Hi Ian,
My comments were not directed to you. Sorry. My intention was more to shift
focus from looking for strange concepts and comment to looking for potential
improvements and make suggestions about these improvements in general. (And as
many non-native English speakers I lack some of the nuances in the language.)
Regards
Mikael
From: openEHR-technical [mailto:[email protected]] On
Behalf Of Ian McNicoll
Sent: den 29 april 2016 23:05
To: For openEHR technical discussions
Subject: Re: SNOMED
Hi Mikael,
I really did not intend my remarks about the 'missing' content in SNOMED-CT to
be seen as a complaint, or criticism. I fully understand that this, by
definition, is work in progress and there is a perfectly good change request
mechanism to have new terms added.
I was only responding to Bert's suggestion that most of the needed terms were
already there, particularly for 'names' of nodes.
Actually I had thought that 'record artefacts' might be what we use in the
future to identify archetypes.
I agree with you about 'situation with explicit context' but there was a time
not so long ago in the UK when this was seen as a key part of fully defining
clinical content as part of the Logical Record Architecture project.
Ian
Dr Ian McNicoll
mobile +44 (0)775 209 7859
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skype: ianmcnicoll
email: [email protected]<mailto:[email protected]>
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[https://docs.google.com/uc?id=0BzLo3mNUvbAjT2R5Sm1DdFZYTU0&export=download]
Co-Chair, openEHR Foundation
[email protected]<mailto:[email protected]>
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL
On 29 April 2016 at 21:20, Mikael Nyström
<[email protected]<mailto:[email protected]>> wrote:
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]<mailto:[email protected]>]
On Behalf Of Thomas Beale
Sent: den 29 april 2016 19:22
To:
[email protected]<mailto:[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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