Development of an excel-based decision support tool for graves orbitopathy

PURPOSE: To describe the development and technical feasibility of a rule-based Excel decision support tool designed to operationalize the 2021 EUGOGO recommendations for Graves' orbitopathy (GO) in routine clinical practice. METHODS: A rule-based Excel tool was constructed to integrate EUGOGO-defined inputs, including Clinical Activity Score (CAS), severity classification, and GO-QoL assessment, into automated, guideline-consistent outputs. The system incorporates progression-related parameters (worsening motility, visual acuity decline, and proptosis increase) as override criteria for disease activity classification. A proof-of-concept validation was performed using representative clinical case scenarios, comparing tool-generated outputs with expert guideline-based decisions. RESULTS: The tool generated structured summaries of disease activity category, severity class, and corresponding guideline-consistent management options for all pilot cases. Data entry relied on routinely collected clinical parameters, and outputs were produced automatically. Pilot use demonstrated technical feasibility and internal consistency of rule execution. CONCLUSIONS: This technical report presents a pragmatic, rule-based tool to operationalize EUGOGO recommendations for GO. The tool is intended to support documentation and workflow, not to replace clinical judgement or to provide validation of diagnostic accuracy. Formal validation and prospective evaluation are required in future studies.