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CPE-006 · Screening
HG-01: Symptom pattern: testosterone not yet measured
Symptom pattern: testosterone not yet measured. Evaluates no total testosterone entered.
Active rulePriority 4Testosterone engine v1.0.0
Condition
- no total testosterone entered
- at least one specific symptom (low libido, erectile dysfunction, loss of morning erections, infertility, gynecomastia, hot flushes, small testes, osteoporosis or fragility fracture) OR three or more symptoms of any kind
What it reports
- Screening opportunity: measure a morning fasting total testosterone
Recommended next steps (for physician review)
- Order a fasting morning total testosterone (two samples to confirm a low value), with SHBG when it is borderline
Diagnostic boundary
- Symptoms are non-specific. They justify measuring, not a diagnosis.
Evidence
- EV-ES-TRT-2018Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.Supports: Diagnose with symptoms plus unequivocally low testosterone on two morning fasting samples Contraindications and cautions to therapy; monitoring of hematocrit and PSA Evaluation of the type of hypogonadism with LH and FSH
- EV-AUA-2018Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423-432.Supports: Total testosterone below 300 ng/dL as the threshold; repeat and confirm; fertility counselling before therapy
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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