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Step-by-step work-up

The step-by-step work-up guides clinicians through a structured diagnostic process, evaluating red flags, focused history, examination signs, and management plans.

What it does

The work-up engine breaks complex presentations into four structured stages: red flags, focused history, examination findings, and treatment planning. It ranks differential diagnoses, flags must-not-miss conditions, and prompts for missing clinical data before generating recommendations.

When to use it

Use the step-by-step work-up when investigating undifferentiated symptoms, complex acute presentations, or diagnostic dilemmas requiring thorough documentation.

Step by step

  1. Type the presenting symptom into the ask box and select Send to initialise the work-up spine. Initialising the work-up spine Work-up spine on mobile
  2. Review the red flags checklist and tick relevant positive or negative clinical findings. Reviewing the red flags checklist

Also on this screen

  • Work-up spine: A visual progression bar on the toolbar indicating current diagnostic stage.
  • Red flags card: Must-not-miss clinical alerts displayed alongside ranked differential diagnoses.
  • Emergency ABCDE card: Activated automatically when acute danger signs or haemodynamic instability are detected.
  • Stable or Unstable: Toggles individual clinical findings as stable or unstable.
  • History card: Checklist of key historical risk factors, onset details, and symptom progression.
  • Examination card: Physical examination checklist, including vitals and clinical signs.
  • Skip and Submit: Skip bypasses detailed questioning; Submit recomputes the differential based on selected findings.
  • More data needed: Prompts for missing key facts (such as symptom duration or severity) before committing to a plan.
  • Stage 2 plan retry: Reloads and re-evaluates the diagnostic pathway if network interruption occurs.
  • Case summary: A compact summary card displaying identified red flags and clinical findings.
  • Clinical calculators: Built-in scorecards (such as Wells DVT score, Centor criteria, or CURB-65) that calculate clinical probability based on ticked findings.
  • Work-up dock: Anchors active stage cards in the central column so findings are not lost while browsing other tools.

What Agent D can do

  • Agent D recalculates the differential diagnosis probability in real time as you tick history and examination findings.
  • Agent D alerts you immediately if high-risk red flags are detected.
  • Agent D brings together selected findings into a comprehensive consultation note draft upon completion.

Safety (what needs your Confirm)

  • Work-up findings and differential rankings are clinical aids. You determine the ultimate diagnosis and treatment pathway.
  • Submitting findings updates diagnostic weights but never sends orders or notifies outside parties.

Common questions

Can I skip questions if the presentation is straightforward?

Yes. Click Skip at any stage to proceed directly to the differential diagnosis and treatment plan.

Where do clinical calculators appear?

When the clinical narrative suggests a validated scoring tool (like Wells score or Centor criteria), the calculator card appears automatically in the work-up dock.

What happens if an emergency condition is detected?

The work-up engine displays the emergency ABCDE card at the top of the screen with immediate stabilization guidance.

Last reviewed: 03/10/2026.