Tim Cook wrote: >On Thu, 2005-01-27 at 05:09, USM Bish wrote: > > > >>I am of the view, that there is no requirement of age at all. >>What is needed is the date of birth in the initial record. >>After that every time the patient/ individual seeks medical >>attendance, the age is automatically calculated. This is of >>special relevance in paediatric practice. >> >>The concept of 'age' varies with context and usage, and it is >>best to avoid anything arbitrary or non-specific. >> >> > > >Interesting discussion. The above comments are very close to my own >thoughts on this when I first read Sam's proposal. The ideas presented >in the other replies are certainly valid. > > I think it's a given that we assume that "age" is not literally recorded in the db - the question is whether date of birth is good enough. Clearly for many paediatric cases it is not, since birth can come at a nearly arbitrary time these days (20 weeks?). To avoid working with negative ages, the one proper point of reference we have is (estimated) date of conception, but for most patients we probabl dont' need this. I suspect an application level type is needed that generates age_since_birth and age_since_conception from recorded expected date of delivery, which should presumably be estimated date of conception + 38 weeks (Sam tells me that actually recording the date of conception can get people into trouble!).. So "expected date of delivery" (assuming normal ful-term pregnancy) seems to me to be the reliable raw datum that paediatricians and other peri-natal carers might be interested in; coupled with a smart "age" class, it should be possble to get the desired effect.
>In the case of neonatal work (as I understand it from the physicians) >there are certain rules of thumb they use based on the (estimated) date >of conception compared with the due date and again compared with the >actual date of birth, modified by factors such as IVF, AI, multiple >births etc......to determine level of prematurity. > > yes - the smart "age" type could incorporate some of this knowledge , or else ask some knowledge base to generate "effective biologic ages" of various kinds (are different systems' development retarded differentially depending on the 'problem'? I.e. premature birth versus IVF,, etc as Tim mentions? This all suggest strongly to me "knowledge layer" not "information model layer"! - thomas - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
