Hi,

<xx or >yy
What does it mean?

To my mind it semantically means a state of exception. Meaning not  
only that the measurement is <xx or >yy but that it is unmeasurable.

If this reasoning is true than each archetype with a measurement  
needs an exception attribute.
In general this will be true in many more circumstances.

Each possible statement (data item and/or archetype) can have a few  
states:
requested/expected- unrequested/not expected  (eg expected is TSH  
measurement but unrequested and unexpected the response is TSH>2000  
as an indication of exception)
As exception there are at least two possibilities:
known-unknown.  (eg RR 120/unknown mmHg. TSH was measured and  
presented but it must not be considered a real result it is in doubt)
true-untrue (eg I measured RR 60/80  this measurement I consider  
untrue, but it was that was was measured. TSH >2000 but is untrue  
because it was unmeasurable)


Gerard




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On 1-mrt-2006, at 2:41, Sam Heard wrote:

> Hi everyone,
>
> We want to report an issue that has arisen in data processing in  
> Australia.
>
> The issue is the somewhat random ability of systems to report a >xx  
> or <yy range where a quantity is expected - there are still units  
> and still a normal range. This is common with TSH and GFR - but can  
> turn up in unexpected instances - e.g. we had a baby with a HCO3 of  
> <5 mmol/L. This can be dealt with at present by substituting an  
> interval - but it is a bit wierd as there is still a normal range -  
> it kind of works as there is only a lower or upper value of the  
> interval and so this single quantity can carry the normal range.
>
> The point is that it is really a point measurement that is outside  
> the range of the measuring device. Also, it means that we will have  
> to have archetypes that allow multiple datatypes for all quantities  
> that could conceivably be measured in this way.
>
> The alternative is to consider a DV_QUANTITY_RANGE that inherits  
> from DV_QUANTITY - it still has only one value - but now it has the  
> ability to set this as the upper or lower value - and also whether  
> this number is included or not.
>
> The advantage is that there would still be a number to graph and  
> this data type could always be substituted for a DV_QUANTITY (ie  
> without archetyping).
>
> I wonder what others think.
>
> Cheers, Sam
> -- 
> Dr. Sam Heard
> MBBS, FRACGP, MRCGP, DRCOG, FACHI
>
> CEO and Clinical Director
> Ocean Informatics Pty. Ltd.
> Adjunct Professor, Health Informatics, Central Queensland University
> Senior Visiting Research Fellow, CHIME, University College London
> Chair, Standards Australia, EHR Working Group (IT14-9-2)
> Ph: +61 (0)4 1783 8808
> Fx: +61 (0)8 8948 0215
>

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