On 11/8/07, Chunlan Ma <chunlan.ma at oceaninformatics.com> wrote: > > Hi Rong, Sam and others, > > > > *From:* openehr-clinical-bounces at openehr.org [mailto: > openehr-clinical-bounces at openehr.org] *On Behalf Of *Rong Chen > *Sent:* Wednesday, November 07, 2007 10:34 PM > *To:* For openEHR clinical discussions > *Subject:* Re: Evaluation Archetypes and assessment protocol > > > > If one chooses the first option one should fill out the criteria each and > every time, when writing down a diagnosis. Of course this can be automated > by the application that is used. Thing is that the knowledge will be stored > locally at application level. My feeling is that your suggestion to use the > GuidelineID is in conjunction this option. Point is that if I refer to an > external guidelines, data in that guideline isn't 'archetyped' and can't be > used for computational purposes. So I have to translated those into an > archetype. > > > > Guidelines can be computerized as well. There are published guidelines > representation formats, e.g. GLIF for instance and their execution > engines. Being rules based and decision trees like, personally I think they > are not best modelled as archetypes since archetype model are designed to > represent more 'static' clinical content model. In applications, EHRs and > guidelines should work hand-in-hand: 1) guidelines need to query EHRs > through standardized EHR representation format and query language; 2) EHRs > need record what guidelines are used etc. > > *[Chunlan Ma] * > > * * > > *I'm personally very interested in how clinical guidelines are used within > an openEHR-based EHR system even though I'm new in this field. In my > understanding, the **guidelineId** in CARE_ENTRY is used as a reference > to an external clinical guideline; the **protocol** attribute in > CARE_ENTRY is used as local guideline/protocol definition. Please correct me > if this is wrong.* > > * * > > *Because the type of **protocol** attribute is **ITEM_STRUCTURE**, it > means the local protocol/guideline definition is archetyepable. Archetypes > are very good to record facts, but don't know how it can be used to record > rule criteria, such as when HbA1c is greater than 9%, do such. * > Hi Chunlan and others,
The limitation is from the underlying information model not the archetype formalism. The archetype formalism is very generic so it can be used to constrain any object model. My thinking was limited to EHR model when I made the statement that guidelines are not best modelled as archetypes. If the underlying model is a good object model for representing guidelines, of course it's possible to model guidelines as archetypes. Back to protocol attribute, quoted from the EHR Information Model, "This may take the form of references to guidelines, including manually followed and executable; knowledge references such as a paper in Medline; clinical reasons within a larger care process". It seems to be intended as a reference to a guideline instead of the guideline itself fully archetyped in-line. /Rong *Cheers,* > > *Chunlan* > > * * > > > > Cheers, > Rong > > _______________________________________________ > 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/20071108/926774b3/attachment.html>
