Pablo,
I have also seen a need for queries that distinguish analyte level
objects, within the new lab archetypes. The original reason was to be
able to distribute pre-built panel templates (or even archetypes) to EMR
(=PEP) locations in Brasil, but your need is generic.
This wiki page
<https://openehr.atlassian.net/wiki/spaces/healthmod/pages/91139266/Implementing+Laboratory+Tests+in+openEHR>
discusses the question; in this solution, you do create distinct
archetype paths, and use normal queries. IN ADL2, this can be done with
templtes, since templates are archetypes, and AQL works the same with
them. The way to do it in ADL2 is shown by the examples here
<https://github.com/openEHR/adl-archetypes/tree/master/Example/openEHR/laboratory>.
If you load these archetypes you will see:
The point here is that you can just specialise the eixsting
laboratory_test_analyte archetype into the specific analytes you want
and then template the group to get a panel. On the basis that probably
100-200 analytes covers the vast majority of lab tests, I think this is
sustainable.
I have not tried it in ADL1.4 / OET.
- thomas
On 15/09/2018 22:08, Pablo Pazos wrote:
Hi all,
Lately I've been working a lot with lab test reports. Current CKM
modeling for this relies on a generic model that applies to any kind
and structure of result in this way:
- COMPO.report-result // any result document
- OBSERVATION.laboratory_test_result // results container, can be
used as a panel
- CLUSTER.laboratory_test_analyte // single result
This kind of generic model relies on specific structures to be set at
runtime, and also to use specific codes to know which type of result
is contained in the analytes (which remembers me of the way CDAs are
modeled).
*An example*
For a lipids panel result, which contains analytes for cholesterol,
triglyceride, HDL and LDL, we need systems to create that structure
and use specific codes like:
- COMPO
- OBSERVATION
- CLUSTER = cholesterol, LOINC::14647-2
- CLUSTER = triglyceride, LOINC::14927-8
- CLUSTER = HDL, LOINC::2085-9
- CLUSTER = LDL, LOINC::39469-2
That is 4 occurrences of the same CLUSTER, and inside each CLUSTER,
the same ELEMENTS (name, result, comment, etc).
*Issues for querying*
Now if we want to query that structure, we need to rely in the codes
instead of in the structure, because the structure is set at runtime
not at design time. So If we need the COMPOs that have cholesterol >
10 mmol/L we need a query like this:
SELECT ...
FROM ..., CLUSTER[CLUSTER.analyte] c
WHERE c/path_to_code = 14647-2 AND c/path_to_magnitude > 10 AND
c/path_to_units = mmol/L
*What's the problem with that query?*
If we have instances like this:
- COMPO
- OBSERVATION
- CLUSTER = name=cholesterol, code=LOINC::14647-2, value=6.3 mmol/L
- CLUSTER = name=triglyceride, code=LOINC::14927-8, value=12.3 mmol/L
- CLUSTER = name=HDL, code=LOINC::2085-9, value=2.0 mmol/L
- CLUSTER = name=LDL, code=LOINC::39469-2, value=1.5 mmol/L
c can be any of the 4 CLUSTERs set at runtime since all of them are
occurrences of the same node defined in the archetype and the
correspondent OPT. So when comparing the code, value and units that
can match values from the other CLUSTERs, so we need a way to ensure
those paths have the same instance parent, and that can't be done with
archetype paths.
So the query above might find the code 14647-2 in the first CLUSTER,
but check the magnitude against the second CLUSTER that is > 10.
The issue goes away if each CLUSTER can have a specific nodeId that
complies with the specification on the archetype but is really an
instance nodeId.
Another solution might be to add some kind of extra expression to the
AQL to say "these paths should be under the same parent instance".
But the simplest would be just not to have generic models, so the
"lipids panel" archetype would have 4 CLUSTERs each with it's own
nodeId, so when querying, the paths are pointing to different CLUSTERs
and they contained ELEMENTs.
Not sure how others solve these cases, would like to hear if you use
these generic models, how to query them without these issues, or if
you just go with specific models.
Thanks.
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