Dear Colleague,
Archetypes are clinical concept models.
They communicate and express domain information models about clinical
concepts.
Archetypes are ways to express clinical knowledge on what has to be
recorded documenting the provision of healthcare.
Archetypes (at this moment) are not designed to deal with clinical
knowledge about the interpretation of documented clinical facts.
Decision support.
Fields in archetypes that are specified are containers to be used for
documentation.
One type of the family of archetypes is the Observation.
One of the possible observations is the Lab-test.
For each lab-test the following things will have to be (can be)
recorded about the test itself and its results:
- name of the test
- value/outcome/result
- units of measurement
- normal values
- interpretation
- comment
-relevance-
Each healthcare provider that is using this archetype will be able to
record the indicated information about any lab-test.
The name of the test plus units of measurement are linked to each other.
Result is the number that is the result of a measurement that is
recorded and can vary.
Normal values are dependent on local circumstances. Each lab has its
own normal values for all of the tests they perform.
The interpretation of the test result and its normal values are
dependent on local arrangements, clinical speciality, and patient
related contexts.
The comment is additional information that has to be recorded about
the test.
Thinking about it I foresee the need for a flag indicating that this
lab test result is considered relevant or irrelevant by the Observer.
The reason for this is: Suppose all fields are filled but the comment
field states that the blood was not collected properly. Then all data
that is recorded is interpreted as less relevant/reliable but can not
(must not) be disregarded fully.
Perhaps all Archetypes of the Observation Type need this extra field
I call Relevance.
To answer your e-mail.
I think that the normal value and the interpretation are NOT part of
the archetype definition. Within the archetype specification one can
not deal with all situations that influence the normal values
dependent on local contexts that vary from point in time to point in
time, from place to place and from context to context. Normal values
have to be provided by the lab. The interpretation has to be provided
by the Observer (e.g. the lab or the physician). Or in the case of
Clinical decision Support the module that handles this type of
clinical knowledge.
Gerard
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Gerard Freriks, arts
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The Netherlands
T: +31 252 544896
M: +31 653 108732
On 25-okt-2006, at 0:27, Rodrigo Filgueira wrote:
We've been running throuh the normal and possible ranges of
values for
lab tests and found that the archetype I mention in the subject
does not
state but a bigger than 0 restriction for Haemoglobin, RCC, etc.
I decided to take a look because ranges provided to me indicated
diferent possible ranges for male and female patients and was
wondering how would archetypes model this issue.
This is a very similar question to another one I did some time ago
regarding normal, abnormal, dangerous, etc. ranges. But in this
case my
question refers to the possible values the test may return.
In order to differentiate male from female ranges assertions would
need
to be introduced?
Or do you believe this is too a matter of decission support?
thank you.
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