Dear ckm lovers, My preference is for your option 3. We have to make updates. Nobody is forced to change anything.
Best regards Gunnar Den 2 okt 2015 06:11 skrev "Heather Leslie" < heather.les...@oceaninformatics.com>: > Hi everyone, > > > > I’m seeking community input around a conundrum that has arisen regarding > archetype governance or, more specifically, if we should offer a new > version of an archetype that included breaking changes/corrections > according to the openEHR specifications but which are not critical in terms > of clinical safety – a bit of a grey zone, if you like. If clinical safety > were implicated, the decision would be easy. > > > > The Blood Pressure archetype was published in 2009 and I believe is in > fairly wide use in systems at this point. Currently published version here > <http://ckm.openehr.org/ckm/#showArchetype_1013.1.130>, and which has had > only ‘trivial’, non-breaking changes, including addition of translations, > etc since publication. > > > > Recently the Norwegian community translated the archetype and then > undertook a local review of the archetype. They have suggested some > modifications to the archetype which include updating some of the data > elements around identifying the body location of the BP measurement to be > in keeping with more recent archetype patterns that we have been using, > plus identified that the representation of degrees of Tilt was not using > the UCUM units, plus a few minor additions. > > > > The result is that their new candidate archetype (here > <http://ckm.openehr.org/ckm/#showArchetype_1013.1.2189>) which includes > these changes is regarded as a Major revision under our current CKM > versioning rules and if republished warrants becoming a version 2. That is > all perfectly OK from an academic governance point of view. > > > > There is no doubt that the archetype is a more accurate and enhanced > iteration but the practical implications of republishing as a v2 are not > trivial to implementers. > > > > So I seek your advice on whether we should proceed with further content > review with the intent of re-publishing as a new v2 archetype: > > · *Pros* > > o Archetype data is updated to include correct UCUM units > > o Archetype data is updated to include more ‘modern’ modelling patterns > that are being used increasingly in more recent archetypes > > o New implementers will be able to use the most up-to-date version of > the archetype, rather than using an archetype that has been identified as > having flaws. Otherwise new implementers will continue to implement a > known, flawed archetype into their new systems > > o Further content review will expose the archetype to a broader range > of clinicians and their input will potentially further enhance, or at least > endorse the current, quality. > > > > · *Cons* > > o Further content review will possibly introduce further changes – > maybe breaking, maybe not. > > o Existing implementers will need to decide whether it is worthwhile to > update to v2. The alternative is to stay with the v1 published archetype as > is and consider updating at some future time. > > o The update of the UCUM unit and body location pattern does not have > major safety implications or significantly impact the modelling quality, > yet will have internal implications in existing clinical systems. > > o Two versions of the archetype will be in circulation, and > implementers will need to manage the interoperability issues that will > arise. > > o Norway will likely use the new archetype as their national standard, > diverging from the openEHR CKM content, which is not desired by either > party. > > > > A portion of the diff is attached, which demonstrates the major breaking > changes. There are many other changes that only refer to translations and > are non-breaking in the rest of the diff > > > > Major changes are: > > · Changing ‘Tilt’ units – ‘°’ to ‘deg’ – at1005 – this is the > critical and breaking correction that has triggered considering these > additional changes: > > o Making Measurement Location a choice of coded text and text – at0014 > > o Removal the redundant ‘Location’ cluster heading > > > > This is the first time we have had to update a published archetype and it > certainly won’t be the last. If there were breaking changes that needed to > be made for clinical safety reasons or similar critical reasons I would > have no hesitation in proceeding to v2. If there were non-breaking changes > we would manage the progression with additional minor revisions or patches > – not a problem. This one has breaking changes but no clinical safety > issues, so a bit of a grey zone because of the possible implementation > implications. > > > > I have no doubt that many implementers are already grappling with these > issues if they have implemented draft archetypes, so perhaps you all have > established systems and approaches for this. > > > > I have had some advice suggesting we should leave the archetype as is, > rather than ‘rock the implementation boat’ for little semantic value, yet > I’m not sure that it is our role to be paternalistic. My own inclinations > are that we should govern the archetypes from a pure point of view, > updating and creating new versions if we have to, and allowing CKM to > provide the transparency that will support implementers to make informed > choices. > > > > So: > > *Option 1*: Do nothing. The current flawed archetype will be the only one > available on the openEHR CKM > > *Option 2*: Promote the new candidate archetype to the public trunk as a > potential new iteration – so available for viewing and download, but with > no official status, effectively in limbo until a further review round is > carried out and it is republished. > > *Option 3*: Promote the new candidate archetype to the public trunk, run > formal content reviews on it and plan to re-publish as v2 > > > > Please, your thoughts? > > > > Regards > > > > Heather > > > > *Dr Heather Leslie *MBBS FRACGP FACHI > *Consulting Lead*, Ocean Informatics <http://www.oceaninformatics.com/> > > *Clinical Programme Lead, *openEHR Foundation <http://www.openehr.org/> > p: +61 418 966 670 skype: heatherleslie twitter: @omowizard > > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical@lists.openehr.org > > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org >
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