Dipak,
I should point out that I am not aiming for any heavy debate of this
right now - it's been done before and is a serious topic. On the other
hand we have all learned more in different areas over the last few
years, so it's interesting to bring up a few points and see if anyone's
thoughts have changed. I have mainly questions.
Dipak Kalra wrote:
> Dear Tom,
>
> The purpose of the flag is not to tell you anything about the
> uncertainty within an ENTRY, but only to tell you that it needs to be
> reviewed as a whole by a person or process capable of reviewing it.
>
this is the question isn't it? What does 'reviewed' mean? If the
information is credible (even if wrong) how can the reviewer tell, when
there is no measure of how wrong?
> It is not the case that "all you have is a flag", but rather that you
> have a flag in addition to the contents to warn you that extracting a
> single part of this ENTRY such as an ELEMENT value through a query
> might not be safe because some other parts of the ENTRY might be
> indicating that there is a caveat or caution about the value's
> interpretation. The ENTRY contents still need to provide the
> appropriate details to inform the reviewer, as captured by the
> original author.
>
various questions come to mind:
* are you saying that any original representation of error etc is
retained in the data?
* So the flag is really a marker on an Entry to say 'somewhere
buried in here is/are one or more indicators of (in)accuracy'?
* What if all the Quantities have accuracy markers on them (is this
possible with the CEN QTY data type?) - and the accuracies are
e.g. +/- 5% (i..e pretty good) - do you set the flag or not?
* What if there were 50 quantities with high accuracy and one of low
accuracy, does the flag get set or not?
* What if there are differential diagnoses indicating confidence
levels?
* You wouldn't set the flag on this would you, since the information
is 100% correctly representing what the physician said
* how hard would it be for software to set this flag?
* the ultimate question is: does this flag give you any more useful
information than the raw data?
...or am I missing the point of this altogether?
> It would be nice if we could be more clever than that, but the
> complexity of this challenge is such that a single unambiguous and
> consistently used representation of each kind of uncertainty or
> caution is not yet feasible (as we all know).
>
> What we found to be appropriate for the standard is to put a label on
> the box to say "open with caution, don't just drill down blindly and
> pluck out an isolated value".
how should software react to this?
- thomas
