Dear Vebjørn, 1-AFAIK
Each documented item in the EHR is following the pattern: Question=Answer Archetype/Template nodes define the Question. The Data Element in the Archetype/Template defines the Answer. Between the two organisations behind LOINC and SNOMED there is an agreement to use LOINC for coding the question. And use SNOMED to code the answer. CIMI is using this convention. This brings me to: Question = Answer use LOINC = use SNOMED 2-Local code sets versus International codes. Interoperability (interpretability) demands that in the end we all use the same Basic Models/standards in our Semantic stacks. Always there will be reasons to create local codes/classifications for specific purposes. Interoperability (interpretability) demands that these local codes/classifications need to be mapped to International models/standards. Gerard Freriks +31 620 34 70 88 +31 182 22 59 46 gf...@luna.nl Kattensingel 20 2801 CA Gouda the Netherlands > On 8 Mar 2019, at 09:07, Vebjørn Arntzen via openEHR-clinical > <openehr-clinical@lists.openehr.org> wrote: > > Hi, Dileep > > There are nodes in archetypes where it could, and perhaps should, be > recommended to use terminology where possible. In many of them, there already > is such recommendations. For example in Problem/Diagnosis name in the > archetype Problem/Diagnosis: > Identification of the problem or diagnosis, by name. > Comment: Coding of the name of the problem or diagnosis with a terminology is > preferred, where possible. > > And in Severity category in Symptom/Sign, the coded text are already binded > to SNOMED-CT: > Mild [The intensity of the symptom or sign does not cause interference with > normal activity.] > [SNOMED-CT::162468002] (Symptom mild (finding)) > Moderate [The intensity of the symptom or sign causes interference with > normal activity.] > [SNOMED-CT::162469005] (Symptom moderate (finding)) > Severe [The intensity of the symptom or sign causes prevents normal activity.] > [SNOMED-CT::162470006] (Symptom severe (finding)) > > If it is preferred to use a local valueset instead, or to extent the number > of codes, the datatype is a choice of either Coded text, or Text, to allow > for this. It's mentioned in the comment of that element: > Comment: Defining values such as mild, moderate or severe in such a way that > is applicable to multiple symptoms or signs plus allows multiple users to > interpret and record them consistently is not easy. Some organisations extend > the value set further with inclusion of additional values such as 'Trivial' > and 'Very severe', and/or 'Mild-Moderate' and 'Moderate-Severe', adds to the > definitional difficulty and may also worsen inter-recorder reliability > issues. Use of 'Life-threatening' and 'Fatal' is also often considered as > part of this value set, although from a pure point of view it may actually > reflect an outcome rather than a severity. In view of the above, keeping to a > well-defined but smaller list is preferred and so the mild/moderate/severe > value set is offered, however the choice of other text allows for other value > sets to be included at this data element in a template. Note: more specific > grading of severity can be recorded using the 'Specific details' SLOT > > Terminologies come and go, what's popular today may not be popular tomorrow. > And as for SNOMED, there is a substantional fee to be paid to use them, which > not all countries in the world are willing (or able) to pay. This is why > there are mostly recommendations to use*a terminology*, and not a specific > named one. > > If you find elements where it should be mentioned to use terminology where > possible, please add a change request for that archetype. > > <image003.png><image002.png> >
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