken for the associated symptom:

Further clicking on a symptom with a set of medical actions, will take you to the next symptom page while displaying the medical actions as a checklist within the Current pathway column:

(note: Medical actions are defined at Plan level for specific Institutions)

 

 

Print

A ‘Print Pathway’ button will be available at any point within a journey:

or at the end of a journey:

Clicking the button will take you to a Print page which includes a form, where notes pertaining to your journey can be added.

(note: Plan specific customised forms for more formalised processes within Institutions will include additional fields, along with the notes)

To preview the pathway that is to be printed, click the ‘Enable print preview’ button:

This can now be printed by clicking the ‘Print’ button.

 

 

Save PDF

 

To export a journey to a standard PDF format document that can be saved on to a device, click on the ‘SavePDF’ button which is besides the ‘Print’ button on the Print page:

Copy to clipboard

The ‘Copy to clipboard’ button which is available besides the ‘Print Pathway’ button or on the Print page is an alternative option to document your journey. Clicking on this button copies the text part of a journey to the clipboard:

And allows for it to be pasted into 3rd party applications. Below is an example of the journey text pasted into a text editor:

Body Map

 

Click on the Body Map tab to initiate diagnosing using an Avatar:

To diagnose, select a body part:

And further drill down or select the whole body part instead:

This will then display a list of symptoms on the right:

Clicking on the most appropriate symptom will take you into the symptom page, where you can proceed to a final diagnosis:

Navigating the Body Map

To assist with navigating the body map, use the drop down box to toggle between male and female:

The view can be rotated from front to back and vice versa, by clicking the circular arrows:

To view general symptoms or skin conditions, click on the ‘General Symptoms’ or ‘Skin’ buttons respectively:

This will then display the symptoms on the right. To return to a clickable body map, click on the Zoom out button:

Alternatively, if you have arrived at a symptom page and would like to navigate back to the body map, click the back button ‘<’ or any one of the bodymap navigation links at the beginning of the Incomplete pathway:

 

Click on the Search tab to access the Search function within Dem Dx:

Type in the keyword to be searched, and click the ‘Search’ button to display the search results on the right:

Sample screen from Dem Dx application

Using the ‘+’ button, additional terms can be included in the search. And all the corresponding search terms found are highlighted in green within the search results: 

To view search results for a specific category (i.e. Presentation, Media or Diagnosis) click on the respective tab:

The search results for Presentation displays the symptoms that includes the keyword searched:

Clicking on a symptom, will take you into the symptom pages with the chosen symptom highlighted in green:

The search results for Media displays all videos and images related to the search term:

To view a specific media file, click the thumbnail to load the image or video:

The search results for Diagnosis displays two sets of results. ‘Diagnosis Exact’ displays all diagnoses with a title that includes the search term, while ‘Diagnosis Includes’ displays all the diagnoses which contain the search term within its description:

Clicking on any diagnosis within the search results, will take us to the diagnosis details page:

To clear a term within the search field, click on the ‘x’ within the same field:

To clear a search term included in memory, click on the search term to be removed:

Alternatively to clear both the search field and the search memory, click the ‘Clear’ button:

This will reset the Search screen:

My Account

 


Trial

Upon signing up for an account, you will receive a free 7 day trial which gives you full access to the Specialty Pathways and Quizzes: 

Clicking on the ‘My Account’ button will take you to your Account page. This page notifies you of your account details and indicates the date for when your trial is due to expire:

After the end of the free trial you will be able to continue accessing the Respiratory chapter, however all other chapter specialties will be locked: 

Subscribe Monthly/Annually

 

To obtain a premium subscription, navigate to the Account page by clicking on the ‘My Account’ button. There are two premium subscriptions available, Monthly (where subscriptions are billed per month) and Annually (where subscriptions are billed per year):

Upon clicking subscribe of the chosen plan, a dialog box will pop up requesting payment details:

After the payment details are filled in, click ‘Next’ and review your details. Once the details are confirmed, click ‘Pay & subscribe’:

Your Account page will now indicate that you have an Active subscription, the plan subscribed to and the date of renewal:

My Account Info


Once a premium subscription is in place a ‘My Account Info’ button will be displayed on the Account page: 

Clicking on the ‘My Account Info’ button opens a dialog box which can be used to manage your subscription plan. From here you can view or change your account and payment details,  as well as view your billing history:

If you want to edit your subscription to another plan or cancel your subscription, click on the plan name. This will open a new dialog box providing the required options to ‘Edit Subscription’ or ‘Cancel Subscription’:

Contact Us


The Contact Us page can be accessed by clicking the ‘Contact Us’ button on the left panel:

Depending on the nature of the message, specify the subject using the drop down box. This will help ensure the message reaches the appropriate targeted group:

You will be presented with a thank you note on the screen, once your message has been successfully sent: