Dear Ian, When you say: > there may be a more generic requirement to flag > 'not thought suitable for decision support or secondary uses', so > that the > result (or entry) is ignored by machine processing.
after many months of debate and ballot commenting, this is also the decision that was arrived at in finalising EN13606 Part 1 (EHR Communications Reference Model): Class ENTRY Attribute uncertainty_expressed:Boolean Description: This attribute is set to TRUE to advise the EHR Recipient that this ENTRY contains data that indicates some degree of uncertainty, and that care should be taken when using these data within automated processes and systems. It is a flag to advise the EHR Recipient that the data structure includes some indication of uncertain findings or opinions, and that care needs to be taken when using the data for automated processing It is based on the assumption that uncertainty might be expressed in many ways within an EHR Provider system, including but not limited to coded expressions with or without qualifiers, which might be challenging for an EHR Recipient to detect reliably. This attribute is a generic way of indicating that the data ought to be critically reviewed (e.g. by a person) in order to verify if it is suitable for any particular computational process. Some years of openEHR thinking was provided as input to that international debate, since we had perviously considered a variety of differnt kinds of uncertainty representation and found them largely to be too problematic with regard to consistent usage, or at risk of creating ambiguity when used in parallel with terminology systems that can express uncertainty formally through qualifiers. With best wishes, Dipak ________________________________________________________ Dr Dipak Kalra Clinical Senior Lecturer in Health Informatics CHIME, University College London Holborn Union Building, Highgate Hill, London N19 5LW Phone: +44-20-7288-5966 Fax: +44-20-7288-3322 Web site: http://www.chime.ucl.ac.uk
