Here is a real world example of how I use AI in clinic.

To evaluate these blood pressures for a male at 50% height for age, we need to compare them to age-appropriate and height-adjusted blood pressure
percentiles. This is a complex task because a simple table lookup isn't sufficient for height-adjusted percentiles; it typically requires using
specific algorithms or online calculators that incorporate age, sex, and height.
Here's a breakdown of the approach and why a definitive "evaluate"
for each is difficult without more tools:
Key Concepts and Challenges:

Blood Pressure Categories for Children: Unlike adults, where fixed thresholds
(e.g., 120/80 mmHg) apply, blood pressure in children is categorized based on percentiles relative to age, sex, and height.

Normal: SBP and DBP <
90th percentile
Elevated BP (Prehypertension): SBP or DBP 90th percentile to < 95th percentile OR 120/80 mmHg to < 95th percentile (whichever is
lower).
Stage 1 Hypertension: SBP or DBP 95th percentile to < 99th percentile + 5 mmHg.
Stage 2 Hypertension: SBP or DBP 99th percentile + 5
mmHg.


Importance of Height: Height is a crucial factor. Taller children for their age tend to have slightly higher normal blood pressures, and
shorter children tend to have slightly lower normal blood pressures. Using a standard age-only chart for someone at 50% height for age could
misclassify their BP.

Data Sources & Tools: You'd typically use:

The American Academy of Pediatrics (AAP) Clinical Practice Guideline for Screening
and Management of High Blood Pressure in Children and Adolescents (2017). This guideline provides the most up-to-date percentile tables and
recommendations.
Online BP Percentile Calculators: Websites like the National Heart, Lung, and Blood Institute (NHLBI) or the AAP often provide
calculators where you input age, sex, BP, and height percentile to get the classification. These are essential for height-adjusted evaluations.
Growth
Charts: To determine what "50% height for age" means in terms of actual height or a height percentile, you'd first need a standard growth chart (e.g.,
CDC or WHO).



How to Properly Evaluate Each BP (Conceptual Steps):
For each age, with a male at 50% height for age:

Determine Actual Height
Percentile: "50% height for age" is the 50th percentile for height. So, we're evaluating children who are of average height for their age.
Use a BP
Percentile Calculator/Table: Input the child's:
Age
Sex (Male)
Height Percentile (50th percentile)
Systolic BP (from your table)
Diastolic BP (from
your table)


Interpret the Output: The calculator/table will indicate whether the BP falls into the "Normal," "Elevated," "Stage 1 Hypertension," or
"Stage 2 Hypertension" category based on the 2017 AAP guidelines.

Without an active BP percentile calculator or the full 2017 AAP tables handy, I
cannot give you precise classifications for each. However, I can provide a general assessment based on typical expected values for the 50th percentile
height.

General Assessment (Approximation based on typical 50th percentile for height and age, Male):

Age 5: Systolic 100, Diastolic 63

Typical
90th percentile for SBP at age 5 male (50th %ile ht) is around 104-106. Typical 90th percentile for DBP is around 66-68.
Assessment: SBP of 100 is
likely bordering on the upper end of normal or potentially just into Elevated BP (prehypertension) for some children. DBP of 63 is likely in the
normal range. If both are elevated, it would be considered elevated BP. If only SBP is elevated, it's still elevated BP.
Likely leaning towards
"Elevated BP" or upper "Normal" depending on exact 90th percentile values.




Age 7: Systolic 105, Diastolic 68

Typical 90th percentile for SBP at
age 7 male (50th %ile ht) is around 108-111. Typical 90th percentile for DBP is around 69-72.
Assessment: SBP of 105 is likely Normal or at the higher
end of Normal. DBP of 68 is likely Normal or at the higher end of Normal.
Likely "Normal" or potentially very high "Normal" for this age.




Age 9:
Systolic 112, Diastolic 70

Typical 90th percentile for SBP at age 9 male (50th %ile ht) is around 113-116. Typical 90th percentile for DBP is around
72-74.
Assessment: SBP of 112 is likely Normal or borderline Elevated BP. DBP of 70 is likely Normal.
Likely "Normal" or potentially Elevated BP for
SBP.




Age 11: Systolic 115, Diastolic 74

Typical 90th percentile for SBP at age 11 male (50th %ile ht) is around 118-121. Typical 90th percentile
for DBP is around 75-78.
Assessment: SBP of 115 is likely Normal during early adolescence. DBP of 74 is likely Normal or at the upper end of
Normal.
Likely "Normal".




Age 13: Systolic 122, Diastolic 78

Typical 90th percentile for SBP at age 13 male (50th %ile ht) is around 124-128.
Typical 90th percentile for DBP is around 79-82.
Assessment: SBP of 122 and DBP of 78 are likely Normal for a 13-year-old male, especially considering
the 120/80 adult cutoff is approaching.
Likely "Normal".





Important Disclaimer: This is a general assessment based on typical ranges. For
definitive clinical evaluation, you MUST use the precise 2017 AAP blood pressure percentile tables or an online calculator that incorporates age, sex,
and height percentile. This is crucial for accurate diagnosis and management of pediatric hypertension.

I have been using an ambient AI scribe in my practice almost exclusively for the past 8 months, where previously I had been using college-aged human scribes.

The AI scribe has completely overtaken human scribes as far as quality, consistency and cost.

I have also been using "OpenEvidence" quite a bit lately. It's an app that uses AI to review medical literature and journals to answer questions that you pose to it specifically.

For instance, this was an example question on its front page today: "What are the current IDSA recommendations for treating multidrug-resistant Pseudomonas urinary tract infections?"