Clinical Framework: OLDCARTS
OLDCARTS is the standard mnemonic for structuring the history of present illness (HPI) within a comprehensive or focused health history. It ensures all eight essential symptom dimensions are explored before clinical hypotheses are formed, preventing premature diagnostic closure. Use for any presenting complaint. Document findings in the patient's own words where possible. The tool generates a structured HPI summary suitable for clinical documentation practice.
OLDCARTS — History of Present Illness Framework
A structured mnemonic for collecting a complete history of present illness (HPI). OLDCARTS ensures all eight essential dimensions of a symptom are systematically explored before clinical hypotheses are formed. Use for any presenting complaint — comprehensive coverage prevents premature diagnostic closure. Enter findings as the patient reports them.
OLDCARTS dimensions
O
Onset
When did it start?
L
Location
Where is it?
D
Duration
How long does it last?
C
Character
What does it feel like?
A
Aggravating factors
What makes it worse?
R
Relieving factors
What makes it better?
T
Timing
Constant or intermittent?
S
Severity
How bad is it? (0–10)
HPI Documentation (OLDCARTS format)