Thanks Grahame, but I disagree.

“•          A generic question/answer pattern is next to useless - 
interoperability is really not helped, especially if both the question and 
answer has to be managed in the template.”

The complete sentence qualifies that the dependence on template modelling is 
the issue wrt interoperability. This is where a generic pattern is made 
specific for a given questionnaire or data set. Also that we have found there 
are multiple generic patterns, none of which is universally applicable and so 
to create multiple generic patterns becomes nonsensical.

In the templating scenario it is only if the exact same template is shared 
(where every question has been renamed and associated value sets inserted) that 
can we get any value. In our experience it is of higher value to create an 
archetype that can at least be shared locally and explicitly models the precise 
question/answer combo in order to achieve better reuse.

Heather

From: openEHR-clinical [mailto:openehr-clinical-boun...@lists.openehr.org] On 
Behalf Of Grahame Grieve
Sent: Monday, 5 June 2017 3:59 PM
To: For openEHR technical discussions <openehr-techni...@lists.openehr.org>
Cc: For openEHR clinical discussions <openehr-clinical@lists.openehr.org>
Subject: Re: Questionnaires

hi Heather

> A generic question/answer pattern is next to useless - interoperability is 
> really not helped

I think you should rather say "A generic question/answer pattern is only useful 
for exchanging the questions and answers, and does not allow re-use of data". 
This is not 'next to useless for interoperability', just not fit for any wider 
purpose

Grahame


On Mon, Jun 5, 2017 at 3:51 PM, Heather Leslie 
<heather.les...@oceanhealthsystems.com<mailto:heather.les...@oceanhealthsystems.com>>
 wrote:
Following Thomas’ suggestion re a separate thread:

I wrote a blog post in 2014 which still reflects our current thinking re 
questionnaires: 
https://omowizard.wordpress.com/2014/02/21/the-questionnaire-challenge/

Our experience is that the data is the priority and so we want to focus on 
questionnaires to support capture of good quality data.

If you want to try to capture data from the majority of existing questionnaires 
then good luck – questionnaires notoriously ask questions badly, conflating 
multiple concepts into one question, Boolean True/False when there are other 
‘shades of gray’ etc. They work variably as far as human interpretation but 
usually very badly wrt computer interpretation.

We do have experience in taking previous paper questionnaires, analysing the 
data requirements sought in terms of what we want to persist and then we design 
the UI/questions to match the data desired and/or suggesting the UI might show 
a questionnaire but each question the clinical data is actually recorded using 
core archetypes – for example “Do you have diabetes?” – ‘Yes’, is recorded 
using the value ‘Diabetes’ in the EVAL.problem_diagnosis and ‘No’ is recorded 
in the matching exclusion archetype. This creates real clinical data that can 
be used as part of a health record rather than create an electronic checkbox 
version of the original paper questionnaire which will never be used again, but 
capture dust in our EHR’s virtual archives.

In summary:

  *   A generic question/answer pattern is next to useless - interoperability 
is really not helped, especially if both the question and answer has to be 
managed in the template. We have tried many variations of this in the past, 
some of which were uploaded into CKM and subsequently rejected.
  *   Lock in those questionnaires that are ubiquitous, evidence based, 
validated as OBSERVATION archetypes and share them in the international CKM – 
eg AUDIT, Glasgow coma scale, Barthel index, Edinburgh post natal depression 
scale – there are many examples in CKM.
  *   Lock in local questionnaires that are going to be reused in your 
organisation, region or jurisdiction even though they may not be reusable 
elsewhere. They will provide some interoperability even if might only be 
appropriate within one clinical system or national CKM. An example is the 
Modified Early Warning Score/National Early Warning Score – there are a few 
different variations used in different locations and whether they should all be 
in the international CKM is still not clear.

BTW Questionnaires should be modelled as OBSERVATIONs (ie evidence that can be 
collected over and over again using the same protocol) not EVALUATIONS (as they 
are not meta-analysis nor summaries).

Regards

Heather

From: openEHR-technical 
[mailto:openehr-technical-boun...@lists.openehr.org<mailto:openehr-technical-boun...@lists.openehr.org>]
 On Behalf Of Pablo Pazos
Sent: Thursday, 1 June 2017 12:58 AM
To: For openEHR technical discussions 
<openehr-techni...@lists.openehr.org<mailto:openehr-techni...@lists.openehr.org>>
Subject: Re: Reports - a new openEHR RM type?

Besides specific ways to model questionnaires, my questions is if our openEHR 
clinical modelers have a pattern to represent questionnaires using the openEHR 
information model.

On Wed, May 31, 2017 at 3:37 AM, GF <gf...@luna.nl<mailto:gf...@luna.nl>> wrote:
There are several kinds of context archetypes/templates and their meta-data are 
used for:
- de novo data - re-used data
- step in the clinical treatment model (observation, assessment/inference, 
planning, ordering, execution)
- kind of interface it is designed for (data presentation on a screen, data 
capture, database store/retrieve, CDSS, …

Each Template needs to capture all this and is a Composition.
All these contexts are characteristics of a Composition in the end.

Questionnaires are in essence a tool that classifies information.
And sometimes it transforms a set of responses into an aggregated value/code
The questionnaire can be treated as any classification, meaning we need to de 
fine inclusion and exclusion criteria,
and possible results per question can be a quantitative result (number, PQ, 
code), or a semi-quantitative result (high, low), or a qualitative result 
(present/ not present).
Semi-Qualitative results need, inclusion/exclusion criteria and a definition of 
what the norm/population is is about (females, children, etc.)


Gerard Freriks
+31 620347088<tel:+31%206%2020347088>
gf...@luna.nl<mailto:gf...@luna.nl>

On 31 May 2017, at 06:54, Pablo Pazos 
<pablo.pa...@cabolabs.com<mailto:pablo.pa...@cabolabs.com>> wrote:

Hi Thomas,
Thinking about the hierarchy, at which level will be a Report be? Below compo? 
Below entry? Structure? Representation?
OT: many asked me this and didn't had a good answer. Do we have a pattern to 
model questionnaires? Some require to define questions, and the answer type in 
most cases is boolean, or coded text (multiple choice), and answers might be 
0..* (more than one answer for the same question is valid).
Cheers,
Pablo.



_______________________________________________
openEHR-technical mailing list
openehr-techni...@lists.openehr.org<mailto:openehr-techni...@lists.openehr.org>
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org



--
Ing. Pablo Pazos Gutiérrez
Cel:(00598) 99 043 145
Skype: cabolabs

[https://docs.google.com/uc?export=download&id=0B27lX-sxkymfdEdPLVI5UTZuZlU&revid=0B27lX-sxkymfcUwzT0N2RUs3bGU2UUovakc4VXBxWFZ6OXNnPQ]<http://cabolabs.com/>
http://www.cabolabs.com<http://www.cabolabs.com/>
pablo.pa...@cabolabs.com<mailto:pablo.pa...@cabolabs.com>
Subscribe to our newsletter<http://eepurl.com/b_w_tj>



_______________________________________________
openEHR-technical mailing list
openehr-techni...@lists.openehr.org<mailto:openehr-techni...@lists.openehr.org>
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org



--
-----
http://www.healthintersections.com.au / 
grah...@healthintersections.com.au<mailto:grah...@healthintersections.com.au> / 
+61 411 867 065
_______________________________________________
openEHR-clinical mailing list
openEHR-clinical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org

Reply via email to