I agree. ‘questionnaire’ is many things, but not at the same time. In any case any EHR needs to be able to cope with all kinds. From ones with one or more qualitative results: such as the checklist To the validated Score where individual results are aggregated in one total score.
It must be possible to create one pattern that can deal with all kinds. Gerard Freriks +31 620347088 [email protected] Kattensingel 20 2801 CA Gouda the Netherlands > On 6 Jun 2017, at 14:46, Vebjørn Arntzen <[email protected]> wrote: > > Hi all > > To me a "questionnaire" is a vague notion. There can be a lot of different > "questionnaires" in health. From the GP's in Thomas's example to a Apgar > score, to a clinical guideline and even a checklist. Those are all a set of > "questions and answers", but the scope and use is totally different. In paper > questionnaires we will find a mix of many, maybe all, of those, crammed into > what the local practice have found to be useful (= "Frankenforms"). To try to > put all of them into a generic questionnaire-archetype is of no use. > > Examples: > The GP questionnaire referred to by Thomas is in the quoted question about > "ever had heart trouble" merely a help for the GP, and of little use for > computation. But if it is supplemented by more specific questions, based on > answers by the individual, then the final result can be "occasional > arrhythmia with ventricular ectopics", which is a relevant information for > later use and should be put into a relevant archetype. So is it a > "questionnaire" or a guideline for the consultation? Not relevant IMO, it's > the content, that's relevant. > > Patients with haemophilia in Oslo university hospital are offered a > questionnaire online to register whether they've had incidents of bleeding, > what caused it, if they needed medications and if so, the batchnumber of the > medication. This is followed up by the staff both for reporting of used > medication, and for the patients next follow-up out-patient control or > admission. Questionnaire or not? Not relevant – it's what the information is > and what it is for, that is important. Find relevant archetypes for them, > OBSERVATIONS or ADMIN-ENTRY for this, I guess. > > Even checklists are a set of questions and answers. "Have you remembered to > fill out the diagnosis?". "Is there a need to offer the patient help to deal > with the cancer diagnosis?". Main thing is to analyze what the resulting > answer is representing, and the use of it. Decision support? Clinically > relevant? Merely a reminder? Put them into a template, using appropriate > archetypes. > > > Regards, Vebjørn > > Fra: openEHR-clinical [mailto:[email protected] > <mailto:[email protected]>] På vegne av Thomas Beale > Sendt: 5. juni 2017 18:55 > Til: For openEHR technical discussions; For openEHR clinical discussions > Emne: Re: openEHR-technical Digest, Vol 64, Issue 6 > > > > this has to be essentially correct, I think. If you think about it, scores > (at least well designed ones) are things whose 'questions' have only known > answers (think Apgar, GCS etc), each of which has objective criteria that can > be provided as training to any basically competent person. When score / scale > is captured at clinical point of care, any trained person should convert the > observed reality (baby's heartrate, accident victim's eye movements etc) into > the same value as any other such person. In theory, a robot could be built to > generate such scores, assuming the appropriate sensors could be created. > > With 'true' questionnaires, the questions can be nearly anything. For > example, my local GP clinical has a first time patient questionnaire > containing the question 'have you ever had heart trouble?'. It's pretty clear > that many different answers are possible for the same physical facts (in my > case, occasional arrhythmia with ventricular ectopics whose onset is caused > by stress, caffeine etc; do I answer 'yes'? - maybe, since I had this > diagnosed by the NHS, or maybe 'no', if I think they are only talking about > heart attacks etc). > > My understanding of questionnaires functionally is that they act as a rough > (self-)classification / triage instrument to save time and resources of > expensive professionals and/or tests. > > There is some structural commonality among questionnaires, which is clearly > different from scores and scales. One of them is the simple need to represent > the text of the question within the model (i.e. archetype or template), > whereas this is not usually necessary in models of scores, since the coded > name of the item (e.g. Apgar 'heart rate') is understood by every clinician. > > Whether there are different types of questionnaires semantically or > otherwise, I don't know. > > - thomas > > > On 05/06/2017 09:48, William Goossen wrote: > 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. > > > -- > Thomas Beale > Principal, Ars Semantica <http://www.arssemantica.com/> > Consultant, ABD Team, Intermountain Healthcare > <https://intermountainhealthcare.org/> > Management Board, Specifications Program Lead, openEHR Foundation > <http://www.openehr.org/> > Chartered IT Professional Fellow, BCS, British Computer Society > <http://www.bcs.org/category/6044> > Health IT blog <http://wolandscat.net/> | Culture blog > <http://wolandsothercat.net/>_______________________________________________ > openEHR-clinical mailing list > [email protected] <mailto:[email protected]> > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org > <http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org>
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