The EHR is not invented to describe the real actual health status of the patient. It is there to document what clinicians deemed important to say ABOUT the health status of the patient. It always is an opinion of a professional about something.
He, himself, always makes statements with varying degrees of certainty. Physicians are no gods that know everything. Readers of the statements made by others necessarily don't take everything for granted what other have stated. So again at the receiving side things are interpreted in varying degrees of certainty. Answering your question: > So back to the short answer above.....is it really relevant to assert > ANY confidence factor in the EHR? > The answer is YES Gerard -- -- Gerard Freriks, MD Convenor CEN/TC251 WG1 TNO Quality of Life Wassenaarseweg 56 Leiden PostBox 2215 22301CE Leiden The Netherlands +31 71 5181388 +31 654 792800 On 27 Apr 2005, at 13:01, Arild Faxvaag wrote: > Tim Cook wrote: > While it might be an interesting exercise for us to record how > confident > a clinician was at the time of recording a diagnosis, it will have no > impact on the health care of that patient. If we were to do this would > we ask them to do so in <sarcasm>10% steps, 5% steps or .01% > steps</sarcasm>? I assert that any one of these would seriously impact > the usability of an EHR in a negative manner and would result in the > clinician taking the option that presents the least liability on their > part. > > So back to the short answer above.....is it really relevant to assert > ANY confidence factor in the EHR? > > > My opinion is that there indeed is highly relevant to assert a > confidence factor in the EHR. > > ln decision analysis one talks about treatment thresholds for > diagnostic uncertainity as "the probability of disease at which the > expected value of treatment and no treatment are exactly equal, and ne > ither option is clearly preferable." (Hunik and Glasziiou "Decision > making in health and biomedicine"). Factors influencing the treatment > threshold are the expected benefit and the expected harm of the > treatment. > Example: Treatment threshold is much lower for pneumonia (treatment: > penicillin) than for cancer of the left mamma (treatment: Mastectomy) > > Thus: How confident a clinician is at the time of recording a > diagnosis has high impact on the health care of that patient. > > Comments on this? > > regards, > Arild Faxvaag -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: text/enriched Size: 2656 bytes Desc: not available URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20050428/c4d3ceb2/attachment.bin>
