Is a protocol a cluster archetype or a component of an observation?
http://www.openehr.org/137-OE.html defines the term 'protocol' as an attribute
of CARE_ENTRY.
A clinical trial protocol document may define a collection of trial specific
observations (as used in the openEHR protocol sense), for example a trial
specific definition (e.g. of an MI) or reference ranges of blood chemistry that
differ for males and females and by country of birth, or a new procedure not
yet in SNOMED.
A 'Protocol' cluster archetype seems to me to be a 'protocol document' or a
reference set of such specialisations.
Or am I trying to overload too much onto the meaning?
Colin Sutton
NHMRC Clinical Trials Centre
http://www.ctc.usyd.edu.au <http://www.ctc.usyd.edu.au/>
-----Original Message-----
From: openehr-clinical-bounces at openehr.org
[mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Gerard Freriks
Sent: Tuesday, 18 December 2007 10:16 AM
To: For openEHR clinical discussions
Cc: ?mer Hotomaroglu
Subject: Re: maximum heart rate
Dear all,
I agree with Sam.
States. Protocols are Cluster archetypes that can be/will be re-used in
ENTRY Archetypes..
Are there more?
Demographics/Localisations, ...
Gerard
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On Dec 17, 2007, at 1:31 AM, Sam Heard wrote:
Hi Andrew
We now have a reason to provide a cluster for exercise related
state - to share this between the heart rate and bp and possibly other
archetypes. So I would suggest that we think about the state as a cluster. It
would seem that there is the idea of a category of exercise - maximal or some
such. We need to hear from people who are experts in this area (Omer may have
some answers).
So I would suggest that the investigation is a stress test - it
will be a composition probably as a report. I do not think it will be recorded
as a procedure in the EHR - but it can be. I would see recording the action
(from a request) that the order was completed as the main form.
It will contain measurements of BP and Heart rate. Each will
have state data on exercise level. This should be a cluster archetype which is
about the level of exercise at a point in time.
So my suggestion is that we go for a cluster on exercise level
for use in State on a few observations. Who has the data that will need to be
entered.
% of Maximal for age is like a percentile chart in weight or
height (normal). At the moment the normal range can be added to the data point.
I am not sure that we have the idea of percentile as part of this - the closest
thing is the normal_status attribute which provides a means of stating whether
the level is very high or low as for HL7 v2. We could extend this to include
the idea of percentiles based on normal range (eg 25 if 25% of people have a
level at or below this level). The idea of maximal heart rate for age is a
reference range and can be added to the peak heart rate - with a percentage as
part of the normal_status.
The alternative is adding data points for these measurements -
which is not a great problem but would mean adding to the weight and height
archetypes.
I am interested in what others think.
Cheers, Sam
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