Hi All

 

It is possible to use the proportion with the numerator of 1 to express
continuous reals from 0...n

 

It is how we say that someone has had 5.1 lots of something, or fractions.

 

Cheers, Sam

 

From: [email protected]
[mailto:openehr-technical-bounces at openehr.org] On Behalf Of
Williamtfgoossen at cs.com
Sent: Wednesday, 11 February 2009 7:27 AM
To: openehr-technical at openehr.org
Subject: Re: CQuantityItem.units not empty

 


Thomas wrote: 

In a message dated 10-2-2009 18:21:06 W. Europe Standard Time,
thomas.beale at oceaninformatics.com writes: 



As far as I can see, the current openEHR data types satisfy your needs (with
one exception - see below):

DvQuantity - handles all PQ, including with no units 
DvOrdinal - handles all ordinals, with any kind of symbols, including from
coding systems I don't understand the need for summations etc for ordinals,
because the general nature of ordinal values is that that symbolically
identify arbitrary ranges in a value space (e.g. amount of pain, amount of
protein in urine etc). Mathematically they don't satisfy the requirements to
be summable. Can you explain further the intended semantics here?






William: That is perfect and will help deal with the VAS and numeric and
base ordinal. 





The exception is that neither of the above types handles a non-integral
'ordinal' idea. Hence my proposal of DV_SCORE. There are probably better
solutions, I have not thought much about it. I do think however, that any
solution needs to be mathematically sound, because downstream data computing
relies on that.





The mathematical requirement of summation is a clinical necessary feature
for about a 1000 to 10.000 assessment scales used in a variety of clinical
domains. 
The generic feature is that an ordinal scale is used as a value for a
variable, so per node the value can be e.g. 0 = no problem, 1 = some problem
and 2 = severe problem
the semantics is clear and indeed an ordinal scaling. 
However, ususally assessment instruments / scales / indexes of scores
consist of more than one variable. E.g. Apgar score has 5 variables, with a
minimum score (worst case) = 0 and a maximum score (best case) = 10.
Similar scales include Barthel, Glasgow coma scale, Braden etc. 


So the summation as mathematical approach is as follows (using the following
explanation to the scores: 0 = no problem, 1 = some problem and 2 = severe
problem). 

variable 1, score = 1
variable 2, score = 0
variable 3, score = 2
variable 4 score = 1
variable 5 score = 0
variable 6, score is 0

Total score on the instrument is score variable 1 + score variable 2 + score
variable 3 + score variable 4 + score variable 5 + score variable 6 =
1 + 0 + 2 + 1 + 0 + 0 = 4.

This is usually viewed agains scientifically derived reference ranges, e.g.
4 out of 12 (maximum for 6 variables is 

So for appropriate scales / indexes etc the mathematics need to be possible
on the ordinal values. 


See for a discussion on these features e.g.

White
<http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22White
%20TM%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.
Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus>  TM, Hauan
<http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Hauan
%20MJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.
Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus>  MJ. Extending the LOINC
conceptual schema to support standardized assessment instruments. J
<javascript:AL_get(this,%20'jour',%20'J%20Am%20Med%20Inform%20Assoc.');>  Am
Med Inform Assoc. 2002 Nov-Dec;9(6):586-99. 









Would you agree with my understanding of the problem as stated here?

- thomas



Sincerely yours,

dr. William TF Goossen
director 
Results 4 Care b.v.
De Stinse 15
3823 VM Amersfoort
the Netherlands
email: Results4Care at cs.com
phone + 31654614458
fax +3133 2570169
www.results4care.nl
Dutch Chamber of Commerce number: 32133713 

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