Is that so? There will be systems that allow pre-coordinated codes. There will be systems that use as many pre-coordinated codes. And several in between solutions. This means that reasoners will be used to create transformations. It is likely that ontological servoces will be used, And then we will have a potential problem. But perhaps solvable with the correct precautions. One being that ontological servoces are NOT used and that ad hoc rules do the transform. What possible solution is the canonical one? which is the ‘golden truth’.
When we add to all this that only part of the epistemology can be pre-coordinated it means that part of the temporal aspects for instance can NOT be dealt with in SNOMED, then we have the situation that part of the epistemology is in SNOMED and part defined in the Archetype/Template. Gerard Freriks +31 620347088 [email protected] Kattensingel 20 2801 CA Gouda the Netherlands > On 2 Apr 2018, at 20:02, Pablo Pazos <[email protected]> wrote: > > Yes, but the main topic here is the use of SNOMED inside openEHR, so there is > no terminology world separated from the content modeling and data recording > world. We will use SNOMED inside the openEHR context, so the SNOMED meaning > will be constrained by the openEHR meaning when recording clinical > information. We should be constraint to that context. > > On Mon, Apr 2, 2018 at 6:01 AM, GF <[email protected] <mailto:[email protected]>> > wrote: > Pablo, > > It is as Thomas and I wrote. > > Open world Assumption: Ontologies declare absolute truths irrespective of > geographical location and point in time. > > Closed World Assumption: Archetypes help express what an author wants to > document. These are very subjective truths at a point in time. > > This subtle but important distinction is only one of the reasons to refrain > from the use of pre-coorodinated SNOMED terms. Things like these matter when > we start to reason about the documented patient data. > > Gerard Freriks > +31 620347088 <tel:+31%206%2020347088> > [email protected] <mailto:[email protected]> > > Kattensingel 20 > 2801 CA Gouda > the Netherlands > >> On 2 Apr 2018, at 01:11, Pablo Pazos <[email protected] >> <mailto:[email protected]>> wrote: >> >> I'm sorry but "...no cancer was, is, or will be present." doesn't even make >> sense. No system can record what can or can't happen in the future, and that >> concept is not part of any terminology AFAIK. >> >> On Sun, Apr 1, 2018 at 7:35 PM, GF <[email protected] <mailto:[email protected]>> >> wrote: >> Thomas, >> >> OpenEHR and 13606 deal with Closed World Assumption systems. >> And therefor both mean in the case of 'No Cancer' that Cancer was not found >> in the database or that No Cancer was the documented result of an evaluation. >> Both statements are documented things in a Template that according to the >> author cancer is not found. >> But any time in the future it might. >> >> 'No Cancer' as pre-coordinated term in the case of SNOMED means that no >> cancer was, is, or will be present. >> >> Gerard Freriks >> +31 620347088 <tel:+31%206%2020347088> >> [email protected] <mailto:[email protected]> >> >> Kattensingel 20 >> 2801 CA Gouda >> the Netherlands >> >>> On 1 Apr 2018, at 14:41, Thomas Beale <[email protected] >>> <mailto:[email protected]>> wrote: >>> >>> >>> On 01/04/2018 13:16, GF wrote: >>>> Pre-coordinated SNOMED codes are like classifications, in that they are >>>> used at the user level, the User Interface, >>>> The Ontology behind SNOMED allows the pre-ordinated codes to be decomposed >>>> in its constituents. >>>> These decomposed primitive codes can be used in structures like archetypes >>>> at the proper places. >>>> In this way the pre-coorodinated SNOMED codes are iso-semantic. >>>> >>>> But we keep the semantic differences codes expressed using the SNOMED >>>> ontology and the Archetype and its codes. >>>> Ontologies have the Open World Assumption. A pre-corodinated code like: >>>> No-Cancer means never there was, is or will be cancer. Ontologies describe >>>> reality. >>>> In archetypes that use the Closed World Assumption Diagnosis=cancer, >>>> PresenceModifier=No means No Cancer found but perhaps they are. It just >>>> was not found. Presence of absence in a database are described. >>> >>> I'm unclear why you call this a use of the closed world assumption: the >>> entire openEHR framework is for building HISs that enable reporting of >>> reality as it is known to those working in it. So if they put 'No cancer' >>> that just means that the current clinical thinking for some patient, with >>> respect to some investigation, is that the original presenting problem is >>> not cancer. >>> >>> That never means that the patient doesn't have cancer in their body >>> somewhere, it just means that the currently investigated signs and symptoms >>> don't relate to cancer, according to the the investigation carried out. >>> Even that can be overturned later. But everyone assumes this - the EHR is >>> always understood as an 'open world' system, where absence of X doesn't >>> mean negation of X, it just means that no-one has investigated X. >>> >>> - thomas >>> _______________________________________________ >>> openEHR-technical mailing list >>> [email protected] >>> <mailto:[email protected]> >>> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org >>> >>> <http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org> >> >> _______________________________________________ >> openEHR-technical mailing list >> [email protected] >> <mailto:[email protected]> >> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org >> >> <http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org> >> >> >> >> -- >> Ing. Pablo Pazos Gutiérrez >> [email protected] <mailto:[email protected]> >> +598 99 043 145 <tel:099%20043%20145> >> skype: cabolabs >> <http://cabolabs.com/> >> http://www.cabolabs.com <http://www.cabolabs.com/> >> https://cloudehrserver.com <https://cloudehrserver.com/> >> Subscribe to our newsletter <http://eepurl.com/b_w_tj> >> _______________________________________________ >> openEHR-technical mailing list >> [email protected] >> <mailto:[email protected]> >> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org >> >> <http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org> > > _______________________________________________ > openEHR-technical mailing list > [email protected] > <mailto:[email protected]> > http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org > <http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org> > > > > -- > Ing. Pablo Pazos Gutiérrez > [email protected] <mailto:[email protected]> > +598 99 043 145 > skype: cabolabs > <http://cabolabs.com/> > http://www.cabolabs.com <http://www.cabolabs.com/> > https://cloudehrserver.com <https://cloudehrserver.com/> > Subscribe to our newsletter <http://eepurl.com/b_w_tj> > _______________________________________________ > openEHR-technical mailing list > [email protected] > http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org
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