Dear all,
I have a question and I wonder which choice other people would make in
such a situation.
A simple example to explain the situation: Imagine I want to record a
few labtests in a template.
There are a few choices:
1) Use a generic lab-test archetype, and clone it inside a template and
give it a label which explains its specific purpose.
2) Specialize a generic lab-test atchetype so it gets an archetype-id
which explains its specific purpose.
Both have advantages (and the advantages are the disadvantages of the
other):
1) Advantages are:
- easy to maintain a single generic archetype
- working constructively on a generic archetype library like CKM.
This construct has one important disadvantage (please correct me if I am
wrong)
In the ADL paths to the data-items it is not anymore recognizable which
specific item was examined in the lab-test, because all lab-test items
in a template offer the same paths. This gives difficulties, for
example, when querying.
The archetype is the base of information, not the template. So
information in the template is not available on archetype-level.
2) This situation avoids the problems caused in situation one. The
specific information about the (as in example) lab-tests is available on
archetype-level. Another advantage is that it will be possible to add
terminology binding (LOINC, SNOMED) to the archetype, because the
archetype is specific. And as we all (I think) agree terminology binding
is one of the most important keys to interoperability. Especially for
lab-test, to be sure a dataset is describing a specific labtest, it is
internationally recognized to use LOINC for that. (It is almost
complete, and internally descriptive, and it is free accessible to all)
But this construct also has one big disadvantage: When thinking this
through, it will come to thousands of (as in example) lab-tests
archetypes (all specialized from one generic lab-test-archetype). If
these were all posted in a single library, that library would become
unmaintainable. When you change the generic archetype, you have to
change all specialized archetypes, in order to adapt the change
And another thing, in extrema, an archetype-library would become like a
LOINC-database, for every LOINC-code a labtest-specialization. Maybe we
could generate archetypes from the LOINC databasase? One good
software-routine could handle this easily.
Would we still be in need of lab-test archetypes then, one could ask?
Mitigating this point, not many institutions will need all LOINC
situations in one template. So the specializations are only necessary of
more (as in example) lab-tests are grouped together in one template.
So, how do others, reading on this list, solve this problem?
Or are there any thoughts about this?
Thank you very much in advantage for sharing
Bert
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