Peter, I like to accept ypur suggestion.
Gerard -- <private> -- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands +31 252 544896 +31 654 792800 On 13 Apr 2005, at 19:55, Elkin, Peter L., M.D. wrote: > Dear Roger and Thomas, > > We have looked extensively at Multivalued logic for quantitating > uncertainty. It turns out that most folks in that world have taking 0 > false and one true with a number of discrete, usually equally spaced > values in between for uncertainty. > > After a longwinded go around with a Prof of Philosophical Logic at > Princeton (Dr. Graham) We determined that there at least three > reproducible types of uncertainty (with good inter-rater reliability) > and ~ seven semantic categories. > > The types are Probable (our guess is around 85% true +/- 5%) and > Unlikely (our guess is around 15% true +/- 5%) or Just as likely as > not (again our guess is around 50% +/- 15%). These number come from > the average PPV of the evidence when a physician "Makes a diagnosis" > and NPV when a physician rules one out. > > Other distinctions are less reproducible. When taken together most > clinicians would say that Probable is stronger than Likely, however > the assignment to actual cases is not in our experience reproducible > between knowledgeable reviewers. > > I suggest that you first code (as we do) True, False or Uncertain. > Then qualify Uncertain with a semantic type indicating strength. This > allows a model that can grow with our ability to represent more > closely evidence based medicine. > > Warm regards, > > Peter > > Peter L. Elkin, MD > Professor of Medicine > Director, Laboratory of Biomedical Informatics > Department of Internal Medicine > Mayo Clinic, College of Medicine > Mayo Clinic, Rochester > (507) 284-1551 > Fax: (507) 284-5370 > > > > -----Original Message----- > From: owner-openehr-technical at openehr.org > [mailto:owner-openehr-technical at openehr.org] On Behalf Of Thomas Beale > Sent: Monday, April 11, 2005 11:42 PM > To: openehr-technical at openehr.org > Subject: Re: Dr R LONJON Confidence indicator ! > > Dr LONJON Roger wrote: > >> hello philippe and thomas, >> excuse me to intervene, in English of bad quality. >> in medicine for me, a result must be validated and must be signed by >> the >> producer. This result is therefore automatically a total confidence >> level. It >> is a very important notion on the legal plan when these results are >> put to >> disposition on a shared medical file (server web) >> >> Inversely if this result is approximate, with a coefficient of mistake >> importing, it is not about a validated data and therefore >> publishable, because >> consequences in r?ponsabilit? for their author are unforeseeable if >> the patient >> carries complaint. >> >> I am unaware of this aspect of the problem so enters in your >> reflection. >> >> > It is actually quite common: consider that in a differential diagnosis, > confidences are always expressed in each of the possible diagnosesa, > e.g. 90%, 9%, 1% for possible reasons for a child's fever. I don't see > it as being about mistakes, it's about the estimation by a clinical > professional of the probability of correctness of an opinion. In > openEHR, confidences always appear in data of the EVALUATION type. > There > is no question of clinician confidence in OBSERVATIONs - they are for > all intents objective. Of course, machines may have limited accuracy > (inbuilt error) and numeric results may be reported with limited > precision; these situations can be archetyped. > > - thomas > >> Cordially >> >> Dr R LONJON >> france >> >> > > > - > If you have any questions about using this list, > please send a message to d.lloyd at openehr.org > > - > If you have any questions about using this list, > please send a message to d.lloyd at openehr.org > -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: text/enriched Size: 3806 bytes Desc: not available URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20050414/7f331f05/attachment.bin>
