Jean-Marc specified that thresholds would need to be able to be "changed 
afterwards" (I assume after the data was committed to the EHR), which to me 
implies that their problem was closer to my item 1) below.


-----Original Message-----
From: openEHR-technical [] On 
Behalf Of Karsten Hilbert
Sent: Friday, March 2, 2018 12:13 PM
Subject: Re: Setting thresholds

On Fri, Mar 02, 2018 at 10:55:47AM +0000, Bakke, Silje Ljosland wrote:

> I've hesitated to participate in this discussion, but I think I have a couple 
> of points to add now, as I think there are two different problems being 
> discussed here:
> 1.       The original problem, which in my opinion is how and where to store 
> reference ranges for clinical observations such as for instance blood 
> pressure. These reference ranges are often based on clinical research, and 
> may change with time as new research emerges. In my opinion these shouldn't 
> be stored with the original observation data, but can (when needed) be stored 
> with any interpretation where the data is used to reach a conclusion, for 
> example a symptom, diagnosis or even just an instruction. The reference 
> ranges that are current at any point in time however, should be stored and 
> accessed from a knowledge base outside the EHR, as they don't relate to the 
> data of a specific patient. However, that knowledge base may well be linked 
> to specific archetypes and archetype elements to facilitate its usage, for 
> example to the systolic, diastolic and position elements of the blood 
> pressure archetype, if the reference ranges vary based on the position of the 
> patient at the time of measurement.
> 2.       The problem of reference ranges that are intricately bound to 
> specific observations and their methods, such as lab results. These should 
> be, and are commonly, stored with the observations in the EHR because the 
> details of analytic method and other factors that affect them are far too 
> complex to include in the EHR data. The RM attributes "normal_range" and 
> "other_reference_ranges" (and "normal_status") of the Quantity data type are 
> well suited for these reference ranges.

That about wraps it up.

Except that I was of the impression that the original question was more about 
2) rather than 1).

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