Hi, I don?t mean to be too pushy on this but I think we are not really on the same grounds at the moment. I?ll try to summarise my points:
- Re universality I agree with you as you describe but I have indicated that this pattern is unique to certain type of observations; so perhaps I shouldn?t have used the term universal but ?common? in many types of clinical findings as a result of some examination. The exclusions you give by examples are very appropriate. - It is perfectly possible, and indeed during the diagnosis of acute appendicitis essential, to denote absence of lump or ?lack of rebound reflex? is almost common expression and pathognomonic to the disease. So I don?t agree with you and my gut feeling is that all findings during physical examination may well be reported as absent. - Yes I?d be also very interested to identify and classify if possible which ones ? but again my gut feeling is that this may not be possible and that relies on the clinical context and semantics. Therefore instead of identifying these at the outset I think giving the modellers a method to tag these will be the pragmatic solution and enable consistency among modellers and implementations. - Re design patterns and tooling support ? I think this should be in place in any case. But as Ian has pointed out there is more to the problem than convenience for modellers. The problem is consistency among modellers and mode critically when these models need to evolve (which is almost guaranteed) then how to avoid changes in paths?i.e. many ELEMENTs will need to be converted to CLUSTERS. Conversely if you anticipate this and design accordingly you might end up having zillion of unnecessary CLUSTERS with single ELEMENTs? Hey Ian! I liked your proposal?Never been to Bahamas Cheers, -koray From: openehr-clinical-bounces at openehr.org [mailto:openehr-clinical-boun...@openehr.org] On Behalf Of Sam Heard Sent: Thursday, 16 December 2010 9:22 a.m. To: For openEHR clinical discussions Cc: openehr-clinical at openehr.org Subject: Re: GUI-directives/hints again (Was: Developing usable GUIs) Hi All I sense Thomas is right. If you look at the exam archetypes there is a pattern of unlimited normal statements. This allows anything to be said but for it to be classified as normal even if it is text. There is work to do on examination as it is fractal and varies on a case by case basis. Happy to talk about this at the implementation meeting. Cheers Sam Sent from my extphoney On 16/12/2010, at 6:24 AM, Thomas Beale <thomas.beale at oceaninformatics.com<mailto:thomas.beale at oceaninformatics.com>> wrote: On 15/12/2010 19:20, Koray Atalag wrote: Hi Tom, I agree that the this is best way how to ?represent? data technically. But what I suggest is, since this is a universal and repeating pattern for all clinical findings (and maybe more) can?t we have an extension in ADL such that we ?tag? a certain sub-tree and then this node is inserted into ADL source automatically. And the way we write queries and process that would be uniform and convenient. Cheers, I am pretty sure it is not universal. Consider any standard lab, e.g. full blood count. Each analyte that is reported is there; if a proper value can't be reported, e.g. haemolysed attached specimen, you get just a report with that in it; otherwise you get numbers (including things like 'trace' where appropriate) and normal ranges. This is a different pattern. A reflex test is going to report a reaction to a stimulus, for each of a number of locations on the body. This will be a different pattern again ('no reaction' is just a value among other values of reaction strength). Your pattern might be a typical pattern for various kinds of physical examination, where the examination proceeds on the basis of looking for a very specific set of possible anomalies, in the way that colonoscopy does. But even then, physical exam of e.g. abdomen is not going to report 'lump: absent' if no lump was encountered in a routine check. I agree it is likely to be a common pattern in some kinds of examination, and it would be interesting to know which ones, and how these could be categorised. I would suggest that what you are really after is a library of 'archetype design patterns' that are available to tools, enabling you to quickly build the definitions for a whole lot of nodes according to a chosen pattern. My suggestion is to try to identify and document such patterns - I started a page on this about 1year ago at http://www.openehr.org/wiki/display/healthmod/Archetype+Design+Patterns+-+Initial+Thoughts - thomas _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org<mailto:openEHR-clinical at openehr.org> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20101216/e3567a43/attachment.html>
