Interpretation

How to Read an NLS Wellness Report

Most of the harm done by this kind of document comes from misreading it, not from the document itself. This page explains the scale, the common misreadings, and the point at which a question stops being a wellness question and becomes a medical one.

The hierarchy of the document

A report has three levels, and they carry different amounts of meaning. Reading them in the wrong order is the source of most confusion.

  1. The practitioner summary. Read this first. It is the only part written by a person who looked at everything together.
  2. The system overview. Read this second, looking for patterns across related systems rather than for the highest number.
  3. The category detail. Read this last, and only for the systems the summary actually discussed. Reading the detail cold is how people frighten themselves over software labels.

What the scale means

NLS software places each entry on an ordered scale, commonly six positions, from a stable reading to a maximally deviant one. The scale describes distance from a reference pattern during that session. It does not describe severity, progression, or risk.

PositionWhat it literally meansWhat it does not mean
Low (1–2)The reading sat close to the reference pattern.Not a clean bill of health.
Middle (3–4)The reading sat some distance from it.Not an early warning, and not a stage.
High (5–6)The reading sat far from it.Not a detected condition, and not urgency.

The five common misreadings

  • Treating a label as a finding. Software libraries name reference patterns using clinical vocabulary. A matched pattern is not a detected condition and QMH reports do not present it as one.
  • Chasing the single highest number. An isolated outlier surrounded by low readings is usually noise. Related categories moving together is the only pattern worth weight.
  • Reading a low score as all-clear. The instrument cannot rule anything out. Absence of a flag is not absence of a problem.
  • Comparing sessions run under different conditions. Trends are only interesting when the sessions are comparable. A session run during illness, travel or acute stress is not a fair comparison point.
  • Acting on it. Starting a supplement, stopping a medication or changing a treatment because of a score is the one thing this document must never be used for.

When to stop reading and call a doctor

These are medical questions. No wellness report addresses them, and no score should be weighed against them.

  • Chest pain, pressure, breathlessness, or pain spreading to the arm, neck or jaw.
  • Sudden weakness, numbness, facial droop, confusion, or difficulty speaking or seeing.
  • Unexplained weight loss, persistent fever, or night sweats.
  • Bleeding that is unexplained, including blood in urine or stool, or coughing blood.
  • A new lump, a mole that is changing, or a sore that does not heal.
  • Severe or worsening pain, or a headache that is the worst you have had.
  • Any symptom that frightens you, whatever the report says.

Useful questions for your practitioner

  • Which of these would you actually pay attention to, and which would you disregard?
  • Is this pattern common in people with my routine, or is it unusual?
  • What would you expect to see in three months if nothing changes?
  • Is there anything here that belongs with a doctor rather than with you?
  • What would have to appear for you to tell me this service is not useful for me?

Questions people ask before booking

The annotated sample shows all of this in a real document layout.