Hi Heather,

the key difference is that the assessment scales have a scientific validation, leading to clinimetric data, often for populations, but e.g. Apgar and Barthell are also reliable for individual follow up measures.

a simple question, answer, even with some total score, does usually not have such evidence base. I agree that in the data / semantic code representation in a detailed clinical model it is not different.

Hence, also Grahame's nonsense comment on the value of semantic interoperability of such things. It is for user groups of stakeholders to determine the clinical and scientific merits of such instruments not a technical implementer.


vriendelijke groeten, with kind regards,

dr. William Goossen

directeur Results 4 Care B.V.
De Stinse 15
3823 VM Amersfoort
the Netherlands
phone: +31654614458
e-mail: wgoos...@results4care.nl
dcmhelpd...@results4care.eu
skype: williamgoossenmobiel
kamer van koophandel: 32133713
http://www.results4care.nl
http://www.results4care.eu
http://www.linkedin.com/company/711047
https://www.researchgate.net/profile/William_Goossen2
https://www.linkedin.com/in/williamgoossen

On 5-6-2017 09:55, openehr-technical-requ...@lists.openehr.org wrote:
Send openEHR-technical mailing list submissions to
        openehr-technical@lists.openehr.org

To subscribe or unsubscribe via the World Wide Web, visit
        
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org

or, via email, send a message with subject or body 'help' to
        openehr-technical-requ...@lists.openehr.org

You can reach the person managing the list at
        openehr-technical-ow...@lists.openehr.org

When replying, please edit your Subject line so it is more specific
than "Re: Contents of openEHR-technical digest..."


Today's Topics:

    1. RE: openEHR-technical Digest, Vol 64, Issue 4 (Heather Leslie)
    2. RE: openEHR-technical Digest, Vol 64, Issue 4 (Pablo Pazos)


----------------------------------------------------------------------

Message: 1
Date: Mon, 5 Jun 2017 06:51:39 +0000
From: Heather Leslie <heather.les...@oceanhealthsystems.com>
To: For openEHR technical discussions
        <openehr-technical@lists.openehr.org>
Subject: RE: openEHR-technical Digest, Vol 64, Issue 4
Message-ID:
        
<sy3pr01mb1913936f8717317d5c7aea76ea...@sy3pr01mb1913.ausprd01.prod.outlook.com>
        
Content-Type: text/plain; charset="us-ascii"

Hi William,

I can concede that for those examples.

Honestly I'm not particularly fussed about categorisation of the examples and 
there are plenty of examples which use a question/answer format with a total 
score at the end, so it is not clear if we should call it a questionnaire or a 
scale.

The principles that I've laid out remain the same.

Regards

Heather

-----Original Message-----
From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On 
Behalf Of William Goossen
Sent: Monday, 5 June 2017 4:45 PM
To: openehr-technical@lists.openehr.org
Subject: Re: openEHR-technical Digest, Vol 64, Issue 4

The examples given as Glasgow Coma Scale and Barthel index are definitely NOT 
questionnaires. These are assessment scales and require quite a different 
approach than the also extremely useful questions and answers.

Vriendelijke groet,

Dr. William Goossen

Directeur Results 4 Care BV
+31654614458

Op 5 jun. 2017 om 08:25 heeft openehr-technical-requ...@lists.openehr.org het 
volgende geschreven:

Send openEHR-technical mailing list submissions to
    openehr-technical@lists.openehr.org

To subscribe or unsubscribe via the World Wide Web, visit
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org

or, via email, send a message with subject or body 'help' to
    openehr-technical-requ...@lists.openehr.org

You can reach the person managing the list at
    openehr-technical-ow...@lists.openehr.org

When replying, please edit your Subject line so it is more specific
than "Re: Contents of openEHR-technical digest..."


Today's Topics:

   1. Re: Questionnaires (Grahame Grieve)
   2. RE: Questionnaires (Heather Leslie)


----------------------------------------------------------------------

Message: 1
Date: Mon, 5 Jun 2017 15:59:26 +1000
From: Grahame Grieve <grah...@healthintersections.com.au>
To: For openEHR technical discussions
    <openehr-technical@lists.openehr.org>
Cc: For openEHR clinical discussions
    <openehr-clini...@lists.openehr.org>
Subject: Re: Questionnaires
Message-ID:
<cag47hgypmsi1u1znhheoh_ymz841m7mlvwd6hgccufsy-vq...@mail.gmail.com>
Content-Type: text/plain; charset="utf-8"

hi Heather

A generic question/answer pattern is next to useless -
interoperability
is really not helped

I think you should rather say "A generic question/answer pattern is
only useful for exchanging the questions and answers, and does not
allow re-use of data". This is not 'next to useless for
interoperability', just not fit for any wider purpose

Grahame


On Mon, Jun 5, 2017 at 3:51 PM, Heather Leslie <
heather.les...@oceanhealthsystems.com> wrote:

Following Thomas? suggestion re a separate thread:



I wrote a blog post in 2014 which still reflects our current thinking
re
questionnaires: https://omowizard.wordpress.com/2014/02/21/the-
questionnaire-challenge/



Our experience is that the data is the priority and so we want to
focus on questionnaires to support capture of good quality data.



If you want to try to capture data from the majority of existing
questionnaires then good luck ? questionnaires notoriously ask
questions badly, conflating multiple concepts into one question,
Boolean True/False when there are other ?shades of gray? etc. They
work variably as far as human interpretation but usually very badly wrt 
computer interpretation.



We do have experience in taking previous paper questionnaires,
analysing the data requirements sought in terms of what we want to
persist and then we design the UI/questions to match the data desired
and/or suggesting the UI might show a questionnaire but each question
the clinical data is actually recorded using core archetypes ? for
example ?Do you have diabetes?? ? ?Yes?, is recorded using the value
?Diabetes? in the EVAL.problem_diagnosis and ?No? is recorded in the
matching exclusion archetype. This creates real clinical data that
can be used as part of a health record rather than create an
electronic checkbox version of the original paper questionnaire which
will never be used again, but capture dust in our EHR?s virtual archives.



In summary:

   - A generic question/answer pattern is next to useless -
   interoperability is really not helped, especially if both the question and
   answer has to be managed in the template. We have tried many variations of
   this in the past, some of which were uploaded into CKM and subsequently
   rejected.
   - Lock in those questionnaires that are ubiquitous, evidence based,
   validated as OBSERVATION archetypes and share them in the international CKM
   ? eg AUDIT, Glasgow coma scale, Barthel index, Edinburgh post natal
   depression scale ? there are many examples in CKM.
   - Lock in local questionnaires that are going to be reused in your
   organisation, region or jurisdiction even though they may not be reusable
   elsewhere. They will provide some interoperability even if might only be
   appropriate within one clinical system or national CKM. An example is the
   Modified Early Warning Score/National Early Warning Score ? there are a few
   different variations used in different locations and whether they should
   all be in the international CKM is still not clear.



BTW Questionnaires should be modelled as OBSERVATIONs (ie evidence
that can be collected over and over again using the same protocol)
not EVALUATIONS (as they are not meta-analysis nor summaries).



Regards



Heather



*From:* openEHR-technical [mailto:openehr-technical-
boun...@lists.openehr.org] *On Behalf Of *Pablo Pazos
*Sent:* Thursday, 1 June 2017 12:58 AM
*To:* For openEHR technical discussions <openehr-technical@lists.
openehr.org>
*Subject:* Re: Reports - a new openEHR RM type?



Besides specific ways to model questionnaires, my questions is if our
openEHR clinical modelers have a pattern to represent questionnaires
using the openEHR information model.



On Wed, May 31, 2017 at 3:37 AM, GF <gf...@luna.nl> wrote:

There are several kinds of context archetypes/templates and their
meta-data are used for:

- de novo data - re-used data

- step in the clinical treatment model (observation,
assessment/inference, planning, ordering, execution)

- kind of interface it is designed for (data presentation on a
screen, data capture, database store/retrieve, CDSS, ?



Each Template needs to capture all this and is a Composition.

All these contexts are characteristics of a Composition in the end.



Questionnaires are in essence a tool that classifies information.

And sometimes it transforms a set of responses into an aggregated
value/code

The questionnaire can be treated as any classification, meaning we
need to de fine inclusion and exclusion criteria,

and possible results per question can be a quantitative result
(number, PQ, code), or a semi-quantitative result (high, low), or a
qualitative result (present/ not present).

Semi-Qualitative results need, inclusion/exclusion criteria and a
definition of what the norm/population is is about (females,
children, etc.)




Gerard Freriks
+31 620347088 <+31%206%2020347088>
gf...@luna.nl



On 31 May 2017, at 06:54, Pablo Pazos <pablo.pa...@cabolabs.com> wrote:



Hi Thomas,

Thinking about the hierarchy, at which level will be a Report be?
Below compo? Below entry? Structure? Representation?

OT: many asked me this and didn't had a good answer. Do we have a
pattern to model questionnaires? Some require to define questions,
and the answer type in most cases is boolean, or coded text (multiple
choice), and answers might be 0..* (more than one answer for the same question 
is valid).

Cheers,

Pablo.






_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-
technical_lists.openehr.org




--

Ing. Pablo Pazos Guti?rrez
Cel:(00598) 99 043 145
Skype: cabolabs

<http://cabolabs.com/>
http://www.cabolabs.com
pablo.pa...@cabolabs.com
Subscribe to our newsletter <http://eepurl.com/b_w_tj>



_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-
technical_lists.openehr.org



--
-----
http://www.healthintersections.com.au /
grah...@healthintersections.com.au
/ +61 411 867 065
-------------- next part -------------- An HTML attachment was
scrubbed...
URL:
<http://lists.openehr.org/pipermail/openehr-technical_lists.openehr.or
g/attachments/20170605/1cd4c49e/attachment-0001.html>

------------------------------

Message: 2
Date: Mon, 5 Jun 2017 06:24:50 +0000
From: Heather Leslie <heather.les...@oceanhealthsystems.com>
To: For openEHR clinical discussions
    <openehr-clini...@lists.openehr.org>,    "For openEHR technical
    discussions" <openehr-technical@lists.openehr.org>
Subject: RE: Questionnaires
Message-ID:
<sy3pr01mb19131a7c8e2e230285779c6eea...@sy3pr01mb1913.ausprd01.prod.ou
tlook.com>
Content-Type: text/plain; charset="utf-8"

Thanks Grahame, but I disagree.

??          A generic question/answer pattern is next to useless - 
interoperability is really not helped, especially if both the question and 
answer has to be managed in the template.?

The complete sentence qualifies that the dependence on template modelling is 
the issue wrt interoperability. This is where a generic pattern is made 
specific for a given questionnaire or data set. Also that we have found there 
are multiple generic patterns, none of which is universally applicable and so 
to create multiple generic patterns becomes nonsensical.

In the templating scenario it is only if the exact same template is shared 
(where every question has been renamed and associated value sets inserted) that 
can we get any value. In our experience it is of higher value to create an 
archetype that can at least be shared locally and explicitly models the precise 
question/answer combo in order to achieve better reuse.

Heather

From: openEHR-clinical
[mailto:openehr-clinical-boun...@lists.openehr.org] On Behalf Of
Grahame Grieve
Sent: Monday, 5 June 2017 3:59 PM
To: For openEHR technical discussions
<openehr-technical@lists.openehr.org>
Cc: For openEHR clinical discussions
<openehr-clini...@lists.openehr.org>
Subject: Re: Questionnaires

hi Heather

A generic question/answer pattern is next to useless -
interoperability is really not helped
I think you should rather say "A generic question/answer pattern is
only useful for exchanging the questions and answers, and does not
allow re-use of data". This is not 'next to useless for
interoperability', just not fit for any wider purpose

Grahame


On Mon, Jun 5, 2017 at 3:51 PM, Heather Leslie 
<heather.les...@oceanhealthsystems.com<mailto:heather.les...@oceanhealthsystems.com>>
 wrote:
Following Thomas? suggestion re a separate thread:

I wrote a blog post in 2014 which still reflects our current thinking
re questionnaires:
https://omowizard.wordpress.com/2014/02/21/the-questionnaire-challenge
/

Our experience is that the data is the priority and so we want to focus on 
questionnaires to support capture of good quality data.

If you want to try to capture data from the majority of existing questionnaires 
then good luck ? questionnaires notoriously ask questions badly, conflating 
multiple concepts into one question, Boolean True/False when there are other 
?shades of gray? etc. They work variably as far as human interpretation but 
usually very badly wrt computer interpretation.

We do have experience in taking previous paper questionnaires, analysing the 
data requirements sought in terms of what we want to persist and then we design 
the UI/questions to match the data desired and/or suggesting the UI might show 
a questionnaire but each question the clinical data is actually recorded using 
core archetypes ? for example ?Do you have diabetes?? ? ?Yes?, is recorded 
using the value ?Diabetes? in the EVAL.problem_diagnosis and ?No? is recorded 
in the matching exclusion archetype. This creates real clinical data that can 
be used as part of a health record rather than create an electronic checkbox 
version of the original paper questionnaire which will never be used again, but 
capture dust in our EHR?s virtual archives.

In summary:

  *   A generic question/answer pattern is next to useless - interoperability 
is really not helped, especially if both the question and answer has to be 
managed in the template. We have tried many variations of this in the past, 
some of which were uploaded into CKM and subsequently rejected.
  *   Lock in those questionnaires that are ubiquitous, evidence based, 
validated as OBSERVATION archetypes and share them in the international CKM ? 
eg AUDIT, Glasgow coma scale, Barthel index, Edinburgh post natal depression 
scale ? there are many examples in CKM.
  *   Lock in local questionnaires that are going to be reused in your 
organisation, region or jurisdiction even though they may not be reusable 
elsewhere. They will provide some interoperability even if might only be 
appropriate within one clinical system or national CKM. An example is the 
Modified Early Warning Score/National Early Warning Score ? there are a few 
different variations used in different locations and whether they should all be 
in the international CKM is still not clear.

BTW Questionnaires should be modelled as OBSERVATIONs (ie evidence that can be 
collected over and over again using the same protocol) not EVALUATIONS (as they 
are not meta-analysis nor summaries).

Regards

Heather

From: openEHR-technical
[mailto:openehr-technical-boun...@lists.openehr.org<mailto:openehr-tec
hnical-boun...@lists.openehr.org>] On Behalf Of Pablo Pazos
Sent: Thursday, 1 June 2017 12:58 AM
To: For openEHR technical discussions
<openehr-technical@lists.openehr.org<mailto:openehr-techni...@lists.op
enehr.org>>
Subject: Re: Reports - a new openEHR RM type?

Besides specific ways to model questionnaires, my questions is if our openEHR 
clinical modelers have a pattern to represent questionnaires using the openEHR 
information model.

On Wed, May 31, 2017 at 3:37 AM, GF <gf...@luna.nl<mailto:gf...@luna.nl>> wrote:
There are several kinds of context archetypes/templates and their meta-data are 
used for:
- de novo data - re-used data
- step in the clinical treatment model (observation,
assessment/inference, planning, ordering, execution)
- kind of interface it is designed for (data presentation on a screen, data 
capture, database store/retrieve, CDSS, ?

Each Template needs to capture all this and is a Composition.
All these contexts are characteristics of a Composition in the end.

Questionnaires are in essence a tool that classifies information.
And sometimes it transforms a set of responses into an aggregated
value/code The questionnaire can be treated as any classification,
meaning we need to de fine inclusion and exclusion criteria, and possible 
results per question can be a quantitative result (number, PQ, code), or a 
semi-quantitative result (high, low), or a qualitative result (present/ not 
present).
Semi-Qualitative results need, inclusion/exclusion criteria and a
definition of what the norm/population is is about (females, children,
etc.)


Gerard Freriks
+31 620347088<tel:+31%206%2020347088>
gf...@luna.nl<mailto:gf...@luna.nl>

On 31 May 2017, at 06:54, Pablo Pazos 
<pablo.pa...@cabolabs.com<mailto:pablo.pa...@cabolabs.com>> wrote:

Hi Thomas,
Thinking about the hierarchy, at which level will be a Report be? Below compo? 
Below entry? Structure? Representation?
OT: many asked me this and didn't had a good answer. Do we have a pattern to 
model questionnaires? Some require to define questions, and the answer type in 
most cases is boolean, or coded text (multiple choice), and answers might be 
0..* (more than one answer for the same question is valid).
Cheers,
Pablo.



_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org<mailto:openehr-techni...@lists.ope
nehr.org>
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org



--
Ing. Pablo Pazos Guti?rrez
Cel:(00598) 99 043 145
Skype: cabolabs

[https://docs.google.com/uc?export=download&id=0B27lX-sxkymfdEdPLVI5UT
ZuZlU&revid=0B27lX-sxkymfcUwzT0N2RUs3bGU2UUovakc4VXBxWFZ6OXNnPQ]<http:
//cabolabs.com/> http://www.cabolabs.com<http://www.cabolabs.com/>
pablo.pa...@cabolabs.com<mailto:pablo.pa...@cabolabs.com>
Subscribe to our newsletter<http://eepurl.com/b_w_tj>



_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org<mailto:openehr-techni...@lists.ope
nehr.org>
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org



--
-----
http://www.healthintersections.com.au /
grah...@healthintersections.com.au<mailto:grahame@healthintersections.
com.au> / +61 411 867 065
-------------- next part -------------- An HTML attachment was
scrubbed...
URL:
<http://lists.openehr.org/pipermail/openehr-technical_lists.openehr.or
g/attachments/20170605/27a46f0d/attachment.html>

------------------------------

Subject: Digest Footer

_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org

------------------------------

End of openEHR-technical Digest, Vol 64, Issue 4
************************************************

_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org



------------------------------

Message: 2
Date: Mon, 5 Jun 2017 04:54:46 -0300
From: Pablo Pazos <pablo.pa...@cabolabs.com>
To: For openEHR technical discussions
        <openehr-technical@lists.openehr.org>
Subject: RE: openEHR-technical Digest, Vol 64, Issue 4
Message-ID:
        <cabzgfwrbch+psdmwe1v4rcgcvj8jxrvranfusafjjeew6vg...@mail.gmail.com>
Content-Type: text/plain; charset="utf-8"

I'm not so sure about this s but here we go:

I don't think that the question/answer format of a record really defined
that is indeed a questionnaire. Sometimes that is just due user interface
design.
If the record needs modeling question definitions and their possible answer
types or answer alternatives, that might be indeed a questionnaire.
In the other hand, if the records don't need the question definitions, just
the content definition e.g. entries, that mighty be a normal clinical
record.

If we don't consider this, anything can be defined as a questionnaire, and
that would be a useless generalization for both software development and
Interoperability. And in some cases would be incorrect, for example
questionnaires AFAIK don't contain time series data or maintain state of
ongoing talks (both examples are related with time related data).

This topic is a good conceptualization exercise!

On Jun 5, 2017 3:52 AM, "Heather Leslie" <
heather.les...@oceanhealthsystems.com> wrote:

Hi William,

I can concede that for those examples.

Honestly I'm not particularly fussed about categorisation of the examples
and there are plenty of examples which use a question/answer format with a
total score at the end, so it is not clear if we should call it a
questionnaire or a scale.

The principles that I've laid out remain the same.

Regards

Heather

-----Original Message-----
From: openEHR-technical [mailto:openehr-technical-
boun...@lists.openehr.org] On Behalf Of William Goossen
Sent: Monday, 5 June 2017 4:45 PM
To: openehr-technical@lists.openehr.org
Subject: Re: openEHR-technical Digest, Vol 64, Issue 4

The examples given as Glasgow Coma Scale and Barthel index are definitely
NOT questionnaires. These are assessment scales and require quite a
different approach than the also extremely useful questions and answers.

Vriendelijke groet,

Dr. William Goossen

Directeur Results 4 Care BV
+31654614458

Op 5 jun. 2017 om 08:25 heeft openehr-technical-request@
lists.openehr.org het volgende geschreven:
Send openEHR-technical mailing list submissions to
    openehr-technical@lists.openehr.org

To subscribe or unsubscribe via the World Wide Web, visit

http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org

or, via email, send a message with subject or body 'help' to
    openehr-technical-requ...@lists.openehr.org

You can reach the person managing the list at
    openehr-technical-ow...@lists.openehr.org

When replying, please edit your Subject line so it is more specific
than "Re: Contents of openEHR-technical digest..."


Today's Topics:

   1. Re: Questionnaires (Grahame Grieve)
   2. RE: Questionnaires (Heather Leslie)


----------------------------------------------------------------------

Message: 1
Date: Mon, 5 Jun 2017 15:59:26 +1000
From: Grahame Grieve <grah...@healthintersections.com.au>
To: For openEHR technical discussions
    <openehr-technical@lists.openehr.org>
Cc: For openEHR clinical discussions
    <openehr-clini...@lists.openehr.org>
Subject: Re: Questionnaires
Message-ID:

<cag47hgypmsi1u1znhheoh_ymz841m7mlvwd6hgccufsy-vq...@mail.gmail.com>
Content-Type: text/plain; charset="utf-8"

hi Heather

A generic question/answer pattern is next to useless -
interoperability
is really not helped

I think you should rather say "A generic question/answer pattern is
only useful for exchanging the questions and answers, and does not
allow re-use of data". This is not 'next to useless for
interoperability', just not fit for any wider purpose

Grahame


On Mon, Jun 5, 2017 at 3:51 PM, Heather Leslie <
heather.les...@oceanhealthsystems.com> wrote:

Following Thomas? suggestion re a separate thread:



I wrote a blog post in 2014 which still reflects our current thinking
re
questionnaires: https://omowizard.wordpress.com/2014/02/21/the-
questionnaire-challenge/



Our experience is that the data is the priority and so we want to
focus on questionnaires to support capture of good quality data.



If you want to try to capture data from the majority of existing
questionnaires then good luck ? questionnaires notoriously ask
questions badly, conflating multiple concepts into one question,
Boolean True/False when there are other ?shades of gray? etc. They
work variably as far as human interpretation but usually very badly wrt
computer interpretation.


We do have experience in taking previous paper questionnaires,
analysing the data requirements sought in terms of what we want to
persist and then we design the UI/questions to match the data desired
and/or suggesting the UI might show a questionnaire but each question
the clinical data is actually recorded using core archetypes ? for
example ?Do you have diabetes?? ? ?Yes?, is recorded using the value
?Diabetes? in the EVAL.problem_diagnosis and ?No? is recorded in the
matching exclusion archetype. This creates real clinical data that
can be used as part of a health record rather than create an
electronic checkbox version of the original paper questionnaire which
will never be used again, but capture dust in our EHR?s virtual
archives.


In summary:

   - A generic question/answer pattern is next to useless -
   interoperability is really not helped, especially if both the
question and
   answer has to be managed in the template. We have tried many
variations of
   this in the past, some of which were uploaded into CKM and
subsequently
   rejected.
   - Lock in those questionnaires that are ubiquitous, evidence based,
   validated as OBSERVATION archetypes and share them in the
international CKM
   ? eg AUDIT, Glasgow coma scale, Barthel index, Edinburgh post natal
   depression scale ? there are many examples in CKM.
   - Lock in local questionnaires that are going to be reused in your
   organisation, region or jurisdiction even though they may not be
reusable
   elsewhere. They will provide some interoperability even if might only
be
   appropriate within one clinical system or national CKM. An example is
the
   Modified Early Warning Score/National Early Warning Score ? there are
a few
   different variations used in different locations and whether they
should
   all be in the international CKM is still not clear.



BTW Questionnaires should be modelled as OBSERVATIONs (ie evidence
that can be collected over and over again using the same protocol)
not EVALUATIONS (as they are not meta-analysis nor summaries).



Regards



Heather



*From:* openEHR-technical [mailto:openehr-technical-
boun...@lists.openehr.org] *On Behalf Of *Pablo Pazos
*Sent:* Thursday, 1 June 2017 12:58 AM
*To:* For openEHR technical discussions <openehr-technical@lists.
openehr.org>
*Subject:* Re: Reports - a new openEHR RM type?



Besides specific ways to model questionnaires, my questions is if our
openEHR clinical modelers have a pattern to represent questionnaires
using the openEHR information model.



On Wed, May 31, 2017 at 3:37 AM, GF <gf...@luna.nl> wrote:

There are several kinds of context archetypes/templates and their
meta-data are used for:

- de novo data - re-used data

- step in the clinical treatment model (observation,
assessment/inference, planning, ordering, execution)

- kind of interface it is designed for (data presentation on a
screen, data capture, database store/retrieve, CDSS, ?



Each Template needs to capture all this and is a Composition.

All these contexts are characteristics of a Composition in the end.



Questionnaires are in essence a tool that classifies information.

And sometimes it transforms a set of responses into an aggregated
value/code

The questionnaire can be treated as any classification, meaning we
need to de fine inclusion and exclusion criteria,

and possible results per question can be a quantitative result
(number, PQ, code), or a semi-quantitative result (high, low), or a
qualitative result (present/ not present).

Semi-Qualitative results need, inclusion/exclusion criteria and a
definition of what the norm/population is is about (females,
children, etc.)




Gerard Freriks
+31 620347088 <+31%206%2020347088>
gf...@luna.nl



On 31 May 2017, at 06:54, Pablo Pazos <pablo.pa...@cabolabs.com> wrote:



Hi Thomas,

Thinking about the hierarchy, at which level will be a Report be?
Below compo? Below entry? Structure? Representation?

OT: many asked me this and didn't had a good answer. Do we have a
pattern to model questionnaires? Some require to define questions,
and the answer type in most cases is boolean, or coded text (multiple
choice), and answers might be 0..* (more than one answer for the same
question is valid).
Cheers,

Pablo.






_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-
technical_lists.openehr.org




--

Ing. Pablo Pazos Guti?rrez
Cel:(00598) 99 043 145
Skype: cabolabs

<http://cabolabs.com/>
http://www.cabolabs.com
pablo.pa...@cabolabs.com
Subscribe to our newsletter <http://eepurl.com/b_w_tj>



_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-
technical_lists.openehr.org



--
-----
http://www.healthintersections.com.au /
grah...@healthintersections.com.au
/ +61 411 867 065
-------------- next part -------------- An HTML attachment was
scrubbed...
URL:
<http://lists.openehr.org/pipermail/openehr-technical_lists.openehr.or
g/attachments/20170605/1cd4c49e/attachment-0001.html>

------------------------------

Message: 2
Date: Mon, 5 Jun 2017 06:24:50 +0000
From: Heather Leslie <heather.les...@oceanhealthsystems.com>
To: For openEHR clinical discussions
    <openehr-clini...@lists.openehr.org>,    "For openEHR technical
    discussions" <openehr-technical@lists.openehr.org>
Subject: RE: Questionnaires
Message-ID:

<sy3pr01mb19131a7c8e2e230285779c6eea...@sy3pr01mb1913.ausprd01.prod.ou
tlook.com>

Content-Type: text/plain; charset="utf-8"

Thanks Grahame, but I disagree.

??          A generic question/answer pattern is next to useless -
interoperability is really not helped, especially if both the question and
answer has to be managed in the template.?
The complete sentence qualifies that the dependence on template
modelling is the issue wrt interoperability. This is where a generic
pattern is made specific for a given questionnaire or data set. Also that
we have found there are multiple generic patterns, none of which is
universally applicable and so to create multiple generic patterns becomes
nonsensical.
In the templating scenario it is only if the exact same template is
shared (where every question has been renamed and associated value sets
inserted) that can we get any value. In our experience it is of higher
value to create an archetype that can at least be shared locally and
explicitly models the precise question/answer combo in order to achieve
better reuse.
Heather

From: openEHR-clinical
[mailto:openehr-clinical-boun...@lists.openehr.org] On Behalf Of
Grahame Grieve
Sent: Monday, 5 June 2017 3:59 PM
To: For openEHR technical discussions
<openehr-technical@lists.openehr.org>
Cc: For openEHR clinical discussions
<openehr-clini...@lists.openehr.org>
Subject: Re: Questionnaires

hi Heather

A generic question/answer pattern is next to useless -
interoperability is really not helped
I think you should rather say "A generic question/answer pattern is
only useful for exchanging the questions and answers, and does not
allow re-use of data". This is not 'next to useless for
interoperability', just not fit for any wider purpose

Grahame


On Mon, Jun 5, 2017 at 3:51 PM, Heather Leslie <heather.leslie@
oceanhealthsystems.com<mailto:heather.les...@oceanhealthsystems.com>>
wrote:
Following Thomas? suggestion re a separate thread:

I wrote a blog post in 2014 which still reflects our current thinking
re questionnaires:
https://omowizard.wordpress.com/2014/02/21/the-questionnaire-challenge
/

Our experience is that the data is the priority and so we want to focus
on questionnaires to support capture of good quality data.
If you want to try to capture data from the majority of existing
questionnaires then good luck ? questionnaires notoriously ask questions
badly, conflating multiple concepts into one question, Boolean True/False
when there are other ?shades of gray? etc. They work variably as far as
human interpretation but usually very badly wrt computer interpretation.
We do have experience in taking previous paper questionnaires, analysing
the data requirements sought in terms of what we want to persist and then
we design the UI/questions to match the data desired and/or suggesting the
UI might show a questionnaire but each question the clinical data is
actually recorded using core archetypes ? for example ?Do you have
diabetes?? ? ?Yes?, is recorded using the value ?Diabetes? in the
EVAL.problem_diagnosis and ?No? is recorded in the matching exclusion
archetype. This creates real clinical data that can be used as part of a
health record rather than create an electronic checkbox version of the
original paper questionnaire which will never be used again, but capture
dust in our EHR?s virtual archives.
In summary:

  *   A generic question/answer pattern is next to useless -
interoperability is really not helped, especially if both the question and
answer has to be managed in the template. We have tried many variations of
this in the past, some of which were uploaded into CKM and subsequently
rejected.
  *   Lock in those questionnaires that are ubiquitous, evidence based,
validated as OBSERVATION archetypes and share them in the international CKM
? eg AUDIT, Glasgow coma scale, Barthel index, Edinburgh post natal
depression scale ? there are many examples in CKM.
  *   Lock in local questionnaires that are going to be reused in your
organisation, region or jurisdiction even though they may not be reusable
elsewhere. They will provide some interoperability even if might only be
appropriate within one clinical system or national CKM. An example is the
Modified Early Warning Score/National Early Warning Score ? there are a few
different variations used in different locations and whether they should
all be in the international CKM is still not clear.
BTW Questionnaires should be modelled as OBSERVATIONs (ie evidence that
can be collected over and over again using the same protocol) not
EVALUATIONS (as they are not meta-analysis nor summaries).
Regards

Heather

From: openEHR-technical
[mailto:openehr-technical-boun...@lists.openehr.org<mailto:openehr-tec
hnical-boun...@lists.openehr.org>] On Behalf Of Pablo Pazos
Sent: Thursday, 1 June 2017 12:58 AM
To: For openEHR technical discussions
<openehr-technical@lists.openehr.org<mailto:openehr-techni...@lists.op
enehr.org>>
Subject: Re: Reports - a new openEHR RM type?

Besides specific ways to model questionnaires, my questions is if our
openEHR clinical modelers have a pattern to represent questionnaires using
the openEHR information model.
On Wed, May 31, 2017 at 3:37 AM, GF <gf...@luna.nl<mailto:gf...@luna.nl>>
wrote:
There are several kinds of context archetypes/templates and their
meta-data are used for:
- de novo data - re-used data
- step in the clinical treatment model (observation,
assessment/inference, planning, ordering, execution)
- kind of interface it is designed for (data presentation on a screen,
data capture, database store/retrieve, CDSS, ?
Each Template needs to capture all this and is a Composition.
All these contexts are characteristics of a Composition in the end.

Questionnaires are in essence a tool that classifies information.
And sometimes it transforms a set of responses into an aggregated
value/code The questionnaire can be treated as any classification,
meaning we need to de fine inclusion and exclusion criteria, and
possible results per question can be a quantitative result (number, PQ,
code), or a semi-quantitative result (high, low), or a qualitative result
(present/ not present).
Semi-Qualitative results need, inclusion/exclusion criteria and a
definition of what the norm/population is is about (females, children,
etc.)


Gerard Freriks
+31 620347088<tel:+31%206%2020347088>
gf...@luna.nl<mailto:gf...@luna.nl>

On 31 May 2017, at 06:54, Pablo Pazos <pablo.pa...@cabolabs.com<mailto:
pablo.pa...@cabolabs.com>> wrote:
Hi Thomas,
Thinking about the hierarchy, at which level will be a Report be? Below
compo? Below entry? Structure? Representation?
OT: many asked me this and didn't had a good answer. Do we have a
pattern to model questionnaires? Some require to define questions, and the
answer type in most cases is boolean, or coded text (multiple choice), and
answers might be 0..* (more than one answer for the same question is valid).
Cheers,
Pablo.



_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org<mailto:openehr-techni...@lists.ope
nehr.org>
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org



--
Ing. Pablo Pazos Guti?rrez
Cel:(00598) 99 043 145
Skype: cabolabs

[https://docs.google.com/uc?export=download&id=0B27lX-sxkymfdEdPLVI5UT
ZuZlU&revid=0B27lX-sxkymfcUwzT0N2RUs3bGU2UUovakc4VXBxWFZ6OXNnPQ]<http:
//cabolabs.com/> http://www.cabolabs.com<http://www.cabolabs.com/>
pablo.pa...@cabolabs.com<mailto:pablo.pa...@cabolabs.com>
Subscribe to our newsletter<http://eepurl.com/b_w_tj>



_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org<mailto:openehr-techni...@lists.ope
nehr.org>
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org



--
-----
http://www.healthintersections.com.au /
grah...@healthintersections.com.au<mailto:grahame@healthintersections.
com.au> / +61 411 867 065
-------------- next part -------------- An HTML attachment was
scrubbed...
URL:
<http://lists.openehr.org/pipermail/openehr-technical_lists.openehr.or
g/attachments/20170605/27a46f0d/attachment.html>

------------------------------

Subject: Digest Footer

_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open
ehr.org

------------------------------

End of openEHR-technical Digest, Vol 64, Issue 4
************************************************

_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-
technical_lists.openehr.org

_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-
technical_lists.openehr.org

-------------- next part --------------
An HTML attachment was scrubbed...
URL: 
<http://lists.openehr.org/pipermail/openehr-technical_lists.openehr.org/attachments/20170605/01123ee5/attachment.html>

------------------------------

Subject: Digest Footer

_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org

------------------------------

End of openEHR-technical Digest, Vol 64, Issue 6
************************************************


_______________________________________________
openEHR-technical mailing list
openEHR-technical@lists.openehr.org
http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org

Reply via email to