Find thresholds instantly, with sources.

What Clinical Thresholds Does

Clinical Thresholds is a feature within the CliniSearch platform that automatically identifies, extracts, and presents numerical decision-making criteria from authoritative UK clinical guidelines. It provides clinicians with immediate access to validated thresholds, such as blood test values, vital sign limits, or scoring system cut-offs, directly alongside their source citations. This tool is designed for healthcare professionals across primary and secondary care, including GPs, hospital doctors, nurses, and allied health professionals, who require rapid, evidence-based answers to support clinical decisions at the point of care.

The feature addresses a critical need in daily practice, where time pressures and information overload can lead to reliance on memory or outdated local protocols. By centralising and standardising access to these key decision points, Clinical Thresholds helps reduce unwarranted clinical variation and supports adherence to national best practice standards. It is particularly valuable in high-acuity settings like emergency departments, acute assessment units, and primary care consultations where timely, accurate decisions are paramount.

How It Works

The system operates through a structured process to ensure accuracy and relevance. It ingests national guidelines from sources like NICE, SIGN, and Royal Colleges, as well as local trust policies where integrated. This content is processed using natural language understanding to index numerical values and their clinical context. Each threshold is version-controlled to track updates. The output to the user is a clear answer displaying the threshold value, the associated clinical action (e.g., "Refer," "Monitor," "Treat"), and a direct citation to the source guideline. The system can also generate audit artefacts, showing which thresholds were accessed and when.

The processing engine employs sophisticated algorithms to parse complex guideline text, distinguishing between primary thresholds, secondary criteria, and contextual examples. It identifies the specific clinical scenario, patient population, and action associated with each numeric value. For instance, it differentiates between a fasting glucose threshold for diagnosing diabetes and a random glucose threshold for suspecting hyperglycaemia. This granular understanding ensures that clinicians receive precise, scenario-specific information rather than a simple list of numbers.

Example Workflow

The following steps illustrate a typical user journey for checking a clinical threshold, contrasting the traditional method with the CliniSearch approach.

Before CliniSearch:

1. Clinician recalls a potential threshold (e.g., a CRP value for sepsis suspicion) from memory or informal training.
2. Time is spent searching through local trust intranet pages or PDF documents to confirm the correct, up-to-date value.
3. Finding the specific number and its source citation is often slow, and the located document may be outdated.
4. Decision is made with uncertain evidence, increasing risk of variation from best practice.

After CliniSearch:

1. Clinician enters a query like "CRP threshold for sepsis referral" into the CliniSearch search bar.
2. The Clinical Thresholds feature instantly returns the current recommended value (e.g., ">100 mg/L"), tags it as a "Referral" trigger, and cites the relevant NICE guideline (NG51).
3. The result includes a link to the full guideline and a note if the threshold has recently changed.
4. Decision is made confidently with immediate, validated evidence, supporting standardised care.

This workflow demonstrates a significant reduction in cognitive load and search time, allowing clinicians to focus on patient assessment and management rather than information retrieval. The system's ability to provide immediate context and provenance transforms threshold checking from a potentially error-prone memory exercise into a reliable, evidence-based process.

Governance & Safety

Clinical governance is central to the Clinical Thresholds feature. The provenance of every threshold is meticulously recorded, detailing the source guideline, publication date, and extraction timestamp. A formal update handling process monitors source guidelines for changes; when a threshold is revised, the system is updated, and the change is logged in a version history available to users. Wording controls ensure that the clinical context and action tags (e.g., "Consider referral") are presented precisely as stated in the source material to avoid misinterpretation. A full audit trail is maintained for enterprise users, recording which thresholds were searched for, by whom, and when, supporting clinical audit and safety initiatives.

The governance framework includes regular validation cycles where extracted thresholds are reviewed by clinical subject matter experts to ensure alignment with current practice. For integrated local implementations, the system supports configuration of local overrides where trust policies legitimately differ from national guidance, with clear labelling to indicate the source of such variations. All changes to the threshold database undergo clinical safety review before deployment, following standard NHS Digital clinical risk management processes.

Frequently Asked Questions (FAQ)

Implementation

How is Clinical Thresholds implemented within an NHS trust?
Implementation typically involves integrating CliniSearch with the trust's existing clinical systems, such as the EPR or intranet, via API or single sign-on. A clinical safety officer and IT team oversee the rollout, which includes user training focused on interpreting threshold results within the local care pathway context.

Can the system be customised for local pathways?
Yes, for enterprise implementations, the system can be configured to highlight trust-specific thresholds or pathways alongside national guidance. Local clinical leads can flag thresholds that are particularly relevant to their service or indicate where local policy differs from national recommendations, ensuring that staff have context-aware information.

Data Handling

What patient data does the feature use?
Clinical Thresholds is a reference tool and does not process or store any patient-identifiable data. Searches are based on clinical concepts (e.g., "eGFR threshold in chronic kidney disease"), not individual patient records. All user search queries are anonymised for product improvement.

How is search data used and protected?
Search queries are aggregated and anonymised to help improve the relevance of results and identify areas where additional guidance coverage may be needed. All data processing complies with GDPR and NHS data security standards, with no retention of personally identifiable information.

Limitations

What are the limitations of the feature?
The tool presents thresholds as they are published in guidelines; it does not replace clinical judgement for complex patients or atypical presentations. It may not capture every nuance or exception noted in the full guideline text, which clinicians are advised to consult for comprehensive guidance. The system's accuracy is dependent on the timely updating of its source guideline database.

Does Clinical Thresholds cover all specialties and conditions?
The system continuously expands its coverage as new guidelines are published. While it covers the majority of high-frequency threshold queries across primary and acute care, some highly specialised or rare condition thresholds may not yet be included. Users are encouraged to submit requests for additional content through the platform's feedback mechanism.

Core capabilities