About MEDiscuss CDSS
What the system does today, and what is plannedDecisions on an Indian ward are taken quickly, often with incomplete information and under a heavy patient load.
The calculators that are most easily available were written for other health systems. They assume drugs that our pharmacies do not stock, units that we do not use, and risk equations derived from populations that differ from ours.
A large part of Indian practice also follows national programme guidance. NACO ART switching, NTEP weight bands, the UIP schedule, intradermal rabies regimens, UDID certification and Anemia Mukt Bharat dosing are not adaptations of Western protocols. They are different algorithms, with different drugs, different thresholds and different reporting requirements. A tool that does not carry them is of limited use at the bedside here.
MEDiscuss CDSS was built to meet that need. It aims to give the clinician a defensible next step, in the drugs and units actually used in Indian hospitals, within the time available on a ward round.
The emphasis throughout is on the management decision rather than the arithmetic. A score still has to be interpreted, and interpretation is the part that takes the time you do not have at the bedside. The tools group as follows.
Every tool states its references and the date it was last revised, so you can judge for yourself how current it is. Several tools also carry a plain-language explanation written to be read aloud to the patient or the relative.
The system runs in the browser and needs no installation. A tool that has been opened once will open again when the network is unavailable, and when the device is online the current version is always fetched, so that a corrected dose reaches the clinician on the very next visit. Any calculation can be shared as a link that opens with the values already entered. The link carries numeric fields, dropdown selections and checkboxes, and nothing else. It never carries free text, so a patient's name or identification number cannot travel in a shared URL.
The content is reviewed periodically and each revision is dated on the page itself. We audit the clinical logic tool by tool, and what an audit finds is corrected and published rather than folded away quietly, including the findings that are uncomfortable to publish. You cannot tell a tool that has been audited from one that has not unless we say so. The editorial policy sets out where the content comes from and who reviews it. The system is used by clinicians and postgraduate residents, largely in India.
MDCalc and UpToDate are excellent resources and remain in daily use. MEDiscuss CDSS is built for the questions that they do not answer well in the Indian setting. The comparison below says where each is useful.
| Aspect | MEDiscuss CDSS | MDCalc and UpToDate |
|---|---|---|
| Clinical context | Indian programme guidance taken as primary where it differs: NACO, NTEP, UIP, NVBDCP, Anemia Mukt Bharat, ICMR, IAP and API, along with international evidence | Predominantly US and European guidance |
| Drug detail | Formulations dispensed here, including Indian fixed dose combinations and generics such as Saroglitazar, Teneligliptin and Cilnidipine | US formulary focus |
| What a tool returns | The next step where the evidence supports one: a dose, a band, an interval, or the investigation that follows | A score or a formula, with the interpretation left to the reader or to the accompanying text |
| Access | No installation and no account. Works on a slow connection, and a tool once opened works without one | App download, or an institutional subscription in the case of UpToDate |
| Editorial record | References and a dated revision stamp on every tool, a published editorial policy, and every correction listed on What's new. Named specialist review is being added tool by tool | Named authors and independent specialist reviewers throughout, with a long publication record and wide citation |
| Breadth | A focused set, chosen for Indian ward practice | Several hundred calculators, and in the case of UpToDate a full reference text behind them |
The scope is narrow, deliberately. This is a set of decision-support tools and not a reference library. Coverage stops where the content can no longer be kept genuinely current, because a tool that has quietly gone out of date is worse than no tool at all. For a question outside that scope, the established references remain the right place to look. For a question inside it, this is built to answer faster, and in the units you actually use.
An optional sign in is being added to the system. It is for personalisation, never for access. Every tool works without an account today and will continue to work without one: no trial period, no registration wall, and no feature held back for members.
If you sign in, it keeps your favourite tools and your saved calculations available on every device you use, so you can compare the same patient's values over time.
Without an account, what you type stays in the browser tab and is discarded when you close it. If you sign in and choose to save a calculation, the values you entered are stored so that you can look at them again. The patient label you type never leaves your device at all, in either case. The privacy notice sets out exactly what is kept, for how long, and how to delete it.
- Named specialist review, tool by tool. A clinician who practises in the field reads a finished tool against current guidance, and is named on it. This is the work that most improves what is here, and it is open to anyone qualified to do it.
- New tools where the burden is high and the decision is time critical. The list is shaped mostly by what clinicians ask for, and several of the tools added this month began as a request from a ward.
- Plain-language explanations for the patient in front of you. Many tools already carry one in English. Bringing them into other Indian languages is next; MEDiscuss Swasthya, the patient-facing companion to this system, already publishes in Kannada.
- The optional sign in described above, so that favourites and saved calculations follow a clinician between their phone and the ward computer.
The system is still being built, and the record of it is public: every new tool, every correction and every change is listed on What's new, and how the content is sourced and reviewed is set out in the editorial policy. If one of the items above is in your field, it is work you could put your name on.
These tools support a clinical decision. They do not replace it. Every output assumes a clinician who can judge whether it applies to the patient in front of them, and every dose should be verified against the product label and the hospital protocol before it is prescribed.
If a result appears wrong, please tell us. You will not be the first, and the message is read before anything else in the queue. Reports from clinicians using these tools, and requests for tools that did not exist yet, have shaped this system more than anything else in it.