Hi to all, At 04:43 02/10/2003 -0400, Williamtfgoossen at cs.com wrote: >b >>) these archetypes will have local vocabulary which defines meanings >>for exactly what terms need to mean in the exact context of the archetypes. > > >Yes, but, if this is going to be constructed, it is wise to already look >at well defined terminology and proceed as follows: > >- if a scientifically validated and reliable scale (mini ontology?) is >available and meets the clinical need then choose that. >if this scales are not available, then use some kind of standardized >terminology like LOINC, SNOMED, ICF, NANDA or whatever. >if that is not available to fullfil the needs for the subject, then choose >your own wording that defines best the meanings for the clinical area.
It certainly makes sense. From what I personnaly experienced, if you don't make the "semantisation" work at the very first stages, you will have a hard time doing it afterward because an ontology is an accurate but restricted langage ; thus you end up translating from natural langage to a more restricted langage - or worse from classification terms, triyng to give a meaning to terms that where only created for "patient grouping". Making "semantic Archetypes" is a job that involves a doctor and a knowledge manager - this one translates between "doctor langage" and "ontological langage", but also asks for the proper level of accuracy in the concepts representation. Very hard to do lately. >Given the earlier suggestion to already use such terms, a part of the >coding has been done. Otherwise, depending on purpose (clinical trial is >different from international prevalence study) map from scale / local term >to classification. We are currently experiencing such things ; it is not easy to have people understand the difference between description (As accurate as possible), local study (question 5 can be answered 5.1, 5.2...) and studies using classifications such as ICD or ICPC where you just can use concepts inside the classification (and it is sometimes complicated since, for example, "send to the hospital" as no entry inside ICPC). I don't think you can expect adressing all these issues through Archetypes >Yes, a validated scale on a particular issue around human functioning >could be part of an ontology, but perhaps not always. The Barthel index or >the APGAR score e.g. have distinct and different variables that probably >would not stand beside each other in an ontology. Or, it would be an >ontology with many to many parent - child relationships. The way we solve this kind of problem is that we incorporated inside the ontology concepts as "ICD10 code", "ICPC code" and so on. These ontology concepts are given the code as a "value" in the same way "patient size (cm)" would be given 180 as a value. >Snomed is probably >>more in this space than pure terminology, so it may be that we send >>change requests of some kind to them, based on archetyps. > > >Yes, the process would become interactively with knowledge determiners >(ontology, scales) terminology developers (semantics) and information >modellers (archetypes as constraining mechanisms for what a record system >/ messaging system must do with this particular grouping of patient data. > > >e >>) due to d), ontologies may change over time in such a way that more >>direct mappings from archetypes become possible. > > >Yes, that might work two ways from archetype to ontology, but reverse to >via including from ontology into archetypes. > > >Hope this helps, > > > >Sincerely yours, > >Dr. William T.F. Goossen > >Senior Researcher and Consultant Health and Nursing Informatics >Acquest Research and Development, Koudekerk aan den Rijn, the Netherlands ><http://www.acquest.nl/>http://www.acquest.nl/ >& >Adjunct Associate Professor in the College of Nursing, faculty in the >Organizations, Systems and Community Health Area of Study, the University >of IOWA, Iowa City, Iowa, USA. www.nursing.uiowa.edu/NI >& >Country Representative for the Netherlands in the Special Interest Group >Nursing Informatics, IMIA. http://www.infocom.cqu.edu.au/imia-ni/ >& >Member Evaluation Committee International Classification for Nursing >Practice, Geneva, ICN. <http://www.icn.ch/>International Council of >Nurses http://www.icn.ch/ and http://www.icn.ch/icnp.htm >& >Associate Professor, Adjunct on the faculty of the School of Nursing, >University of Colorado Health Sciences Center, Denver, USA. >& >Bestuurslid Vereniging voor Medische en Biologische Informatieverwerking ><http://www.vmbi.nl/>http://www.vmbi.nl/ >& >Fellow of the Centre for Health Informatics Research and Development >(CHIRAD), School of Social Sciences, Kings Alfred's, Winchester ><http://www.chirad.org.uk/>www.chirad.org.uk - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
