Archetypes - regex question
In a message dated 13-6-2008 19:10:07 W. Europe Daylight Time, sam.heard at oceaninformatics.com writes: We are getting into dangerous options here: include all and exclude all in a time series where 'all' definitely changes both with respect to revisions of the existing ones, deletions and new to be added might lead to inconsistent calls to archetypes over time. I believe such constraining should not take place on the archetype over archetype level, but at the (OpenEHR) template level. In here you can be explicit in what is to be included or excluded. Hi Adam This is another example of the approach to be as specific as possible. The exclude statement can be used to exclude specific archetypes and the Include ALL in this case means that all others are allowed. If the Exclude ALL statement is added to an archetype, it means ONLY those specifically stated can be added. The issue here is backward compatibility and new archetypes. The include will generally be seen as the appropriate list but others could be added if they arise and are required (the list is not closed). Tony Shannon has argued (along with me) that this should be the default (ie we do not usually know that it would never be appropriate to add another archetype here. Is that helpful? Do you think this is useful? It does mean there is no need to reversion archetypes if new ones might fit in a cluster (which is also useful). Cheers, Sam Sincerely yours, dr. William TF Goossen director Results 4 Care b.v. De Stinse 15 3823 VM Amersfoort email: Results4Care at cs.com phone + 31654614458 fax +3133 2570169 www.results4care.nl Dutch Chamber of Commerce number: 32133713 -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080614/96d6e87a/attachment.html
Archetypes - regex question
William, It is potentially dangerous ground. But ... - Archetypes express what can be documented about a specific topic. Since such a 'Real Archetype' can or will consist of re-usable patterns, 'Real Archetypes' consist many times of a collection of sub- archetypes that express recurring patterns of documentation. In other words archetypes can and will be nested. And there must be a way to specify what archetypes are part of the ensemble at what spots. - It will create the problem for Archetype Governance. We need to have rules and ways to manage and enforce them. This needs a tool. Ocean Informatics, for this purpose, has developed the Archetype Knowledge Manager. Gerard On 14, Jun, 2008, at 7:31 , Williamtfgoossen at cs.com wrote: We are getting into dangerous options here: include all and exclude all in a time series where 'all' definitely changes both with respect to revisions of the existing ones, deletions and new to be added might lead to inconsistent calls to archetypes over time. I believe such constraining should not take place on the archetype over archetype level, but at the (OpenEHR) template level. In here you can be explicit in what is to be included or excluded. -- private -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: gfrer at luna.nl Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080614/8845ef4a/attachment.html
Decision Support was: MIE-2008
Hi Hugh and Gerard, I very much agree that snomed coding should only be done where it adds value. Since archetypes provide meaning themselves not everything has to be coded (as opposed to HL7 that relies more on external codes). Although for export to non-openEHR formats (or data-mining on openEHR *and* non-EHR data) it could still be useful. But since finding suitable codes can be very tough, such gimmick coding will probably rarely happen in the first instance. Using codes to reduce the number of archetypes is a very valuable use case. Having a generic archetype as a recording pattern (e.g. lab archetype) and using codes to specify the actual analyte makes sense. As mentioned before templates should be used to aggregate these archetypes in a specific testing 'battery'. Looking at the openEHR archetype repository, there is a generic lab archetype and several specialiced ones based on it. However, it seems to me that the specialisations were done mainly to create battery type lab results structures (e.g. laboratory-liver_function) I think keeping the lab archetype to one analyte and aggregating them in a template would be cleaner and better from a query perspective. Specialisations of the generic lab archetype should only be used to add a field that is missing for an unkonventinal lab test. What do you think? Again, I would like to point you to the terminology use case section in the openEHR wiki: http://www.openehr.org/wiki/display/healthmod/Archetypes+and+Terminology#ArchetypesandTerminology-Usecasesforterminologyreferencesinarchetypes Lets fill this use case list in a *collaborative* manner. It is better to have our thoughts in a permanent spot (wiki) than only in a mailing list thread where they get burried and forgotten after a while. No hesitation, add/rearrange etc as you please ... everything is versioned so nothing gets lost! Hugh, could you add the fewer archetypes use case please. Cheers, Thilo On Fri, Jun 13, 2008 at 10:53 AM, Gerard Freriks gfrer at luna.nl wrote: Hi, The way I like to think about it is that there is a generic archetype for lab-tests as a recurring 'pattern'. Each individual lab test procedure is a code from a general coding system. The way Lab-test are reported (quantitative data, in what units of measurement, precision, normal value ranges, semi quantitative data, in what ordinal scale ,etc, etc) will be 'codes' as well, but this time from the Laboratory Resource Description System. The 'patterns' will probably be a special type of Archetype that is of the cluster nature. Batteries have Template nature. Gerard On 13, Jun, 2008, at 6:11 , Hugh Leslie wrote: Hi Daniel I was just using that as an example where its not always useful to code everything. I certainly wasn't trying to say that its not useful to code anything and the example that you give is where it is useful to code. I was just pushing back against those that want to code everything as I believe that we need to code those things that make sense. In terms of battery archetypes, thats another problem because batterys tend to vary between labs (certainly here in Australia anyway.) I would expect that it might be templates that solve this problem with the archetype providing something more generic. Coding of the analytes would then make sense so that you can compare different result sets. This could be also solved by producing archetypes for each analyte and then reusing them for different batteries. This would then mean that P-ALAT is the same archetype where ever it is used. Personally, I think the coded solution is better here as we would have fewer archetypes to manage. regards Hugh -- private -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: gfrer at luna.nl Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 ___ openEHR-technical mailing list openEHR-technical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
Decision Support was: MIE-2008
Dear all, It is all about patterns for documenting. I agree that inspection of the present collection of openEHR archetypes and those produce by the NHS are a nice resource. But we must realize that these were produced for demonstration, testing, learning or the collection of information requirements. The Templates and Archetypes we need must be designed for semantic correct, reusable, patient safe recording, retrieval, exchange and archiving in mind. A complete new set of scopes that need explicit requirements. - Patterns are to be re-used and aggregated in other archetypes or templates. Question: What are the rules to be applied to make that decision? - A pattern will need a new specialization only when new things have to be added to the original pattern. Question: What are the rules for to decide when to specialize or when to add a new item to the original archetype and create a new version? - What patterns do we have to have in order to be able to document what we need to document? Will we find the answer when we look at the language aspects of what we document? - Some Archetypes document complex notions. For example: the Barletts Index. It is a collection of Observations about a patient system. Each of these observations can be recorded using a documentation pattern. The aggregation of observations is expressed as a number using an algorithm. This aggregation is named the Bartletts Index. All of the observations can be documented using separate archetypes using semi-quantitate patterns. The algorithm can be documented in whatever format. The result is documented using a semi-quantitative pattern, either on its own as the professional opinion of the healthcare provider, or as the result of the application of the algorithm, as substitute of the healthcare providers subjective estimation. So the Bartletts Index can be a subjective statement of the class of Evaluation Archetypes based on Observations, or the a subjective statement (Evaluation) by a healthcare provider without any reference to feeding observations, What will we do when new observation elements are added to the Bartletts Index? What will we do when a new algorithm is used to do the calculations? Is this line of reasoning not leading to the following statements: Observations are observations and end up in Observation Archetypes and are recorded in the EHR, as such. The Bartlett Index is a derivative that either is an Evaluation of Risk expressed as the ARchetype Index as perceived by the documenting healthcare provider, or, the Bartletts Index is a formalism (algorithm) applied to a set of documented Observations leading to a risk index that has to be documented as an Evaluation. I might even argue that the Bartletts Index is an agreed Common Template to express risk for the new born, that could change over time as it is the result of present opinions that can change. This means that there are two versions of the Bartlett Index that express the same notion. One is the professional opinion of the risk for the newborn by the healthcare provider is a certain number. And that the risk is calculated by a specified algorithm using a defined set of observations. Question: Is the Bartlett Index an Observation or an Evaluation? Question: Are there two kinds of Indexes? Question: Is the Bartlett Index an Archetype or Template? Or more general: Are Archetype about recording patterns? Are Templates about context (location, time and culture) dependent collection of constituting archetypes? Gerard On 14, Jun, 2008, at 15:55 , Thilo Schuler wrote: Looking at the openEHR archetype repository, there is a generic lab archetype and several specialiced ones based on it. However, it seems to me that the specialisations were done mainly to create battery type lab results structures (e.g. laboratory-liver_function) I think keeping the lab archetype to one analyte and aggregating them in a template would be cleaner and better from a query perspective. Specialisations of the generic lab archetype should only be used to add a field that is missing for an unkonventinal lab test. What do you think? -- private -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: gfrer at luna.nl Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080614/1a2f5da0/attachment.html
