I agree this ‘definition’ problem is outside of the scope of this list.
But since you misused terms, I reacted.

In your example in words:
- Observation 'Serum sodium = X’,  'Normal associated and stored Normal range 
for adult males:: Lower=A, Higher=B 
- Evaluation 1 'X is abnormal and lower than Lower bound A’
- Evaluation 2 'Patient System has a state of  Hyponatrenomy’
- Evaluation 3 ‘Patient System has problem item on the Problem list Y’
- Evaluation 4 ‘Patient System has risk to have as possible diagnosis Z1, Z2, 
- …
-  Evaluation N ‘Patient has diagnosis Z4’

I agree that just one single Observation is not enough to safely diagnose the 
More is needed than that.

Gerard   Freriks
+31 620347088

Kattensingel  20
2801 CA Gouda
the Netherlands

> On 2 Mar 2018, at 17:29, Bakke, Silje Ljosland 
> <silje.ljosland.ba...@nasjonalikt.no> wrote:
> 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! J
> Regards,
> Silje

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