On Wed, Feb 08, 2006 at 10:43:14PM +1100, Ian Haywood wrote: > > I will take your word for it here and draw from your > > experience. Let's perhaps not think of > > vacc_indication.description as "disease to be vaccinated > > against" but rather "agreed-upon human-comprehensible > > indication identifier". > This is complex, as all vaccine epitopes do target a single disease entity, > the point is that not usually the way we use them (at least here) The way we use them doesn't really have to do with how we represent them in the database. In the backend we should represent things "medically correct". As long as we do that we can compute any aggregation thereof we wish to display.
Also, we are not talking about vaccine_indication here, but rather about vaccination_indication, IOW the indications for vaccination in general no matter whether there be any single-epitope vaccine available for that or not. > Oh, and Q-fever for meatworkers (do you have Q-fever in germany?) Nope, not of any known significance, to my knowledge. > The rest of the time we are giving according to a schedule, > either because the patient has reached a certain age, or > they wish to travel to a certain country. Absolutely, and thus the "main" (as in most-used) initial entry line in a vacc edit area should accept both schedule and vaccine but not necessarily indication. Accepting indications is bound to create consistency problems: - user selects "hepatitis A" in "main" line - user then selects TwinRix in the vaccine line Now what ? > Personally I think we should aim for a "fully automatic" system: > the vaccine dialogue computes the outstanding vaccinations based on the > patient's > age We already have that in a view inside the database. It's not perfect, though. > Oh, asthmatics and a few others get pneumo+flu as well, so there is a good > case for linking > vaccine indications to disease codes. Ah, well, but that's decision support which is another can of worms entirely. So, when you enter a diagnosis of asthma et al simply ask the user whether to put the patient on the pneumo/flu schedule(s) and be done with it. > The means we *do* need schedule_max_age, Yawn, we've been having that for ages. clin.vacc_def.max_age_due The *values* of which, however, are subject to much debate and speculation, I suppose. > so we don't try > to vaccinate the 75-year-old Sudanese refugee grandmother > against whooping cough. For exactly this reason. Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list [email protected] http://lists.gnu.org/mailman/listinfo/gnumed-devel
