> OBX contains a field > > 004 Observation Sub ID > > Which is used to enumerate multiple OBX records when they > > 1) pertain to the same LOINC code, for example when there are > multiple pathologists' comments:
IMO those should be rolled into the relevant parent OBX note_test_org. This is where the importer will actually have to have some intelligence as to the *content* of the data. Welcome to the idiosyncrasies of HL7 :-( > 2) describe Microbiology results that describe sites, potentially > multiple organisms, and their antibiotic susceptibilities (see also > HL7 V2.3 Section 7.4.5): > > Here is one format and example in which reported first are all the > Culture results; the Observation Sub-ID contains the id of the > culture (i.e. 1, 2, 3 etc); after this, the Organism is reported, > followed by all the antibiotics, in the order of the culture result: > > OBR|1||02-123456-URC-0^bcb|URC^URINE CULTURE^L||200011081429| > 200011081429|||||||200011081429||TTTT2^TEST^BLAIR^^^^^L|||||| > 200011300944|MICRO|LAB_ORG > |F||^^^200011081429|||||||204 > OBX|1|FT|19803-6^SITE^L||Urine|||N|||F|||200011081430|EDM|204 > OBX|2|FT|6463-4^Culture^L|1|Light growth of: Klebsiella sp.|||N|||F||| > 200011081434 > OBX|3|FT|28-1^Ampicillin^L|1|R|||N|||F|||200011081434 > OBX|4|FT|149-5^Cephalexin^L|1|R|||N|||F|||200011081434 > OBX|5|FT|267-5^Gentamicin^L|1|S|||N|||F|||200011081434 > OBX|6|FT|7057-3^TMP/SMX^L|1|S|||N|||F|||200011081434 > OBX|7|FT|363-2^Nitrofurantoin^L|1|S|||N|||F|||200011081434 > OBX|8|FT|6463-4^Culture^L|2|Light growth of: Staphylococcus aureus||| > N|||F|||200011081434 > OBX|9|FT|6932-8^Penicillin^L|2|R|||N|||F|||200011081434 > OBX|10|FT|197-4^Cloxacillin^L|2|R|||N|||F|||200011081434 > OBX|11|FT|233-7^Erythromycin^L|2|S|||N|||F|||200011081434 > OBX|12|FT|7057-3^TMP/SMX^L|2|S|||N|||F|||200011081434 > OBX|13|FT|193-3^Clindamycin^L|2|R|||N|||F|||200011081434 > OBX|14|FT|524-9^Vancomycin^L|2|R|||N|||F|||200011081434 > OBX|15|FT|Ms.OX2^Cloxacillin^L|2|R|||N|||F|||200011081434 > OBX|16|FT|28-1^Ampicillin^L|2|S|||N|||F|||200011081434 > OBX|17|FT|149-5^Cephalexin^L|2|S|||N|||F|||200011081434 > OBX|18|FT|20-8^Amoxicillin/clavulanate^L|2|S|||N|||F|||200011081434 > > The above would carry little meaning as individual items in a GNUmed > test_result table... I agree. However, if I were to write an importer I'd attempt to roll the above into some tabular format to be put into val_alpha (note that there can be multiline results in val_alpha). Note: site == "Urin" ;-)) > They seem to need to be linked to the test panel > from which they originated (in this case, Urine culture) so maybe we > need a foreign key to the test_profile as a nullable column in > test_results... I'd rather handle this particular case as a test_result of test_type == "Urine Culture" with a multiline val_alpha. There's one argument against doing so in a simplistic way: computability. The way it is structured in the original HL7 it, well sort of, lends itself to clinical reuse -- GNUmed might check AB sensitivity against currently prescribed antibiotics. One way to preserve that information would be to use a well-defined structure for the multiline text, say, XML or StructuredText (as in a wiki). > Do we see some value or need (or none) to the OBX sequence counter > (above, OBX|1 through OBX|18) and similarly any need to store the > 'Observation SubID" which in this case associates the individual > species (Klebsiella sp versus Staphylococcus aureus) with their > specific antibiotic profile? I absolutely see value in preserving the information it carries. We'd need to analyze more instances of this to develop a suitable relational structure if needed. Karsten -- Psssst! Schon vom neuen GMX MultiMessenger gehört? Der kann`s mit allen: http://www.gmx.net/de/go/multimessenger _______________________________________________ Gnumed-devel mailing list [email protected] http://lists.gnu.org/mailman/listinfo/gnumed-devel
