UTI/ Cystitis – ROD
[text size="3"] yo [select value="female|male"] complains of [checkbox value="dysuria|frequency|urgency|incontinence|hematuria|cloudy urine|fever|chills|vaginal discharge|flank pain"] starting [text size="3"] day(s) ago. Patient [select value="has not|has"] had a UTI in the past. Review of systems: [select value="no|YES"]<-symptoms >7 days duration [select value="no|YES"]<-shaking chills [select value="no|YES"]<-flank pain [select value="no|YES"]<-Suprapubic cramping [select value="no|YES"]<-Fever [text name="variable_6" default="sample text"] [select value="no|YES"]<-nausea [select value="no|YES"]<-vomiting [select value="no|YES"]<-abdominal pain [select value="no|YES"]<-change in vaginal discharge or odor [select value="no|YES|n/a"]<-painful intercourse Risk factors present: [select value="no|YES"]<-Concern about STI's [select value="no|YES"]<-Frequent UTI's [select value="no|YES"]<-pyelonephritis within the last 3 months [select value="no|YES"]<-diabetes [select value="no|YES"]<-pregnancy [text name="variable_5" default=""] [select value="no|YES"]<-immunosuppression [select value="no|YES"]<-kidney stones [select value="no|YES"]<-kidney failure [select value="no|YES"]<-antibiotic for a UTI in the last 4 weeks [checkbox name="variable_2" value="Azo|Hydration|abx"] [text name="variable_6" default=""]
Result - Copy and paste this output:
Sandbox Metrics: Structured Data Index 0.82, 28 form elements, 87 boilerplate words, 5 text boxes, 2 checkboxes, 21 drop downs, 39 total clicks
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