Hi Mikael, I would be very sorry to have this conversation become too formal or appear as some criticism. I am much willing to learn, and I think that, as a master thesis supervisor, you teach Mattias not just to be happy with "established concepts" but to have a push on it and check if it is a stone basement or just a theater set.
My questions : "are you certain that a structure can host any terminology", "what is the discourse complexity level you can address" are of the "have a push on it" kind. My feeling is that the good order to ask questions (and answer it) is : Why do you want to communicate ? What discourse complexity level can allow to address these needs ? What discourse representation technology fits these "required language" ? So, you may already have answered questions 1 and 2, and that it is possible to answer Q3 with a discourse structure that can host any existing terminology. But at large, I don't agree that such a concept can address any answer to questions 1 and 2. My personal opinion is even that, as a bottom-up strategy, it constraints the system to a very specific range of environments. By the way, the term "terminology" itself would demand to be made more accurate. It is often used to describe coding systems, classifications, dictionaries, standardized vocabularies, ontologies... All these components can actually appear somewhere in a discourse structure, but at a specific place ! One can say, for example : "The patient complains from a terrible abdominal pain 2 hours after meal. We can classify it as D01 in ICPC" But not : "The patient complains from a terrible (D01 in ICPC) 2 hours after meal." This is certainly a multi-axial discussion. I hope I make my point of view understandable. Cheers, Philippe Mikael Nystr?m a ?crit : > Hi Philippe, > >>From my point of view is the lack of communicable structure between >different EHR systems the main problem openEHR?s archetypes tries to solve. >I think this is what Mattias tries to say with his letter. In general >medical informatics is it of cause also a large need for medical terminology >systems of good quality, but openEHR?s archetypes don?t try to solve this >problem by themselves. Instead you are able to link your archetypes to the >medical terminology systems of the flavor you prefer, like SNOMED CT, >ICD-10, ICF, ICPC, NCSP or something built by yourself. (At least in Sweden >there exist maybe too many ?home built? medical terminology systems.) > > Regards, > Mikael Nystr?m > Mattias? and Johan?s master thesis supervisor > > > >-----Original Message----- >From: owner-openehr-technical at openehr.org >[mailto:owner-openehr-technical at openehr.org] On Behalf Of Philippe AMELINE >Sent: den 9 februari 2006 12:34 >To: openehr-technical at openehr.org >Subject: Re: dictionary > >Hi Mattias, > >The more I work on medical information systems, and the less I believe that >the structure is more important than the terminology. > >To be a little bit more accurate, my opinion is that any health information >system is there to "tell stories". >I started in the domain 20 years ago with endoscopy reports : the story to >tell was a 10 to 20 minutes medical act. Now, for many reasons (but it would >be too long to explain it there), the "big thing" is continuity of care, and >the challenge is to be able to tell someone's whole medical journey. > >So, how can we tell these stories (from a 10 minutes encounter to the whole >life and the fighting strategies to remain as healthy as possible) ? >The answer is rather simple (at least to express) : we need to make >"sentences". And to make sentences requires a grammar (the discourse >structure) and a vocabulary (to populate the discourse structure). > >Is it possible to have a discourse structure that can "host" any terminology >? >My personal answer is 'no', but maybe I try to tell more complex stories >than you intend, or maybe you have a more powerful technological solution. > >At large, I can ask you a question : do you think that you could communicate >using the english grammar and let people choose any other language's >vocabulary to populate it ? >You can answer that natural language is more complex that formal language, >but I can say that the more complex the story you intend to tell and the >closer they need to be. > >Regards, > >Philippe > > > >>The important thing in openEHR archetypes is the structure of them. As >>long as there is a structure that is equal for both "Weight" and >>"Bodyweight", it shouldn't be a problem. The allowed information model >>structures in archetypes is what really matters and the terms can >>always be bound to external terminologies to create a mutual >>understanding. >> >>Regards, >> >>Mattias Forss >> >> >> >> >> > > > > > >
