Mikael
Ok, I take your point in one sense, but how are we to know what is 'in
use', 'not really in use', 'outdated', ....? More importantly, how would
a national programme signal to its user base which hierarchies are
deprecated, semi-deprecated, needing work - don't use), or something
similar? What happens if two national programmes have different ideas
about using the same hierarchies, e.g. Sweden and Denmark. How would GP
systems in CPH / southern Sweden deal with different policies on use /
non-use of say the Qualifiers hierarchy?
What should an application do if it receives a code string containing
terms from the Qualifiers hierarchy, but the user orgs have been told to
'avoid the Qualifiers hierarchy'?
The record hierarchy just doesn't belong in SNOMED CT. IAO / OBI maybe.
I would have much less of a problem if the 'use status' of these
hierarchies was clearer, but as far as I can see, it is not - there is
no lifecycle state (other than for properly obsoleted terms)...
- thomas
On 29/04/2016 20:20, Mikael Nyström 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because there are some outdated or draft archetypes of lesser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
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