> -----Original Message-----
> From: Hugh Leslie [mailto:[EMAIL PROTECTED] 
> Sent: Tuesday, 3 January 2006 9:25 PM
> To: 'General Practice Computing Group Talk'
> Subject: RE: GP Requirements - was [GPCG_TALK] Re: The Dreaming
> .. This leads to ever expanding and inflexible 
> schemas that have to be added to or changed whenever our 
> clinical understanding grows or changes.  It means that we as 
> clinicians have to try to describe clinical concepts to 
> programmers so that they can build systems that work.
> 

I don't know that the concept of archetype isn't just shifting the
inflexible schema elsewhere.
Below is an extract from the archetype for blood gases

http://svn.openehr.org/knowledge/archetypes/dev/adl/openehr/ehr/entry/observ
ation/openEHR-EHR-OBSERVATION.blood_gases.v1.html

A few comments:
I note the site of collection (arterial vs venous) produces a (partial)
doubling of the archetype
   - why not one set of analytes with a slot for site of origin? While what
has been chosen is one way to go how is the choice arrived at? How does it
cope with reporting an arterial blood gas bicarbonate - or is that part of
another electrolyte archetype? So do you need a super-archetype to bring
together commonly co-reported information?
How does it cope with local practice differences e.g. some use Base Excess
while others may prefer Standard Bicarbonate as a derived parameter.

I realise all these sorts of questions have been (or are being)  agonised
over with LOINC coding and SNOMED-CT with no one answer - so are archetypes
related to these or another bite of the same cherry?

I also note the "copyright (c) 2004 Ocean Informatics" on the archetype.

The basic question in this is perhaps "What is the process for archetype
creation, stabilisation and updating?".

Regards
Nigel


    openEHR-EHR-OBSERVATION.blood_gases.v1

concept
    [at0000]    -- Blood gas assessment
description
    original_author = <
        ["name"] = <"Sam Heard">
        ["organisation"] = <"Ocean Informatics">
        ["date"] = <"2004-09-01">
    >
    details = <
        ["en"] = <
            language = <"en">
            purpose = <"Report blood gas measurement result and protocol">
            keywords = <"blood gases", ...>
            copyright = <"copyright (c) 2004 Ocean Informatics">
        >
    >
    lifecycle_state = <"draft">

definition
    OBSERVATION[at0000] ∈ {    -- Blood gas assessment
        data ∈ {
            HISTORY[at0002] ∈ {    -- history
                events cardinality ∈ {1..*; ordered} ∈ {
                    EVENT[at0003] occurrences ∈ {0..*} ∈ {    -- Any event
                        data ∈ {
                            TREE[at0001] ∈ {    -- structure
                                items cardinality ∈ {0..1; ordered} ∈ {
                                    CLUSTER[at0011] occurrences ∈ {0..*} ∈
{    -- Arterial
                                        items cardinality ∈ {0..1; ordered}
∈ {
                                            ELEMENT[at0004] occurrences ∈
{0..1} ∈ {    -- PaO2
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"pressure">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"kPa">
                                                                magnitude =
<|>= 0.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0005] occurrences ∈
{0..1} ∈ {    -- PaCO2
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"pressure">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"kPa">
                                                                magnitude =
<|>= 0.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0006] occurrences ∈
{0..1} ∈ {    -- pH
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"concentration">
                                                        list = <
                                                            ["1"] = <
                                                                units = <"">
                                                                magnitude =
<|0.0..14.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0007] occurrences ∈
{0..1} ∈ {    -- Base excess
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"concentration">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"mmol/l">
                                                                magnitude =
<|-30.0..30.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0008] occurrences ∈
{0..1} ∈ {    -- Alveolar-arterial pO2 difference
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"pressure">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"kPa">
                                                                magnitude =
<|0.0..1000.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0015] occurrences ∈
{0..1} ∈ {    -- SaO2
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"concentration">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"%">
                                                                magnitude =
<|0.0..1000.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0012] occurrences ∈
{0..1} ∈ {    -- Site
                                                value ∈ {
                                                    CODED_TEXT ∈ {
                                                        code ∈ {[ac0005]}
-- Any term that 'is_a' artery or cavity
                                                    }
                                                }
                                            }
                                            ELEMENT[at0018] occurrences ∈
{0..1} ∈ {    -- CaO2
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"concentration">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"{VOLUME/VOLUME}">
                                                                magnitude =
<|>= 0.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                        }
                                    }
                                    CLUSTER[at0013] occurrences ∈ {0..*} ∈
{    -- Venous
                                        items cardinality ∈ {0..1; ordered}
∈ {
                                            ELEMENT[at0016] occurrences ∈
{0..1} ∈ {    -- PvO2
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"pressure">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"kPa">
                                                                magnitude =
<|0.0..1000.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0017] occurrences ∈
{0..1} ∈ {    -- PvCO2
                                                value ∈ {
                                                    C_QUANTITY <
                                                        property =
<"pressure">
                                                        list = <
                                                            ["1"] = <
                                                                units =
<"kPa">
                                                                magnitude =
<|0.0..1000.0|>
                                                            >
                                                        >
                                                    >
                                                }
                                            }
                                            ELEMENT[at0014] occurrences ∈
{0..1} ∈ {    -- Site
                                                value ∈ {
                                                    CODED_TEXT ∈ {
                                                        code ∈ {[ac0003]}
-- Any term that 'is_a' vein or cavity
                                                    }
                                                }
                                            }
                                            use_node ELEMENT
/[at0000]/data[at0002]/events[at0003]/data[at0001]/items[at0011]/items[at000
6]/
                                        }
                                    }
                                }
                            }
                        }
                    }
                }
            }
        }
        state ∈ {
            LIST[at0009] ∈ {    -- state structure
                items cardinality ∈ {0..1; ordered} ∈ {
                    ELEMENT[at0010] occurrences ∈ {0..1} ∈ {    -- FiO2
                        value ∈ {
                            C_QUANTITY <
                                property = <"qualified real">
                                list = <
                                    ["1"] = <
                                        units = <"">
                                        magnitude = <|0.0..1.0|>
                                    >
                                >
                            >
                        }
                    }
                }
            }
        }
    }

ontology
    primary_language = <"en">
    languages_available = <"en", "de">
    term_definitions = <
... [truncated,  below this are English and German versions of ontology
(where is the Tamil?)]
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