Op 13-jul-2007, om 14:38 heeft Gerard Freriks het volgende geschreven: > Dear all, > > There are several types of models: > -first order: models about what really happened > -second order: models about observations of what happened in real > life (perhaps). The direct observation. > -third order: models about what somebody (something) observed and > reports about. The indirect observation. > > In our discussion about Observation Archetypes we need to be clear > what we are talking about. > > In contrast to HL7 (they mix all three in one bag and create chaos) > we CEN, OpenEHR, never talk about first order models. > We talk about second and third order models. > > The Observation archetype must have two distinct variants: the > direct observation and the indirect observation. > > A Blood pressure measurement by a clinician recorded in his ICT- > system is a direct observation. > A Blood pressure measurement by a patient recorded by the clinician > in his ICT-system is an indirect observation. > A Blood pressure measurement by an automatic device recorded in the > ICT system of the patient or clinician is an indirect measurement.
Nice distinctions, this works for me. > > In all cases the origin and its characteristics of the observation > must be recordable. > In many cases these actors (entities) are to be found in a > registry where this resource is managed. > When information is exchanged between jurisdictions (that do not > use the same resource registries) this information ends up in a > message/template. > > In the example of the Blood Pressure Archetype we see aspects from > the second and third order models. > Second order models do not describe the source explicitly because > this is the author. > Third order models define the actors in one level of more detail. > The source and its characteristics must be described. > The characteristics of persons differ from those of machines. > Machines have device dependent characteristics but many times > include persons as operators. Very well put, I guess this is exactly the thing I'm struggling with. > > This brings me to a cascade of archetypic building blocks. > These building blocks I would like to call atomic archetypes. > And many GPICS (an European CEN standard) will provide input to > archetypes. > > 1 Observation > a- first order (implicit actor) > b- second order (explicit actors) > I- Person characteristics > II- Medical device > i- Hardware, software characteristics > ii- Person as operator characteristics I really like this model and would love to see if we can use this to 'model trust' > > Based on all recorded objective characteristics each author > allowing data in his ICT-system must make a subjective value > judgement. > Next to each entry it must be possible to indicate at a certain > time the value judgement. > Many times this indication will be empty, some times it will > indicate its trust value. Indeed, but we have to start somewhere. Cheers, Stef > > > Gerard Freriks > > > conexis > > --------------------------- > Gerard Freriks, MD > Huigsloterdijk 378 > 2158LR Buitenkaag > the Netherlands > > M: +31 620347088 > E: gf at conexis.nl > > > > On Jul 13, 2007, at 11:23 AM, Thomas Beale wrote: > >> Stef Verlinden wrote: >>> >>> >>> So I guess I have several questions, which I try to separate. >>> >>> The first part is: how/where can we add the accessory data that >>> necessary to establish data quality. As Thomas pointed out, most of >>> these things are already recorded. In would like to have clarity >>> on to >>> things: >>> >>> 1. device information (calibration, maintained etc, etc.). Thomas >>> suggested that one should store those in the protocol part of an >>> observation. That?s a possibility but then one has to fill out that >>> data every time an observation is made. >> do >> an INR competently. >>> Form what I understood form the demographic IM , there is a >>> capability >>> class in which ? the qualifications of the performer of the role for >>> this capability?. I guess my question is, is there a role self/ >>> citizen/ non-professional (I don?t know how we should call that >>> role) >>> and can we attach capabilities to that role? >> I can see you are already ahead of me;-) >>> >>> The second part is about the data quality criteria. Although these >>> criteria are subjective, they?re real and useful for the parties who >>> agreed upon those criteria. Look for instance at the ?report of the >>> independent advisory group on blood pressure monitoring in clinical >>> practice? by the MHRA. This is an example of quality criteria one >>> could agree upon. Based on such criteria one could rate the recorded >>> data as good or poor (or even an more refined scale if required) >>> Now my question. Where can/ should we store such a data quality >>> marker. I figured that since these are local/subjective criteria you >>> don?t want to put them in the original/ root archetype that?s >>> intended >>> for ?worldwide? use. So my suggestion is to create a ?local? >>> specialization of this root archetype in which both the criteria and >>> the data quality label are added (see my previous mail). >>> Is this a good suggestion and if not where can I store that data >>> after >>> all. I don?t want to create a second system for this and in my >>> opinion >>> this type of data belong somewhere in an EHR. >> Various places it could go in the current openEHR model: >> - in the protocol (it is essentially meta-data to do with 'how' the >> measurement was done) >> - in the 'data' art of the archetype, which might be sensible, >> particularly for patient questionnaires >> >> but this is assuming that you don't want to use the Quantity.accuracy >> approach. You could already record +/-20% (95% confidence, normal >> distribution) in a Quantity. Some people here e.g. Tim Churches >> who has >> a population health perspective - have correctly suggested that to be >> comprehensive, we should allow for other distributions, and >> therefore a >> more elaborate model of 'accuracy'. If the community indeed sees the >> added complexity (over and above the simple approach of recording >> accuracy = +/-5% etc) is worth it, then we will add it to the model. >> >> - thomas >> >> >> _______________________________________________ >> openEHR-clinical mailing list >> openEHR-clinical at openehr.org >> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical > > > > > > conexis > > --------------------------- > Gerard Freriks, MD > Huigsloterdijk 378 > 2158LR Buitenkaag > the Netherlands > > M: +31 620347088 > E: gf at conexis.nl > > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20070713/e2562de8/attachment.html>
