2006/11/6, Sam Heard <sam.heard at oceaninformatics.biz>:
>
> Hi Mattias
>
> I'm currently working in a group that has been evaluating archetypes and
> they found out that there in archetypes may be needed to add external nodes
> from other archetypes instead of only adding complete archetypes as slots.
>
> Not sure what you mean = only parts of archetypes e,g, Hb only from Blood
> count?
>
Hi Sam,
I will provide you with some examples from one of the group members.
Reusing nodes: It would be reusing single nodes from archetypes, as your
example above, and here are two more examples.
Example 1. If the blood pressure measurement archetype allowed recording
average 12h blood pressure (protocol) it would be important to be able to
record the arousal state of the patient during the measurements (awake or
asleep). This node ("state of arousal: awake / asleep") would also be useful
in an archetype for electroencephalographic results, and hence one could
want to reuse it.
Example 2. If there is a blood pressure measurement observation archetype
without the current treatment in the patients state, there must be another
observation archetype to record the current treatment, because this
information is mandatory to interpret blood pressure results. In this
"current treatment" archetype, one could wish to record the pharmacological
class of each hypertensive drug (quite long list). This list could be reused
in a "treatment history" evaluation archetype, that would record when every
drug has been started and stopped and why.
Is it possible, by one way or another, to reuse a single node defined in a
first archetype when building another archetype? when building a template?
Does the current ADL specification allow that external parts from other
archetypes can be included?
> This is done in templates at present = need some examples
>
So I need to know if we could remove everything but a single node (ELEMENT)
from for example an OBSERVATION slot.
I think the openEHR templates allow to cut off parts in a slot, but I'm not
> sure if they can exclude everything except a single item.
>
> You can exclude all archetypes - again need more specificity!
>
Vide supra
The group also found out that there is a need to deduct certain answers
> depending on previously answered questions. For example if we previously
> answered that the blood pressure was above 160, then another question about
> hypertension should be answered automatically. Is this possible to do in
> archetypes?
>
> I think this is application space - I do not think you can express this in
> an archetype...probably better if there is more detail.
>
Example:
If the blood creatine value is included an archetype, it could be useful to
state that if the result is more than a given upper value, then the default
value to the following boolean node "renal failure" has to be "yes".
It might be that this always is in application space and probably a task of
a template builder (user-interface business logic building).
Another feature is value reporting, which should work when we use several
> archetypes in an openEHR template. For example if some question was answered
> in one archetype, then another archetype that has the same question should
> get the value reported from the previous archetype. Is this possible? I
> guess this has to do with external references as I mentioned in my first
> question.
> Again difficult to know what you mean = sounds like application space
> though.
>
Example:
In an observation archetype having the body weight as one of its nodes, it
could be useful to state that the default value for this node is the last
previously entered value through this same archetype or even through another
archetype.
The latter might be easier to achieve in the runtime system if there could
be some way of having external references (pointers) but archetypes could
more easily be broken if they reference non-existing items. Anyway, this
shall be dealt with on the user-interface level. For example, values could
be linked together by some value map that has the related archetype paths
that share values which allows the user-interface to know if values have
been previously added (and when).
We would also like to ask if there is a way of specifying validity for
> questions depending on previously answered questions. E.g. if a certain
> answer was given from a multiple alternative question (coded_text), then and
> only then, some other group of questions will be valid. Is this possible to
> do in archetypes? Perhaps it's possible with invariants?
>
> Perhaps = but we see this as application space unless it is an absolute
> fact - then it the other values could become mandatory based on the value of
> another value.
>
Example:
It could be useful to state that the cluster node "smoking habits" is not
valid (and not displayed to the user) if the value of the node (which
doesn't neccessarily have to reside within the cluster) "current smoker" is
No.
Again, this can probably be considered as application space, but there seems
to be a fine line between archetypes and application space for certain
examples, such as this.
It sounds as though you are starting to think about applications and
> decision support - it is tempting to push too much back into the information
> space at first but there are clear boundaries that arise from experience.
>
Okay, thanks
Mattias
Cheers, Sam
>
>
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