Hi Ian,

My comments were not directed to you. Sorry. My intention was more to shift 
focus from looking for strange concepts and comment to looking for potential 
improvements and make suggestions about these improvements in general. (And as 
many non-native English speakers I lack some of the nuances in the language.)

                             Regards
                             Mikael


From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On 
Behalf Of Ian McNicoll
Sent: den 29 april 2016 23:05
To: For openEHR technical discussions
Subject: Re: SNOMED

Hi Mikael,

I really did not intend my remarks about the 'missing' content in SNOMED-CT to 
be seen as a complaint, or criticism. I fully understand that this, by 
definition, is work in progress and there is a perfectly good change request 
mechanism to have new terms added.

I was only responding to Bert's suggestion that most of the needed terms were 
already there, particularly for 'names' of nodes.

Actually I had thought that 'record artefacts' might be what we use in the 
future to identify archetypes.

I agree with you about 'situation with explicit context' but there was a time 
not so long ago in the UK when this was seen as a key part of fully defining 
clinical content as part of the Logical Record Architecture project.

Ian

Dr Ian McNicoll
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skype: ianmcnicoll
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[https://docs.google.com/uc?id=0BzLo3mNUvbAjT2R5Sm1DdFZYTU0&export=download]
Co-Chair, openEHR Foundation 
ian.mcnic...@openehr.org<mailto:ian.mcnic...@openehr.org>
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On 29 April 2016 at 21:20, Mikael Nyström 
<mikael.nyst...@liu.se<mailto:mikael.nyst...@liu.se>> wrote:
Hi Tom,

Most of the concepts in the situation hierarchy had probably been added because 
they have been useful in EHR systems without advanced information models and 
without the possibility to post-coordinate and they are probably still in 
SNOMED CT because some of these EHR systems are still in use. However, if you 
have the possibility to use better EHR systems there are no need to use these 
concepts. I therefore doesn’t see any real problem with them.

The concepts in the qualifier value hierarchy are no longer in use to the same 
extent as they were when SNOMED CT was new 2002 and will probably be cleaned up 
in the future.

I agree that the Record artefact hierarchy could be more useful, but I guess 
that this hierarchy to a quite large extent needs to be filled with content on 
the national level, because a quite large part of the administrative concepts 
are country dependant.

However, I believe these kinds of complains about the content in SNOMED CT are 
less useful. It is more like complains about openEHR because there are some 
outdated or draft archetypes of lesser usefulness in the CKM. This kind of 
content is always possible to ignore to use. Much more useful complains would 
be complains about lack of content or incorrect modelled content in areas that 
are central for the healthcare system. These kinds of complains can improve the 
content and make SNOMED CT easier and better to use. Please submit them in the 
SNOMED CT International Request Submission (SIRS) System at the address 
https://sirs.nlm.nih.gov/ .

                             Regards
                             Mikael


From: openEHR-technical 
[mailto:openehr-technical-boun...@lists.openehr.org<mailto:openehr-technical-boun...@lists.openehr.org>]
 On Behalf Of Thomas Beale
Sent: den 29 april 2016 19:22
To: 
openehr-technical@lists.openehr.org<mailto:openehr-technical@lists.openehr.org>
Subject: Re: SNOMED




Hi Mikael,
right... but the usual idea is that these codes would be used in a 
post-coordinated expression. I think most of those expressions are problematic 
as well.

Aside: quite what 'Abuse counselling for non-offending parent (situation)' is 
doing there is another question. Or 'Both parents misuse drugs (situation)'...

But the problem is more widespread than Situation with explicit context.

The 'Qualifier value' hierarchy is also problematic, particularly 'Context 
values', and the 'Temporal context' sub hierarchy. Having all this under 
'Qualifiers' is an information recording view of things, not an ontological 
view. Also terms like 'Current - time specified' don't really make sense.

'Descriptors' - a huge bag of ontologically different things lumped together... 
none of these would be usefully computable as far as I can see, since they are 
not connected to meaningful parents.

Then we have 'Record artifact', also informational in nature, and specifying an 
ad hoc set of headings. I can't see what use this is.


- thomas
On 29/04/2016 16:37, Mikael Nyström wrote:
Hi,

I can just add that those entities Tom mentions below as

“The waters are muddied further by the attempts to represent informational, 
timing and context-related entities in SNOMED CT.”

Are the clearly separated sub-hierarchy called “Situation with explicit 
context” 
(http://browser.ihtsdotools.org/?perspective=full&conceptId1=243796009&edition=en-edition&release=v20160131&server=http://browser.ihtsdotools.org/api/snomed&langRefset=900000000000509007)
 and that sub-hierarch contains only 1 % of the concepts in SNOMED CT. It is 
therefore no problem to use SNOMED CT without these concepts for those who want 
to do it.

                             Regards


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