Clinical disclaimer

1. Absence of clinical guidance

Retroact does not calculate, recommend or suggest a dose, and it does not interpret a result for a particular patient. It expresses no view as to what any patient should receive. Every dose recorded in Retroact reflects a decision taken by a clinician before the software was opened.

Praxio is a software company. We do not practise pharmacy or medicine, we do not supervise your practice, and the use of our software creates no clinical, professional or advisory relationship between us and you or your patients.

2. Function of the software

What Retroact provides is the application of limits. The account selects the protocol the clinician follows, and the software applies that protocol's reference limits to every entry recorded, consistently and without exception. It flags a dose above a ceiling, a value inconsistent with the dispensable increment, an INR beyond an alert threshold, and a week-over-week change exceeding what the protocol permits.

The undertaking we give concerns fidelity rather than correctness: whatever protocol is in force on the account, we apply it faithfully. We do not substitute the values of another jurisdiction, we do not average sources, and we do not supply a value in order to fill a gap. Where a protocol contains no sourced value for a given parameter, the software states as much rather than infer one.

3. Interpretation of a protocol value

A protocol value is to be read as a reference value, and is only as authoritative as the source cited beneath it.

Every value in every protocol carries a record of its origin, and the three origins are not of equal authority. The citation should be read before the value is relied upon:

• Taken from a published clinical guideline, cited by document, edition and section. This is the most authoritative category. It nevertheless represents the view of that document rather than ours, and remains subject to the qualifications that document itself sets out.
• Taken from a marketing authorisation or national formulary: tablet strengths, labelled maintenance ranges, and the increments into which a tablet may be divided. These are regulatory facts concerning supply, not clinical guidance concerning treatment.
• Set by us, because no external source states the value. The milligram dose ceilings are all of this category. They exist to detect a dose entered with an additional digit. They are not a clinical opinion as to a maximum safe dose and must not be read as one.

Where we have not sourced guidance for your jurisdiction, Retroact applies a baseline protocol. A baseline cites no clinical authority of any kind: it holds the account to the most restrictive threshold used anywhere in the product, and can therefore only warn earlier than a sourced protocol, never later. It does not represent the guidance of your jurisdiction and must not be relied upon as such.

Guidance also changes. Documents are revised, superseded and withdrawn, and we give no warranty that a protocol reflects the current edition of any document, that it is complete, or that it is suitable for your patients, your indication mix or your jurisdiction. We publish the source behind each value so that it may be verified, and verification is your responsibility.

4. Reference limits do not override the clinician

Where an entry falls outside a reference limit, Retroact issues a warning or requires a justification to be recorded before saving. The clinician may proceed in every case. The software will not prevent the recording of clinically indicated care, and a recorded justification constitutes a note of the clinician's decision and not our approval of it.

Therapeutic target ranges are determined by the clinician for each patient. Retroact assumes none.

5. Responsibility of the clinician

You are the licensed professional, and you are solely and entirely responsible for:

• every dosing, monitoring and treatment decision for every patient in your care;
• verifying that the protocol selected on your account matches the guidance actually in force in your jurisdiction, and your own professional standards, before relying on it;
• verifying everything entered into or produced by Retroact — including printed dosing calendars and prescriptions — before acting on it or handing it to a patient;
• determining the therapeutic target range for each patient; and
• meeting the professional, regulatory and record-keeping obligations that apply to you.

6. Liability

Retroact is provided as is, without warranties of any kind. We are not liable for any clinical outcome, dosing decision or patient harm arising from your use of, or reliance on, the reference limits described here.

Nothing on this page or in our Terms excludes or limits any liability that cannot lawfully be excluded, including liability that consumer-protection or professional-liability law reserves. Where a limitation is unenforceable in your jurisdiction, it applies to the fullest extent that jurisdiction permits.

7. Enquiries

The full agreement is set out in section 7 of the Terms of Service. If any matter on this page is unclear, or if you consider a cited source to be incorrect or out of date, please inform us: a mis-cited value is a defect and we wish to be told of it.

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