Hi Ian, thanks for the answer.

I see, so the "reference range" is only for lab test results.

Yes, what I like to do is something that for certain observation values it 
display something to the physician.

Blood presure was just an example, the observations I have are:

- Glasgow Comma Scale: <15 is a problem
- Cardiac Frequency: <60 or >100 is a problem
- Breath Frequency: <10 or >20 is a problem

I'll look to Rong's work.

Thanks a lot!

Cheers,
Pablo.

From: ian.mcnic...@oceaninformatics.com
Date: Mon, 12 Oct 2009 23:59:32 +0100
Subject: Re: Modeling reference ranges
To: openehr-technical at openehr.org
CC: openehr-clinical at openehr.org

Hi Pablo,

The Quantity datatype in the Reference model has built-in support for Reference 
ranges so these do have to be modelled overtly in archetypes.

See 
http://www.openehr.org/svn/specification/TRUNK/publishing/architecture/rm/data_types_im.pdf



This makes sense for lab tests etc where each test  will report a reference 
range (which are often lab/analysis method dependent) along with the results 
themselves.
However, you are talking about something different. There is really no such 
thing as a reference range for blood pressure, which might indicate 
hypertension. The definitions of hypertension vary, over time and by locality 
and the diagnosis will depend on many other factors than just the blood 
pressure itself.



I think what you may be trying to capture is some thing more like a 'trigger 
blood pressure' which displays an alert to the clinician or initiates some 
other action if a set of criteria have been reached e.g 3 readings with a 
diasstolic > 100.



This is more akin to a guideline or care pathway. You might want to have a look 
at the work Rong Chen has been doing using archetypes within computerised 
guidelines for chemotherapy. In this case the archetype does not represent 
actual patient data but an abstract of ALL patients who might fall within the 
guideline.



See http://www.hst.aau.dk/~ska/MIE2009/papers/MIE2009p0653.pdf  

Hope this helps,

Ian

Dr Ian McNicoll
office / fax  +44(0)141 560 4657


mobile +44 (0)775 209 7859
skype ianmcnicoll
ian at mcmi.co.uk

Clinical Analyst  Ocean Informatics ian.mcnicoll at oceaninformatics.com


BCS Primary Health Care Specialist Group www.phcsg.org



2009/10/12 pablo pazos <pazospablo at hotmail.com>







Hi,

I'm playing around with archetypes trying to model an observation and its 
reference ranges,
I mean something like "blood pressure" and some range to define what is 
"hypertension", but


I can't found an archetype that defines a reference range for an observation.

Any one has experience in modeling something like this? 
An archetype is the correct place to define a reference range for an 
observation value?


Any ideas?


Thak you!

Cheers,
Pablo Pazos Gutierrez

                                          
Windows Live: Keep your friends up to date with what you do online.



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