GF: "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."
---
Using SNOMED does not block using other terminologies or even local
terminologies.

In OpenEhr is always a part of the epistemology in the context of the
archetype, that is its power. Terminologies serve to undoubtable define the
presented data-item or act as a data-item. This is also the case in CEN13606


>
> Gerard   Freriks
> +31 620347088
>   gf...@luna.nl
>
> Kattensingel  20
> 2801 CA Gouda
> the Netherlands
>
> On 2 Apr 2018, at 20:02, Pablo Pazos <pablo.pa...@cabolabs.com> 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 <gf...@luna.nl> 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 <+31%206%2020347088>
>>   gf...@luna.nl
>>
>> Kattensingel  20
>> 2801 CA Gouda
>> the Netherlands
>>
>> On 2 Apr 2018, at 01:11, Pablo Pazos <pablo.pa...@cabolabs.com> 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 <gf...@luna.nl> 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 <+31%206%2020347088>
>>>   gf...@luna.nl
>>>
>>> Kattensingel  20
>>> 2801 CA Gouda
>>> the Netherlands
>>>
>>> On 1 Apr 2018, at 14:41, Thomas Beale <thomas.be...@openehr.org> 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
>>> openEHR-technical@lists.openehr.org
>>>
>>> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org
>>>
>>>
>>>
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>>>
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>>>
>>
>>
>>
>> --
>> Ing. Pablo Pazos GutiƩrrez
>> pablo.pa...@cabolabs.com
>> +598 99 043 145 <099%20043%20145>
>> skype: cabolabs
>> <http://cabolabs.com/>
>> http://www.cabolabs.com
>> https://cloudehrserver.com
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>
>
>
> --
> Ing. Pablo Pazos GutiƩrrez
> pablo.pa...@cabolabs.com
> +598 99 043 145
> skype: cabolabs
> <http://cabolabs.com/>
> http://www.cabolabs.com
> https://cloudehrserver.com
> Subscribe to our newsletter <http://eepurl.com/b_w_tj>
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