The is a sample test result from the diagnostic paradigm from, Internet Medical Evaluations.

1. Scheduled Test Information
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Today's Date : Apr 20, 2010
Prefix: Mrs.
First Name: Priscilla
Middle Initial : R
Last Name: XXXXX
Suffix :
Street Address (2) : XXXXXXX
 Street Address :
City : XXXXXXXX
My Country : United States
Hom State or Province : Maryland
e
Postal Code : XXXXXX
Page
Phone Number: 999 999 999
( ) -
 Client Company : Free Test User
Claim / Account Number: 732
Logo
Authorization Number : 100002895
ut
Test Language : English
 Diagnostic Paradigm and Treatment
Test To Take :
Algorith Test (tm)
Test Scheduled to be taken between : 04/07/2010 -04/08/2010
Test Completed : 04/07/2010
Test Status : Completed
Test Score : 0.000000
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Test Messages :
The following is a report of those conditions and information that the patient
indicated on the Pain Test:
The patient was born on 04/10/1940.

2. Patient reports that the pain is not the result of an accident. Patient reports having
the following conditions: "Lupus", "Arthritis", "Heart disease, or high blood
pressure, or stroke". The patient did not report having any of the following
conditions: "Diabetes", "Thyroid disease", "Multiple Sclerosis or M.S.",
"Cancer", "Infection", "Muscular Dystrophy". The injury that gave rise to the
claim occurred on 02/24/1989. Patient reports not having had accidents or injuries
before this date. Patient reports not having had accidents or injuries since this
date.
Patient reports having a low back problem. Patient reports having had no surgery
to the low back. Patient reports that low back pain: "comes and goes". Patient
reports that the low back problem feels like: "dull ache". Patient reports that the
low back problem gets worse when: "I ride in a car", "I lift things", "I stand too
long". Patient reports that the low back pain gets better when: "I lay down", "I
rest".
Patient reports having no problems in the left leg. Patient reports having had no
surgery or injury to the left leg.
Patient reports having no problems with the right leg. Patient reports having had
no surgery or injury to the right leg.
Patient reports having no neck problems. Patient reports having had no surgery or
injury to the neck.
Patient reports having no problems with the left arm. Patient reports having had
no surgery or injury to the left arm.
Patient reports having no problems with the right arm. Patient reports having had
no surgery or injury to the right arm.
Patient reports having no problem just in front of the ear (where the jaw hinges
the skull).
Patient reports having no problem with the chest or ribs. Patient reported having
had no injury to the chest. Patient reported having had no surgery to the chest.
On the left side of the body, the patient reported the following:
Left side of low back: "pain that comes and goes".
On the right side of the body, the paitient reported the following:
In right middle finger: "weakness", "swelling". In right middle finger: "pain that
comes and goes".

3. Right side of the low back: "pain that comes and goes".
The patient also reported the following:
Along left ribs, in the back: "pain that comes and goes".
The Patient reported no problems in the mid back. Patient reported having an
injury to the mid back. Patient reported having no surgeries on the mid back.
Patient reported not having a medical problem other than injury or surgery in the
mid back. Patient reported the mid back problem, "comes and goes". Patient
reported that the mid back problem feels like a: "dull ache". Patient reported that
the mid back problem gets worse if: "I ride in a car", "I lift things". Patient
reported that the mid back problem gets better if: "I lie down", "I rest".
Below is a list of possible diagnoses, organized into groups for viewing
purposes:
Group 2 - Lumbar Herniated Disc L2-S1
 L5-S1 Herniated or Disupted Disc - Score=0.916667
 L4-L5 Herniated or Disrupted Disc - Score=0.666667
 Unstable Spinal Segment at L3-L4 - Score=0.500000
 Unstable Spinal Segment at L4-L5 - Score=0.500000
 Spondylolysis/Spondylolythesis/Anterio-Lysthesis/Unstable Lumbar
Spinal Segment - Score=0.500000
 Unstable Spinal Segment at L5-S1 - Score=0.500000
 L3-L4 Herniated or Disrupted Disc - Score=0.416667
 Lumbar Facet Syndrome L3-S1 - Score=0.250000
Lumbar Herniated Disc L2-S1
If If
Positive, If Negative,
Treatme If
Treatment/T next Positiv next Treatment/T
nt Negativ
est Treatme e Treatme est Time
Number e then:
nt then: nt
Number Number
Bed rest as
needed,
NSAID,
2.1 STOP - 2.2 - 3 weeks
muscle
relaxants, and
narcotics
STOP.
Trial with
2.2 STOP Remov 2.3 - 3 weeks
corset
e

4. corset.
If pain
returns
, go to
#2.3
Flexion-
Extension X-
2.3 Rays with 2.5 - 2.4 - 1 day
obliques of
lumbar spine
M.R.I. of L2-
2.4 2.5 - 2.6 - 1 day
S1
EMG/Nerve
conduction
studies of
2.5 2.7 - 2.6 - 1 day
legs, and
neurometer
studies
3D-CT of L2-
2.6 2.10 - 2.7 - 1 day
S1
Body jacket
with thigh
2.7 2.11 - 2.8 - 1 day
spika to leg
with less pain
Root blocks,
L2-L3, L3-
2.8 2.10 - 2.9 - 2 days
L4, L4-L5,
L5-S1
If
Negativ
e, go to
Provocative protocol
2.9 discogram 2.11 - 14.1 for 1 day
L2-S1 Lumbar
Facet
Syndro
me
Orthopedic
2.10 surgery 2.12 - 2.11 - 1 day
consult
Neurosurgical
2.11 2.12 - 2.13 - 1 day
consultation

5. Wait 1
Discectomy
year,
and fusion
2.12 2.13 then 2.14 - 1 year
and/or
go to
foraminotomy
#2.13
Functional
capacity
evaluation,
2 days to 3
2.13 then STOP - STOP -
weeks
vocational
rehabilitation
- then STOP
M.R.I. with
gadolinium,
2.14 2.13 - 2.15 - 1 day
to rule out
scarring
3D-CT to rule
2.15 out broken 2.11 - 2.16 - 1 day
fusion
Bone scan -
2.16 rule out 2.11 - 2.17 - 1 day
infection
Indium 111
2.17 2.11 - 2.18 - 1 day
scan
Rule out
disc
above or
below
2.18 Gallium scan 2.11 - 2.3 1 day
fusion
site is
disrupte
d.
Group 14 - Lumbar Facet Syndrome
 Lumbar Facet Syndrome L3-S1 - Score=0.250000
Lumbar Facet Syndrome
If If
Treatm Positive Negativ If
Treatment/ If Positive Treatment/
ent , next e, next Negative
Test then: Test Time
Number Treatm Treatm then:
ent ent

6. Number Number
Muscle
relaxants,
14.1 NSAID, bed STOP - 14.2 - 3 weeks
rest as
needed
14.2 Corset STOP - 14.3 - 3 weeks
Flexion- If positive
Extension for facet
14.3 14.4 14.4 - 1 day
X-rays with sclerosis,
obliques go to #14.4
Facet blocks
14.4 14.5 - 14.6 - 1 day
L3-S1
Immediat
ely, or if
the facet
denervatio
ns lose
their
effectiven
There is a
ess, new
40%
Facet diagnoses
chance the
denervation are to be
patient will
14.5 at STOP 14.6 considere 1 day
have 2
appropriate d - a)
years of
level Facet
relief -
break, b)
STOP
neural
foraminal
stenosis,
or c)
unstable
back. Go
to 14.6
The
diagnosis
will be
Consider
either: (A)
unstable
Facet break
14.6 3D-CT STOP 14.9 spine, 1 day
(B) Neural
then go to
foraminal
14.7
stenosis.
Go to
appropriate

7. surgery:
(A)
Intrabody
fusion or
factectomy
(B)
Foraminot
omy
Go to
14.7 Facet break STOP appropriate STOP - 12 weeks
surgery
Neural Go to
14.8 foraminal STOP appropriate STOP - 3 weeks
stenosis surgery
Body jacket
with thigh
spika to leg
14.9 14.11 - 14.11 - 6 weeks
without pain
or leg with
less pain
Fusion at
14.10 appropriate STOP - 14.13 - 1 year
level
Provocative
14.11 14.12 - 14.13 - 1 day
discogram
Discectomy,
14.12 STOP - STOP - 1 year
and fusion
Bone scan,
indium 111
scan,
gallium
scan, blood
studies CBC
14.13 14.14 - 14.14 1 day
with diff,
sed rate, C3.
C4. Total
compliment,
alk phos for
infection
Institute 14.15
weeks to
14.14 medical STOP - and -
months
therapy 14.16
14.15 Group STOP - STOP - 1 year

8. therapy for
chronic pain
patients
Functional
capacity
evaluation
and return to 2 days to 3
14.16 STOP - STOP -
work, after weeks
vocational
rehabilitatio
n - STOP
Group 15 - Herniated or Disrupted Thoracic Disc T1-T12
 T1-T4 Herniated or Disrupted Disc - Score=1.000000
 T1-T4 Facet Syndrome - Score=0.750000
 T5-T8 Herniated or Disrupted Disc - Score=0.687500
 T5-8 Facet Syndrome - Score=0.625000
 T9-T12 Herniated or Disrupted Disc - Score=0.416667
Herniated or Disrupted Thoracic Disc T1-T12
If If
Positive, Negative,
Treatme If If
Treatment/T next next Treatment/T
nt Positiv Negativ
est Treatme Treatme est Time
Number e then: e then:
nt nt
Number Number
Do MRI of T
spine,
Provocative
15.1 discogram of 15.2 - 15.2 - -
T spine and
3D-CT of T
spine.
Does MRI
and/or 3D-CT
15.2 show 15.6 - 15.3 - -
compression
fracture?
Does MRI or
3D-CT show
15.3 neural 15.7 - 15.4 - -
foraminal
stenosis or

9. spinal
stenosis?
Does MRI or
15.4 3D-CT show 15.8 - 15.5 - -
facet disease?
Is Provocative
15.5 Discogram 15.10 - 15.11 - -
positive?
Do
15.6 STOP - 15.12 - -
vertebroplasty
Do
15.7 decompressio STOP - 15.11 - -
n
Do facet
blocks above,
15.8 15.9 - 15.11 - -
at the site, and
below the site
Do facet
15.9 STOP - 15.11 - -
denervation
Do disectomy
15.10 STOP - 15.12 - -
and fusion
Body jacket
15.11 with thigh 15.10 - 15.12 - -
spika
Epidural
15.12 Morphine STOP - 15.13 - -
Pump
Use pain
15.13 STOP - STOP - -
medication
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