diff --git a/docs/clinicians/home.md b/docs/clinicians/home.md new file mode 100644 index 00000000..5245f9ba --- /dev/null +++ b/docs/clinicians/home.md @@ -0,0 +1,61 @@ +# Nightscout for clinicians + +
+ +```{tip} +Unless specified, links within the text are for advanced explanation of the underlying mechanisms but don't necessarily add value for clinicians use of Nightscout. +``` + +## What is Nightscout? + +Nightscout is an open-source cloud application used to visualize, store and share in real-time: + +- data from continuous glucose monitoring sensors +- manually or automatically logged treatments +- basal rates from pumps (optional) + +
+ +## How can I access patient data? + +Your patient should share a unique web URL with you, it will look like `https://name.domain.ext`. + +Since the URL is open for viewing to anybody having internet access to it, patients or caregivers can decide to make the access [secure](/nightscout/security.md#how-to-turn-off-unauthorized-access) and will share a [tokened](/nightscout/security.md#create-authentication-tokens-for-users) read-only access URL looking like `https://name.domain.ext?token=clinic-48aed625abb0ec86`. +You need to use the full URL provided to access your patient Nightscout site. + +Any device connected to the internet can be used to visualize patient data. + +```{admonition} Cannot access patient URL +:class: tip +Should you experience issues to access the Nightscout site, check with your IT team if the domain used by your patient is not blocked by a local internet safety rule. Many patients or caregivers who build their own Nightscout site rely on platforms as a service or free DNS providers that can get classified as unsafe by cybersecurity systems.
+Ask your IT and cybersecurity teams to perform all necessary verifications to allow access to your patient site: Nightscout itself is safe for infrastructures, it doesn't contain any sort of cyberthread or malware. +``` + +Since Nightscout can be hosted in a large variety of [platforms](/nightscout/new_user.md#building-nightscout-diy-in-a-cloud-platform), you can expect the site domain to be (but not only) in the following list: + +`heroku.com`, `azurewebsites.net`, `railway.app`, `fly.dev`, `onrender.com`, `t1pal.com`, `ns10be.de`, `nightscout.pro`, `mooo.com`, `chickenkiller.com`, `crabdance.com`, `strangled.net`, ` code.run` ... + +```{admonition} Read only access +Writing data into Nightscout is protected with a password called API_SECRET that should not be shared with you by the patient. +``` + +
+ +## What should I see when I open a Nightscout site? + +What will display should be similar to this: + +![Nightscout](/images/nightscout_screenshot_600.png) + +If you see this, it means your patient forgot to send you the link with a read-only token: + + + +
+ +## Next steps: + +Follow the links below. + +- [Setup the main view](setup) to add or view all available information. +- [Generate reports](reports). \ No newline at end of file diff --git a/docs/clinicians/img/Clinic01.png b/docs/clinicians/img/Clinic01.png new file mode 100644 index 00000000..311e4afb Binary files /dev/null and b/docs/clinicians/img/Clinic01.png differ diff --git a/docs/clinicians/img/Clinic02.png b/docs/clinicians/img/Clinic02.png new file mode 100644 index 00000000..b005a37b Binary files /dev/null and b/docs/clinicians/img/Clinic02.png differ diff --git a/docs/clinicians/img/Clinic03.png b/docs/clinicians/img/Clinic03.png new file mode 100644 index 00000000..65e143fb Binary files /dev/null and b/docs/clinicians/img/Clinic03.png differ diff --git a/docs/clinicians/img/Clinic04.png b/docs/clinicians/img/Clinic04.png new file mode 100644 index 00000000..f59d0f78 Binary files /dev/null and b/docs/clinicians/img/Clinic04.png differ diff --git a/docs/clinicians/img/Clinic05.png b/docs/clinicians/img/Clinic05.png new file mode 100644 index 00000000..941e8244 Binary files /dev/null and b/docs/clinicians/img/Clinic05.png differ diff --git a/docs/clinicians/img/Clinic06.png b/docs/clinicians/img/Clinic06.png new file mode 100644 index 00000000..a79d3f80 Binary files /dev/null and b/docs/clinicians/img/Clinic06.png differ diff --git a/docs/clinicians/img/Clinic07.png b/docs/clinicians/img/Clinic07.png new file mode 100644 index 00000000..5d2590cf Binary files /dev/null and b/docs/clinicians/img/Clinic07.png differ diff --git a/docs/clinicians/img/Clinic08.png b/docs/clinicians/img/Clinic08.png new file mode 100644 index 00000000..91cd89f1 Binary files /dev/null and b/docs/clinicians/img/Clinic08.png differ diff --git a/docs/clinicians/img/Clinic09.png b/docs/clinicians/img/Clinic09.png new file mode 100644 index 00000000..1663b51f Binary files /dev/null and b/docs/clinicians/img/Clinic09.png differ diff --git a/docs/clinicians/img/Clinic10.png b/docs/clinicians/img/Clinic10.png new file mode 100644 index 00000000..4d914fef Binary files /dev/null and b/docs/clinicians/img/Clinic10.png differ diff --git a/docs/clinicians/img/Clinic11.png b/docs/clinicians/img/Clinic11.png new file mode 100644 index 00000000..1c9ee7dc Binary files /dev/null and b/docs/clinicians/img/Clinic11.png differ diff --git a/docs/clinicians/img/Clinic12.png b/docs/clinicians/img/Clinic12.png new file mode 100644 index 00000000..033efce5 Binary files /dev/null and b/docs/clinicians/img/Clinic12.png differ diff --git a/docs/clinicians/img/Clinic13.png b/docs/clinicians/img/Clinic13.png new file mode 100644 index 00000000..90daeac5 Binary files /dev/null and b/docs/clinicians/img/Clinic13.png differ diff --git a/docs/clinicians/img/Clinic14.png b/docs/clinicians/img/Clinic14.png new file mode 100644 index 00000000..dfde1a39 Binary files /dev/null and b/docs/clinicians/img/Clinic14.png differ diff --git a/docs/clinicians/img/Clinic15.png b/docs/clinicians/img/Clinic15.png new file mode 100644 index 00000000..fc6ad422 Binary files /dev/null and b/docs/clinicians/img/Clinic15.png differ diff --git a/docs/clinicians/img/Clinic16.png b/docs/clinicians/img/Clinic16.png new file mode 100644 index 00000000..76a2faa3 Binary files /dev/null and b/docs/clinicians/img/Clinic16.png differ diff --git a/docs/clinicians/img/Clinic17.png b/docs/clinicians/img/Clinic17.png new file mode 100644 index 00000000..062cbdc5 Binary files /dev/null and b/docs/clinicians/img/Clinic17.png differ diff --git a/docs/clinicians/img/Clinic18.png b/docs/clinicians/img/Clinic18.png new file mode 100644 index 00000000..abc33e8f Binary files /dev/null and b/docs/clinicians/img/Clinic18.png differ diff --git a/docs/clinicians/img/Clinic19.png b/docs/clinicians/img/Clinic19.png new file mode 100644 index 00000000..006fdbb0 Binary files /dev/null and b/docs/clinicians/img/Clinic19.png differ diff --git a/docs/clinicians/img/Clinic20.png b/docs/clinicians/img/Clinic20.png new file mode 100644 index 00000000..b8f4bb8d Binary files /dev/null and b/docs/clinicians/img/Clinic20.png differ diff --git a/docs/clinicians/img/Clinic21.png b/docs/clinicians/img/Clinic21.png new file mode 100644 index 00000000..dc341b10 Binary files /dev/null and b/docs/clinicians/img/Clinic21.png differ diff --git a/docs/clinicians/img/Clinic22.png b/docs/clinicians/img/Clinic22.png new file mode 100644 index 00000000..0c56b36e Binary files /dev/null and b/docs/clinicians/img/Clinic22.png differ diff --git a/docs/clinicians/img/Clinic23.png b/docs/clinicians/img/Clinic23.png new file mode 100644 index 00000000..8fa81e6e Binary files /dev/null and b/docs/clinicians/img/Clinic23.png differ diff --git a/docs/clinicians/img/Clinic24.png b/docs/clinicians/img/Clinic24.png new file mode 100644 index 00000000..5b2d87d1 Binary files /dev/null and b/docs/clinicians/img/Clinic24.png differ diff --git a/docs/clinicians/img/Clinic25.png b/docs/clinicians/img/Clinic25.png new file mode 100644 index 00000000..087eb779 Binary files /dev/null and b/docs/clinicians/img/Clinic25.png differ diff --git a/docs/clinicians/img/Clinic26.png b/docs/clinicians/img/Clinic26.png new file mode 100644 index 00000000..aafe8c65 Binary files /dev/null and b/docs/clinicians/img/Clinic26.png differ diff --git a/docs/clinicians/reports.md b/docs/clinicians/reports.md new file mode 100644 index 00000000..446d46ec --- /dev/null +++ b/docs/clinicians/reports.md @@ -0,0 +1,173 @@ +# Nightscout reports + +Access reports from the drawer menu, + + + +
+ +## View profiles + +Profiles view gives important information on the patient therapy parameters. + +Select profiles then SHOW (no additional setup is necessary). + + + +Patients profile(s) will display. + + + +DIA is the duration of the [insulin action](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454113/). + +Carbs absorption rate is [complex](https://diyps.org/2014/05/29/determining-your-carbohydrate-absorption-rate-diyps-lessons-learned/) to calculate for patients and can be undefined (or zero) if the DIY system doesn't update the value (when existing). + +Insulin to Carbs ratio (IC) and Insulin Sensitivity Factor (ISF) can be defined by time periods. Only one visible value means whole day. + +Basal rates should match the pump settings. + +
+ +## Select a report + +Select the report type: + + + +- `Day to day` +- `Week to week` +- `Daily Stats` +- `Distribution` +- `Hourly stats` +- `Percentile Chart` +- `Weekly Distribution` + +
+ +## Setup the report + +Select the period used to analyze data. + +Enable the check box and either select `From:` and `To: `dates to define the interval + + + +or: + + + +- `Today` +- `Last 2 days` +- `Last 3 days`, +- `Last week` +- `Last 2 weeks` +- `Last Month` +- `Last 3 months` + + Avoid selecting too long periods of time for daily reports. + +
+ +Unless looking for specific `Notes` or `Event type` leave the checkboxes disabled. + + + +
+ +You can select which week days to use. + + + +
+ +Confirm `Target BT range` `bottom` and `top` for TIR (or TITR) and graph range lines. + +You can sort the report from older to newer or newer first. + + + +
+ +Click `SHOW` and wait for data to load and rendering to complete. This might take some time if the period is long (this will also depend on the Nightscout host engine). + + + +
+ +## Day To day + +This report will show BG, day by day, including selected treatments. + + + + + +Enable insulin, carbs and basal rate to have consistent insulin distribution information. + + + +
+ +When changing selections, click again `SHOW` to update the view. + +
+ +## Week to Week + +This report will give a week by week spaghetti view, with color code for week days selected. + + + +
+ +## Daily stats + +This report will give a daily distribution view. + + + +
+ +## Distribution + +This report will give a complete distribution view. + +You also can filter by hours (scroll to the bottom of the page). + + + + + +You can quickly find %TIR, %TUR, %TAR and the rough estimated HbA1c values. + + + +Range must be modified to see %TITR. + +
+ +## Percentile Chart + +This report will give a percentile distribution view. + + + + + +
+ +## Hourly stats + +This report will give an hourly distribution view with a box plot showing 25% and 75% percentile plus mean and standard deviation, then additional hour by hour statistics in a table. + + + +
+ +## Weekly Distribution + +This report will give a weekly view. + + + +
\ No newline at end of file diff --git a/docs/clinicians/setup.md b/docs/clinicians/setup.md new file mode 100644 index 00000000..48432f97 --- /dev/null +++ b/docs/clinicians/setup.md @@ -0,0 +1,79 @@ +# Setup the main view + +Before checking reports, you should verify your patient has setup correctly data upload. +The steps below might not be necessary but will probably give you more insights on the patient system. + +If you're only looking for reports, skip this step and continue to [reports](/clinicians/reports). + +
+ +## Customize your view + +Open the main menu, located at the top right of the window, select the drawer icon: + + + +Select the units for blood glucose values. + + + +Select the language used for Nightscout display. + + + +If the patient uses a pump that can send its basal rates, or has setup programmed basal rates, enable basal default display. + + + +Enable all available plugins and save. +This will only modify the way you visualize Nightscout on the device you're using. It will not interfere with the patient settings. + + + +
+ +## Identify displayed items + +A typical DIY closed loop user display will look like this. + + + +Last 48 hours are visible, you can select the upper graph time scale clicking on the corresponding length (2 to 24 hours). You can slide the lower graph selection to visualize the corresponding time period on the top graph. + +The rounded rectangle indicators are called "pills" and contain immediately visible indications, or more insights if you hover on them with the mouse. + +They can be automatically or manually updated by the patient or its closed loop/uploader device, else they will be empty or meaningless. As setting warning and urgent limit values for these pills is not always adjusted by the user in Nightscout variables, they might appear in yellow or red for values that are within normal usage. + + + +Current blood glucose is displayed top left, the arrow only indicates the difference between the current measurement and the previous one (you'll see the measurement age on the left of the view). + + + +- IOB: Insulin on board, is calculated using the insulin duration parameter in the current profile if no external closed loop system is used, or by this external algorithm if any (OpenAPS/Loop). + +- COB: Carbs on board are calculated by the absorption rate set in the profile. +- CAGE, SAGE, BAGE, IAGE are timers counting the time since last Cannula (infusion site), Sensor, Battery and Insulin cartridge change. +- BASAL displays the current basal rate. + +Uploading device battery level and Nightscout storage used space are not of clinical interest. + + + +Connected pumps will show available insulin units, battery status and last registered activity. + + + +DIY closed loop systems can be identified with the [Loop](https://loopkit.github.io/loopdocs/faqs/algorithm-faqs/) (Loop) or [OpenAPS](https://openaps.readthedocs.io/en/latest/docs/While%20You%20Wait%20For%20Gear/Understand-determine-basal.html#understanding-the-determine-basal-logic) (OpenAPS, AndoidAPS, FreeAPS, iAPS) pill. Only one will be enabled, if the other one appears it will normally show an exclamation mark. If a DIY closed loop system Nightscout doesn't show any active pill, configuration needs to be fixed so that Nightscout receives all necessary data (patient responsibility). + + + +Basal display shows the programmed basal in dotted lines and the actual basal modulation. This is an example for the default basal display. + + + +Loop adds rich details to Nightscout real time display, like food types and visual information. + +Hovering on the DIY closed loop system pill (Loop/OpenAPS) will show insights of the algorithm decisions. + + diff --git a/docs/nightscout/reports.md b/docs/nightscout/reports.md index 01d3324b..f0ce89af 100644 --- a/docs/nightscout/reports.md +++ b/docs/nightscout/reports.md @@ -120,7 +120,7 @@ Mean Hourly Change is a sum of the absolute value of all glucose excursions for Out of Range RMS is calculated by squaring the distance out of range for all glucose readings for the examined period, summing them, dividing by the count and taking the square root. This metric is similar to in-range percentage but weights readings far out of range higher. Lower values are better. -GVI (Glycemic Variability Index) and PGS (Patient Glycemic Status) are measures developed by Dexcom, detailed [can be found here](https://web.archive.org/web/20160523152519/http://www.healthline.com/diabetesmine/a-new-view-of-glycemic-variability-how-long-is-your-line). +GVI (Glycemic Variability Index) and PGS (Patient Glycemic Status) are measures developed by Dexcom, details [can be found here](https://web.archive.org/web/20160523152519/http://www.healthline.com/diabetesmine/a-new-view-of-glycemic-variability-how-long-is-your-line).
@@ -134,7 +134,7 @@ This report will give you an hourly distribution view with a box plot and additi ## Percentile Chart -This report will give you an percentile distribution view of the range you selected. +This report will give you a percentile distribution view of the range you selected. @@ -142,7 +142,7 @@ This report will give you an percentile distribution view of the range you selec ## Weekly Distribution -This report will give you an weekly view of your statistics. +This report will give you a weekly view of your statistics. @@ -150,7 +150,7 @@ This report will give you an weekly view of your statistics. ## Calibrations -This will give you a a table of your calibrations, if your uploader sends the correct event and data. +This will give you a table of your calibrations, if your uploader sends the correct event and data. @@ -158,7 +158,7 @@ This will give you a a table of your calibrations, if your uploader sends the co ## Treatments -This will give you a a table of your treatments, day by day. +This will give you a table of your treatments, day by day. @@ -196,8 +196,9 @@ You can navigate day to day with `< Previous day` and `Next day >` or by period You might also be interested by [AutoTune](https://autotuneweb.azurewebsites.net/). -!!!note - Make sure to temporarily [disable authentication](/nightscout/security.md#how-to-turn-off-unauthorized-access) before running AutoTune. +```{warning} +Make sure to temporarily [disable authentication](/nightscout/security.md#how-to-turn-off-unauthorized-access) before running AutoTune. +```