One suggestion is to use for some of these observations the concept of "critical" reference range, which can then be exploited for implementing 'triggers' or rules.
Obviously, the values to be used as critical reference range will depend on appropriate clinical knowledge and guidelines. Alain Maskens CLASS REFERENCE_RANGE<T:DV_ORDERED> Purpose Defines a named range to be associated with any ORDERED datum. Each such range is particular to the patient and context, e.g. sex, age, and any other factor which affects ranges. Use May be used to represent normal, therapeutic, dangerous, critical etc ranges. ISO 18308 STR 3.13 Attributes Signature Meaning 1..1 meaning: DV_TEXT Term whose value indicates the meaning of this range, e.g. "normal", "critical", "therapeutic" etc. 1..1 range: DV_INTERVAL<T> The data range for this meaning, _____ From: [email protected] [mailto:openehr-clinical-bounces at openehr.org] On Behalf Of pablo pazos Sent: mardi 13 octobre 2009 15:48 To: openehr clinical; openehr technical Subject: RE: Modeling reference ranges Hi Ian, thanks for the answer. I see, so the "reference range" is only for lab test results. Yes, what I like to do is something that for certain observation values it display something to the physician. Blood presure was just an example, the observations I have are: - Glasgow Comma Scale: <15 is a problem - Cardiac Frequency: <60 or >100 is a problem - Breath Frequency: <10 or >20 is a problem I'll look to Rong's work. Thanks a lot! Cheers, Pablo. _____ From: [email protected] Date: Mon, 12 Oct 2009 23:59:32 +0100 Subject: Re: Modeling reference ranges To: openehr-technical at openehr.org CC: openehr-clinical at openehr.org Hi Pablo, The Quantity datatype in the Reference model has built-in support for Reference ranges so these do have to be modelled overtly in archetypes. See http://www.openehr.org/svn/specification/TRUNK/publishing/architecture/rm/da ta_types_im.pdf This makes sense for lab tests etc where each test will report a reference range (which are often lab/analysis method dependent) along with the results themselves. However, you are talking about something different. There is really no such thing as a reference range for blood pressure, which might indicate hypertension. The definitions of hypertension vary, over time and by locality and the diagnosis will depend on many other factors than just the blood pressure itself. I think what you may be trying to capture is some thing more like a 'trigger blood pressure' which displays an alert to the clinician or initiates some other action if a set of criteria have been reached e.g 3 readings with a diasstolic > 100. This is more akin to a guideline or care pathway. You might want to have a look at the work Rong Chen has been doing using archetypes within computerised guidelines for chemotherapy. In this case the archetype does not represent actual patient data but an abstract of ALL patients who might fall within the guideline. See http://www.hst.aau.dk/~ska/MIE2009/papers/MIE2009p0653.pdf <http://www.hst.aau.dk/%7Eska/MIE2009/papers/MIE2009p0653.pdf> Hope this helps, Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll ian at mcmi.co.uk Clinical Analyst Ocean Informatics ian.mcnicoll at oceaninformatics.com BCS Primary Health Care Specialist Group www.phcsg.org 2009/10/12 pablo pazos <pazospablo at hotmail.com> Hi, I'm playing around with archetypes trying to model an observation and its reference ranges, I mean something like "blood pressure" and some range to define what is "hypertension", but I can't found an archetype that defines a reference range for an observation. Any one has experience in modeling something like this? An archetype is the correct place to define a reference range for an observation value? Any ideas? Thak you! Cheers, Pablo Pazos Gutierrez _____ Windows Live: Keep your friends up to date with <http://www.microsoft.com/middleeast/windows/windowslive/see-it-in-action/so cial-network-basics.aspx?ocid=PID23461::T:WLMTAGL:ON:WL:en-xm:SI_SB_1:092010 > what you do online. _______________________________________________ openEHR-technical mailing list openEHR-technical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical _____ Windows Live: Keep your friends up to date with what you do online. <http://www.microsoft.com/middleeast/windows/windowslive/see-it-in-action/so cial-network-basics.aspx?ocid=PID23461::T:WLMTAGL:ON:WL:en-xm:SI_SB_1:092010 > -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20091013/2f6594fa/attachment.html>
