Hi Tom, Most of the concepts in the situation hierarchy had probably been added because they have been useful in EHR systems without advanced information models and without the possibility to post-coordinate and they are probably still in SNOMED CT because some of these EHR systems are still in use. However, if you have the possibility to use better EHR systems there are no need to use these concepts. I therefore doesn't see any real problem with them.
The concepts in the qualifier value hierarchy are no longer in use to the same extent as they were when SNOMED CT was new 2002 and will probably be cleaned up in the future. I agree that the Record artefact hierarchy could be more useful, but I guess that this hierarchy to a quite large extent needs to be filled with content on the national level, because a quite large part of the administrative concepts are country dependant. However, I believe these kinds of complains about the content in SNOMED CT are less useful. It is more like complains about openEHR because there are some outdated or draft archetypes of lesser usefulness in the CKM. This kind of content is always possible to ignore to use. Much more useful complains would be complains about lack of content or incorrect modelled content in areas that are central for the healthcare system. These kinds of complains can improve the content and make SNOMED CT easier and better to use. Please submit them in the SNOMED CT International Request Submission (SIRS) System at the address https://sirs.nlm.nih.gov/ . Regards Mikael From: openEHR-technical [mailto:[email protected]] On Behalf Of Thomas Beale Sent: den 29 april 2016 19:22 To: [email protected] Subject: Re: SNOMED Hi Mikael, right... but the usual idea is that these codes would be used in a post-coordinated expression. I think most of those expressions are problematic as well. Aside: quite what 'Abuse counselling for non-offending parent (situation)' is doing there is another question. Or 'Both parents misuse drugs (situation)'... But the problem is more widespread than Situation with explicit context. The 'Qualifier value' hierarchy is also problematic, particularly 'Context values', and the 'Temporal context' sub hierarchy. Having all this under 'Qualifiers' is an information recording view of things, not an ontological view. Also terms like 'Current - time specified' don't really make sense. 'Descriptors' - a huge bag of ontologically different things lumped together... none of these would be usefully computable as far as I can see, since they are not connected to meaningful parents. Then we have 'Record artifact', also informational in nature, and specifying an ad hoc set of headings. I can't see what use this is. - thomas On 29/04/2016 16:37, Mikael Nyström wrote: Hi, I can just add that those entities Tom mentions below as "The waters are muddied further by the attempts to represent informational, timing and context-related entities in SNOMED CT." Are the clearly separated sub-hierarchy called "Situation with explicit context" (http://browser.ihtsdotools.org/?perspective=full&conceptId1=243796009&edition=en-edition&release=v20160131&server=http://browser.ihtsdotools.org/api/snomed&langRefset=900000000000509007) and that sub-hierarch contains only 1 % of the concepts in SNOMED CT. It is therefore no problem to use SNOMED CT without these concepts for those who want to do it. Regards
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