We’re getting into territory that maybe doesn’t belong in the technical list anymore, but anyway.
I suspect this may be a disagreement in choice of words. I’m talking about the difference between observational and evaluative statements. The lab result is observational and what I called “diagnosis” is evaluative. The point I was trying to make is that these are different in nature, whether we choose to call the evaluative statement “problem” or “diagnosis”. The S-sodium lab result by itself doesn’t necessarily mean that the patient actually had a real hyponatremia, though I see that my previous statement could be interpreted as such. Maybe the patient had simultaneous hyperlipidemia or hyperproteinemia? The assessment of the larger picture is of course what leads to the evaluative statement. The overall point I was trying to make was that you can’t expect to be able to computationally draw conclusions about the health of a patient based only on reference ranges for single observational statements; you also need a human (or perhaps in the future a machine?) to assess a larger picture. I wish you all a nice weekend! ☺ Regards, Silje From: openEHR-technical [mailto:[email protected]] On Behalf Of GF Sent: Friday, March 2, 2018 4:19 PM To: Thomas Beale <[email protected]> Subject: Re: Setting thresholds I agree with Karsten. Diagnosis (in my terms) is a statement as the result of an Evaluation process about the Patient System. Measurement is the result of an Observation process about the Patient System using materials of the Patient System as source. Evaluation is the result of an Evaluation process that indicates that the result is ‘normal’, ‘elevated’, ‘low’, ‘abnormal’, ‘risk of’, etc. Gerard Freriks +31 620347088 [email protected]<mailto:[email protected]> Kattensingel 20 2801 CA Gouda the Netherlands On 2 Mar 2018, at 15:22, Karsten Hilbert <[email protected]<mailto:[email protected]>> wrote: On Fri, Mar 02, 2018 at 01:48:40PM +0000, Bakke, Silje Ljosland wrote: A doctor making and recording a conclusion that a measurement of some kind is too high or too low, IS a diagnosis. Uhm, no. their conclusion would be recorded as a diagnosis of hyponatremia. While most doctors will do that it is wrong. Hyponatremia is not a diagnosis. It is just a supposedly-clever way of saying what the lab already said. It is intended to make non-doctors think we doctors are in control of the situation. At best, it is an unresolved problem. All in all it is a _finding_, or observation, notably out-of-range :-) Karsten -- GPG key ID E4071346 @ eu.pool.sks-keyservers.net<http://eu.pool.sks-keyservers.net> E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ openEHR-technical mailing list [email protected]<mailto:[email protected]> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org
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