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GenPRES User Guide (English)

⚠️ Medical Disclaimer GenPRES is not intended for direct clinical use without appropriate validation and regulatory approval. See SUPPORT.md for the full disclaimer.

Table of Contents

  1. Introduction
  2. Accessing the Application
  3. Basic Navigation
  4. Prescribing Medication
  5. Emergency List and Infusion Pumps
  6. Testing Without Patient Data
  7. Unit Conversion Testing
  8. Common Use Cases
  9. Troubleshooting

1. Introduction

GenPRES (Generic Prescribing System) is an open-source Clinical Decision Support System (CDSS) designed to assist clinical staff in:

  • Looking up evidence-based dosing rules and constraints
  • Performing safe medication calculations
  • Verifying the correct application of clinical protocols

GenPRES targets pediatric and neonatal intensive care settings, but can be adapted to any medical environment.

The live system runs at http://genpres.nl.

2. Accessing the Application

With Patient Data (EPD Integration)

In a clinical setting GenPRES is typically launched from an Electronic Patient Dossier (EPD) with patient parameters pre-filled in the URL, for example:

https://genpres.nl/#patient?pg=pr&dc=n&la=en&ad=730&wt=12000

The URL uses hash-based routing (/#patient?...). Supported query parameters:

Patient parameters:

Parameter Description Unit / Values
ad Age Days (e.g., 730 ≈ 2 years)
by Birth year YYYY
bm Birth month 1–12
bd Birth day 1–31
wt Weight Grams (e.g., 12000 = 12 kg)
ht Height Centimeters
gw Gestational age weeks Weeks
gd Gestational age days Days
cv Central venous line y = yes
dp Department Text

Use either ad (age in days) or by/bm/bd (birth date), not both.

Medication parameters:

Parameter Description Unit / Values
md Medication Generic name
rt Route e.g., oraal, intraveneus
in Indication Text
dt Dose type Text
fr Form Text

UI parameters:

Parameter Description Unit / Values
pg Page pr, el, cm, fm, pe
la Language en, du, fr, gr, sp, it
dc Disclaimer n = hide

Example patients using query parameters:

Age (years) Age (days) GA (weeks) Weight (kg) Height (cm) Medication Route Indication Link
1 10 paracetamol oraal Milde tot matige pijn; koorts GenPRES
2 35 1.2 45 paracetamol oraal Pijn, acuut/post-operatief GenPRES
1 10 gentamicine intraveneus Ernstige infectie, gram negatieve microorganismen GenPRES
2 35 1.2 45 gentamicine intraveneus Ernstige infectie, gram negatieve microorganismen GenPRES
1 10 adrenaline intraveneus Circulatoire insufficientie GenPRES
2 35 1.2 45 adrenaline intraveneus Circulatoire insufficientie GenPRES
1 10 trimethoprim/sulfametrol intraveneus Bacteriele infecties GenPRES
1 10 trimethoprim/sulfametrol intraveneus Behandeling Pneumocystis Jiroveci Pneumonie (PCP) GenPRES
16 60 trimethoprim/sulfamethoxazol intraveneus Behandeling Pneumocystis Jiroveci Pneumonie GenPRES
2 35 1.2 45 coffeine 0-water intraveneus Neonatale apneu GenPRES
2 35 1.2 45 coffeine citraat intraveneus Neonatale apneu GenPRES
1 10 tramadol oraal Pijn GenPRES
21 3.8 50 benzylpenicilline intraveneus Infecties, sepsis GenPRES
1 10 benzylpenicilline intraveneus Infecties, sepsis GenPRES
2 35 1.2 45 benzylpenicilline intraveneus Infecties, sepsis GenPRES
5 20 100 midazolam intraveneus Status epilepticus GenPRES
aciclovir intraveneus GenPRES
3 29 1.05 45 amoxicilline intraveneus (Ernstige) waarschijnlijke bacteriële infecties bij pasgeborenen GenPRES
13 rituximab intraveneus Granulomatose met polyangiitis (GPA/ziekte van Wegener), microscopische polyangiitis (MPA) GenPRES
5 20 109 ceftazidim/avibactam intraveneus Gecompliceerde intra-abdominale of urineweg infecties, nosocomiale pneumonie, andere ernstige infecties door gevoelige verwekkers wanneer andere behandelopties beperkt zijn. GenPRES
30 2.77 piperacilline/tazobactam intraveneus GenPRES
10 dantroleen oraal GenPRES

Without Patient Data (Demo / Testing)

The application can be used without patient data in the query string. Open the application directly:

http://localhost:5173

or on the production server:

http://genpres.nl

When no patient context is provided the application starts in demo mode. You can enter patient details manually in the interface before selecting a medication.

3. Basic Navigation

After opening the application you will see the main screen divided into functional areas:

Patient Panel (top)

Displays patient parameters (age, weight, gender, height). If these are not provided via the URL, you can enter them manually here.

Medication Search (main area)

Use the search field to find medications by:

  • Generic name (e.g., paracetamol, morphine)
  • ATC code

Medication List

Select a medication from the search results to open the dosing panel.

Dosing Panel

Shows the calculated dose range based on the patient parameters and the selected dosing protocol. Fields include:

  • Dose per kg – weight-adjusted dose
  • Total dose – calculated absolute dose
  • Frequency – number of doses per day
  • Route – administration route (oral, IV, etc.)
  • Concentration / Volume – for infusion preparations

4. Prescribing Medication

Step-by-step workflow

  1. Enter patient details (age, weight, gender) in the patient panel.
  2. Search for a medication by typing the generic name or ATC code in the search field.
  3. Select the medication from the list of results.
  4. Review the dose range shown in the dosing panel. The system highlights values that are outside safe limits.
  5. Adjust dose or frequency if clinically indicated. The system will warn you if the entered value exceeds maximum or minimum limits.
  6. Select the administration route (oral, IV, rectal, etc.).
  7. Confirm the prescription and transfer the details to the EPD or print/export as required.

Safety alerts

GenPRES displays colour-coded alerts:

Colour Meaning
🟢 Green Value within safe range
🟡 Yellow Value at the boundary of the safe range – use with caution
🔴 Red Value outside safe range – review before proceeding

5. Emergency List and Infusion Pumps

The emergency list provides quick access to standard infusion pump settings for critical medications (e.g., adrenaline, dopamine, noradrenaline). It is designed for use in emergency and ICU scenarios.

Opening the Emergency List

  1. Open the application.
  2. Navigate to Emergency or Noodlijst in the main menu.
  3. Enter or confirm the patient's weight.
  4. The system generates the standard infusion concentrations and pump rates for each medication.

Standard Infusion Pumps

Each entry on the emergency list shows:

  • Medication name
  • Recommended concentration (e.g., 1 mg/mL)
  • Starting dose (µg/kg/min or mL/h)
  • Dose range (minimum – maximum)

6. Testing Without Patient Data

You can run a complete end-to-end workflow without real patient data, which is useful for:

  • Developer onboarding
  • QA testing
  • Training and demonstrations

Procedure

  1. Start the application locally:

    dotnet run

    Open http://localhost:5173 in your browser.

  2. Leave the URL query string empty (no query parameters).

  3. On the main screen, manually enter test patient data:

    • Age: e.g., 2 years
    • Weight: e.g., 12 kg
    • Gender: Male

  4. Search for a medication, e.g., paracetamol.

  5. Review the calculated dosing information.

  6. Optionally adjust dose values and observe safety alerts.

Demo cache

The repository contains a demo cache file with sample medication data. This is sufficient for all testing workflows above. No live internet connection or proprietary data files are required.

7. Unit Conversion Testing

GenPRES internally uses BigRational arithmetic for exact unit-safe calculations via Informedica.GenUNITS.Lib. The following procedure lets you verify unit conversions in the UI.

Verifying dose units

  1. Select a medication with a known dose (e.g., paracetamol oral).
  2. Observe the dose per kg field — it should show the value in mg/kg.
  3. Change the patient weight and confirm that the total dose field updates correspondingly.

Verifying infusion concentrations

  1. Select an IV medication (e.g., morphine).
  2. Observe the concentration field (mg/mL) and the rate field (mL/h).
  3. Modify the desired dose and confirm the pump rate recalculates correctly.

Example: Paracetamol oral

Patient weight Dose/kg Expected total dose
10 kg 15 mg/kg 150 mg
20 kg 15 mg/kg 300 mg
30 kg 15 mg/kg 450 mg

8. Common Use Cases

Use case 1: Oral paracetamol for a toddler

  1. Enter: age 2 years, weight 12 kg, gender Male.
  2. Search: paracetamol.
  3. Select Paracetamol – oral.
  4. Observe the recommended dose range (typically 10–15 mg/kg, 4–6 times daily).
  5. Confirm the maximum daily dose is not exceeded.

Use case 2: IV morphine infusion for a child

  1. Enter: age 5 years, weight 20 kg, gender Female.
  2. Search: morphine.
  3. Select Morphine – IV continuous infusion.
  4. Observe the starting dose (e.g., 10–40 µg/kg/h) and the calculated pump rate.
  5. Adjust the dose; confirm the rate updates.

Use case 3: TPN calculation

  1. Enter patient parameters (weight, age).
  2. Navigate to TPN in the main menu.
  3. Review the auto-generated macronutrient and micronutrient formula.
  4. Adjust individual components if clinically indicated.
  5. Export or print the TPN order for pharmacy.

9. Troubleshooting

Application does not start

  • Make sure you have the required prerequisites installed (.NET SDK, Node.js, npm). See DEVELOPMENT.md.
  • Run dotnet run from the repository root.
  • Check that port 5173 is not occupied by another process.

No medication data shown

  • The application requires a cache file. The demo cache (*.demo) included in the repository is sufficient for testing.
  • Ensure the GENPRES_PROD environment variable is set to 0 (demo mode). See DEVELOPMENT.md.

Dose values appear incorrect

  • Verify that patient weight and age are entered correctly.
  • Check whether the correct administration route is selected.
  • Review the safety colour coding — a red alert indicates a value outside the permitted range.

Further help

Version: 1.0 — March 2026 Language: English 🇳🇱 Nederlandse versie