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 

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! ☺


From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On 
Behalf Of GF
Sent: Friday, March 2, 2018 4:19 PM
To: Thomas Beale <openehr-technical@lists.openehr.org>
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

Kattensingel  20
2801 CA Gouda
the Netherlands

On 2 Mar 2018, at 15:22, Karsten Hilbert 
<karsten.hilb...@gmx.net<mailto:karsten.hilb...@gmx.net>> 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

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 :-)

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