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Reference Ranges & Out-of-Range Markers

ClinLang can automatically annotate numeric vitals and lab values in your notes when they fall outside a configured reference range.

[!IMPORTANT] Transcription Aid Only Out-of-range markers are designed strictly as a transcription aid to help clinicians double-check values. They are not clinical decision support, severity indicators, or recommendations. The clinician is always the final authority and must interpret all findings in context.

What it Looks Like

When markers are enabled, the SOAP note will flag out-of-range values like this:

Vitals: BP: 160/100 | HR: 105 bpm | SpO2: 94% | Temp: 98.6 | RR: 22 /min
        - HR 105 bpm (outside ref 60-100, AHA adult defaults)
        - BP 160/100 mmHg (outside ref 90-140 / 60-90, JNC-8 defaults)

In the ClinLang web UI, these markers are highlighted on hover over the vitals or lab lines, and are displayed in the SOAP preview.

Default Reference Ranges

ClinLang comes with standard adult reference ranges built-in. Below is the list of values checked:

Field Key Default Range Unit Source Citation
Heart Rate vitals.hr 60 – 100 bpm user-default adult ranges
Systolic BP vitals.bp.systolic 90 – 140 mmHg user-default adult ranges
Diastolic BP vitals.bp.diastolic 60 – 90 mmHg user-default adult ranges
Oxygen Saturation vitals.spo2 94 – 100 % user-default adult ranges
Respiratory Rate vitals.rr 12 – 20 breaths/min user-default adult ranges
Temperature vitals.temp 97.0 – 100.0 °F user-default adult ranges
Haemoglobin (Male) labs.hb.M 13.0 – 17.0 g/dL user-default adult ranges
Haemoglobin (Female) labs.hb.F 11.0 – 17.0 g/dL user-default adult ranges
White Blood Cells labs.wbc 4,000 – 11,000 /µL user-default adult ranges
Creatinine labs.creatinine 0.6 – 1.2 mg/dL user-default adult ranges
Sodium (Na) labs.na 135 – 145 mEq/L user-default adult ranges
Potassium (K) labs.k 3.5 – 5.0 mEq/L user-default adult ranges
Glucose labs.glucose 3.9 – 7.8 mmol/L user-default adult ranges

Customizing Reference Ranges

You can override any default range to match your local laboratory guidelines or hospital policy.

Editing in the Web UI (Easiest)

  1. Open the Settings Drawer (gear icon in top right).
  2. Scroll to the Shorthand & Terms section.
  3. Select reference_ranges.json from the configuration files dropdown.
  4. Modify the values in the JSON text box and click Save Configuration.

Reference Range Schema Format

Each entry in reference_ranges.json looks like this:

"vitals.hr": {
  "low": 60,
  "high": 100,
  "unit": "bpm",
  "source": "AHA Adult Defaults"
}
  • low (number, optional): The lower limit. Values below this are flagged.
  • high (number, optional): The upper limit. Values above this are flagged.
  • unit (string, optional): A text label showing the unit.
  • source (string, required): The citation source shown in the warning. Always name this so you (and other readers) can audit where the range came from (e.g. "Hospital X Lab Guideline 2026").

Special Range Rules

1. Haemoglobin (Sex-Specific)

Haemoglobin ranges are split into labs.hb.M and labs.hb.F. * If a patient is registered as male (pt 58M), the system uses labs.hb.M. * If a patient is registered as female (pt 58F), the system uses labs.hb.F. * If you omit the sex in the pt line (e.g. pt 58), no Haemoglobin markers will be generated. The engine does not guess.

2. Temperature (Unit Suffixes)

ClinLang does not perform automatic unit conversion between Fahrenheit (°F) and Celsius (°C). * If you type your temperature in Celsius (temp37.5c), it must match a range configured with "unit": "C". * If you type your temperature in Fahrenheit (temp98.6f), it must match a range configured with "unit": "F". * If the units do not match, the range check is skipped. If you want to use Celsius defaults, edit your reference_ranges.json to reflect your desired Celsius limits and set "unit": "C".