I mostly agree with Ian, but with the small caveat that for very
specific and well-known cases such as body laterality, you just /might
consider/ post-coordination on body site e.g.
* 56459004 |foot structure| : 272741003 |laterality| = 7771000 |left|)
However, even here, laterality often seems to be divided out in various
ways depending on what you are talking about. E.g. anything to do with
eyes, the whole exam is per-eye rather than each finding being marked as
being on the 'eye, left' or 'eye, right'. In other places, 'left' and
'right' don't even have symmetrical meanings e.g. the heart (think
left-branch bundle etc).
Nevertheless, for those body sites where findings are reported as being
on some X+left or right, I think we probably should consider
post-coordination of the site and the laterality at some point. For
everything else, it's a nice idea but forget it in data models.
Where it could be used is via a /mapping formula /for multiple data
points, e.g. in an archetype. The archetype data would be defined
populated as a structure (as today), but a 'post-coordination formula'
that indicates how to bind the values of particular coded elements
together to obtain a Snomed expression could be used to generate such
expressions from the data, for consumption by inference engines. This is
the only place where they can be usefully computed with, in my opinion.
Such a formula might look like this:
* 47933007 |$pain_finding| : 363698007 |finding_site| = (
$finding_site: 272741003 |laterality| = $laterality)
where $pain_finding, $finding_site and $laterality are bound to paths in
the archetype.
If the formula were evaluated, it might give this:
* 22253000 |pain| : 363698007 |finding site| = ( 56459004 |foot
structure| : 272741003 |laterality| = 7771000 |left| )
With minor adjustments in the binding part of the ADL2 grammar, such
formula bindings could be accommodated fairly easily I would think.
Note: this is speculation, and has never been tried as far as I know.
Even if it does, it's only for SNOMED, unless the SNOMED model of
post-coordinated expressions is adopted by other terminologies...
- thomas
On 19/11/2018 13:32, Ian McNicoll wrote:
Basically - don't!!
The UK has been trying to do this for over 20 years without success.
It is a terminologists dream but implementers nightmare.
Make a start with high-value use cases e.g Allergy agent "Allergic
to + causative agent" - so that you do not have to generate a new
Snomed code for every potential allergen.
Perhaps consider laterality. Beyond that, you risk delaying SNOMED CT
implementation, as has happened in the UK.
Post-coordination is like nuclear fusion - a damned good idea but
tricky to do without blowing everything up.
Ian
Ian
Dr Ian McNicoll
mobile +44 (0)775 209 7859
office +44 (0)1536 414994
skype: ianmcnicoll
email: i...@freshehr.com <mailto:i...@freshehr.com>
twitter: @ianmcnicoll
Co-Chair, openEHR Foundation ian.mcnic...@openehr.org
<mailto:ian.mcnic...@openehr.org>
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL
On Mon, 19 Nov 2018 at 13:20, Bakke, Silje Ljosland
<silje.ljosland.ba...@nasjonalikt.no
<mailto:silje.ljosland.ba...@nasjonalikt.no>> wrote:
Hi everyone,
We’ve recently started an informal and practically oriented
regular contact with the Norwegian SNOMED CT NRC. One of the
things they were interested in discussing was how to use
postcoordinated SNOMED CT (expression constraint language)
expressions with openEHR, which I know nothing about. Does anyone
have any knowledge about or experience with this?
Kind regards,
*Silje Ljosland Bakke*
**
Information Architect, RN
Coordinator, National Editorial Board for Archetypes
Nasjonal IKT HF, Norway
Tel. +47 40203298
Web: http://arketyper.no <http://arketyper.no/>/ Twitter:
@arketyper_no <https://twitter.com/arketyper_no>
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