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Tools to Keep Track of Your Lab Results





You might have been one of those lucky people who never got sick, never cared to see your annual medical exam results. Now that CLL has entered you life, things can become very different, very quickly. It is amazing how quickly that little manila folder you started with fills up with CBC charts, assorted test reports, insurance forms and other paper work. Pretty soon, it is impossible to find anything, let alone keep track of important trends in your blood reports.

Reading one of these lab reports is not easy either, crowded as it is with a lot of acronyms that make no sense. Attached is a template (a Microsoft Excel spreadsheet) that might help you with organizing and making sense of your rapidly accumulating medical information. The format is similar to the one we use for our Patient Profiles on the CLL Topics discussion group. Each of the Chart headings are commented: as you slide your cursor over them, you get a brief description of the term and what it means. There are separate pages for CBC, electrolytes, flow cytometry and BMB, immunoglobulins, and a general wellness index, each accessible by clicking on a tab at the bottom of the spreadsheet. They say a picture is worth a thousand words, and it is certainly a lot easier to spot trends in your blood counts if they are plotted neatly. The graphs on page two of the spread sheet are set up to track the important numbers on your CBC automatically, as you enter the data over time. 

You are welcome to download this template (Records.xls) to your own computer, modify it if you wish, use it any way that makes sense to you. I have personally found this format easy to use - and in addition, our medical practitioners are pleased to have the data organized and laid out graphically.  

Also included is a sample Excel workbook (Sample.xls) with data from an fictitious patient, Joe Patient . We hope that this sample workbook will provide an illustration of the kinds of trends and variations that can be illuminated by using this tool. 


Working with Spreadsheets:  

You Need Spreadsheet Software: To use the templates provided above, you need to have Microsoft Excel installed on your computer. It would be best if you save the files locally on your computer under names that you select and then open them directly in Excel so that you can make data entries and other changes in your own local files. Most people who have Excel or Microsoft Office installed on their computers should be able to launch the files seamlessly by clicking on the links above. Doing so will start the download process and the templates should  load into your browser window in Excel format. Save the files on your computer under names of your choice. You can also right-click on the links here and select "Save Target As..." from the context menu.

The templates have been constructed on PCs running Microsoft Windows and Excel 2000. Excel on the Mac should be at least file-compatible with these templates but we have not tested them on the Mac.

File formats have changed. Those who are using earlier versions of Excel (Excel 5.0, 95/97-98) might experience trouble with the version of the files shown in the panel above. For these people, the following links offer versions of the same templates that could be more compatible with their installed software: Records95.xls and Sample95.xls

What, you don't have Excel? Excel (sometimes abbreviated to XL or MS XL) is a part of the Microsoft Office suite which many users already have installed on their machines.  However, there are a significant number of people who do not. For these users, here are a few suggestions. Of course, running out to your local computer store and buying a copy of the software is one option. But remember, both the MS Office suite and the standalone Excel package are quite expensive. If you have other uses for your cash and are not dying to experiment with Microsoft Office, read on. We have unearthed a few low cost solutions and at least one no-cost solution to the need for a modern and fully functional piece of spreadsheet software that operates across a variety of hardware platforms - all without running afoul of copyright laws or even questioning their intelligence. 

This Viewer lets you see but not touch. A free Excel viewer is available from Microsoft. You can download a copy from the official Microsoft site. The viewer, as its name implies, can only display the spreadsheets and is therefore a partial solution at best. You can certainly inspect the Sample.xls file with this viewer and it is entirely adequate for reviewing the contents of any other XL file you come across.  You cannot, of course, use the viewer to make data entries in Records.xls or to make your own modifications to any of these templates. For that you will need a live spreadsheet program - ideally Excel, but an alternative spreadsheet program that can import Excel files may work for you.  

You can use other spreadsheet programs. While the Records.xls template has not been tested for compatibility with other spreadsheet programs, it is likely that you will be able to use this template with certain alternative spreadsheet programs that can read Excel files - such as Lotus 1-2-3, Star Office or Quattro Pro - if you just happen to have one of those programs installed instead of Excel. If you succeed in loading the record-keeping template into such a program and it accepts data entry - well, then, you might have just solved your problem. In this regard, the spreadsheet program in the latest version of Microsoft Works (Microsoft's entry-level productivity application) seems to be able to load the tabular clinical data but does not seem to be able to reproduce the graphs. In addition. you may find the color scheme it applies a little bizarre. Some other solution would seem to be preferable to MS Works. Another package, Easy Office, available as a free but massive download (80MB), is not recommended as the spreadsheet component does not display MS Excel charts. 

In all these cases, you may have to adjust column widths (or change fonts) so that labels and data display properly. If you do not already have one of these programs, or if you run into an unexpected snag, we have a couple of more suggestions.

Older versions of MS Office will work just fine. You might be able to find a friend or associate who has more than one licensed copy of Excel as a result of upgrading or getting a new computer. A currently unused version of the software from an older Office or standalone Excel package is still a very capable spreadsheet program and should serve your purpose. Logically, these older versions of the software should function better with the file formats of Records95.xls and Sample95.xls

This solution won't cost you a dime. Finally, the Open Source movement has produced a number of very useful tools available without cost to anyone. Open Office (which shares its code base with Sun Microsystems' Star Office and is reported to be virtually identical), is available as a free download from http://www.openoffice.org/. Where cost is a concern, this is a treasure. The download is available for a number of platforms, including Windows, Linux and Mac OS X. Open Office is a full-featured office suite with a word processing program, a spreadsheet, a presentation program and a number of other office tools. You can pick and choose the components to be installed during the setup process by selecting "custom install". If you choose to download this office suite, be warned that it is a sizable download (about 58 MB for the Windows version and even larger for the Mac and Linux versions - broadband access helps) and you have to follow some detailed instructions to get the suite installed. We have tried the templates provided here with OpenOffice Calc (the Excel equivalent) on machines running Windows Me, Windows 2000 and Windows XP and they appear to load and function without a glitch. Once again, you may have to fiddle with its settings to make OpenOffice Calc work just like MS Excel - but this effort might be worth your time since the price is right. For your trouble you will also have at your disposal the MS Word equivalent for word processing and the MS Powerpoint equivalent for presentations that are part of the suite, to mention just two of the other components. All the modules in this suite are reported to be fully functional, stable, versatile and, for the most part, to work just like their corresponding modules in Microsoft Office. If you would like to read a review of Open Office/Star Office before you go to the trouble of downloading the software, you might find the following link to an August 2002 article by Marcel Gagne in Unix Reviews helpful - http://www.unixreview.com/documents/s=7459/uni1029855913341/. If you decide to go ahead with this experiment, you may fortify yourself with the reflection that you are saving a few hundred dollars. And if you get everything to work, you should be extremely pleased with yourself.

Our Interest: CLL Topics does not endorse or offer technical support for any of the software mentioned here, nor do we warrant that anything will work as advertised. Our intention is merely to point out potential solutions to patients who might benefit from the use of spreadsheet software to track their clinical data. These questions have come up a number of times and this note documents what we have discovered so far. 

If you discover or know of another effective, low-cost (and law-abiding) solution to the lack of Microsoft Excel on one's machine, please do let us know. You may use the Feedback form to report your ingenious solution so we can share it with others. 

P. C. Venkat    

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