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RE: Follow up: Clinical Observations Interoperability Telcon @ Tue Oct 30

From: Forsberg, Kerstin L <Kerstin.L.Forsberg@astrazeneca.com>
Date: Sun, 4 Nov 2007 23:22:10 +0100
Message-ID: <00EF518168DD14409AA8DB92601D87360175B398@SEMLRDEMBX02.rd.astrazeneca.net>
To: "Kashyap, Vipul" <VKASHYAP1@PARTNERS.ORG>, "Alan Ruttenberg" <alanruttenberg@gmail.com>
Cc: <public-hcls-dse@w3.org>

I am getting lost now - different levels, data model vs information model, ontological and epistemological issues,  "degenerated" domain ontologies, ..., ...

Alan: I trust you insights and ideas. Regardless of the issues with SDTM, DCM, NCIt etc., how would you like to setup a scenario "from a blank paper" in which we can enable secondary use of health care data for different purpose, including formal reasoning? 
 
Regards
Kerstin


-----Original Message-----
From: Kashyap, Vipul [mailto:VKASHYAP1@PARTNERS.ORG]
Sent: 4 november 2007 22:56
To: Forsberg, Kerstin L; Alan Ruttenberg
Cc: public-hcls-dse@w3.org
Subject: RE: Follow up: Clinical Observations Interoperability Telcon @
Tue Oct 30



Kerstin,

The issue you bring up here is related to the confounding of ontological and
epistemological issues in clinical and other ontologies as pointed out by Barry
Smith.

> > The domain level
> > corresponds to actual things that happen to patients. The statement
> > level corresponds to observations, and the record level corresponds
> > to information model.

[VK] "actual things that happen" is indicative an ontological perspective.
Observations correspond to what physicians know (or do not know) about patients
based on those actual things and hence are indicative of an epistemological
perspective.

> Kerstin: Thanks Alan for the reference to an intersting paper. I do think
> I understand the distinction you make between these three different levels
> and how to apply them in clinical informatics.

[VK] The crucial issue here is: does this have any impact on the design of an
information system? I would believe the separation between the record level
(which I call the data model) and the statement/domain level (which I call the
information model) is important. It will be great if we can identify concrete
use cases in our current effort to show the value of distinguishing between
these various perspectives.

> - To what level belong in your mind the model of "blood pressure
> observation, another real-world phenomenon, but of an entirely different
> sort [than your blood pressure itself]" that Barry outlines in one of the
> postings on his HL7Watch blog 1)? Domain or Statement level?

[VK] Here's an attempt at answering this question (Alan might differ)
- Blood Pressure Phenomena = Ontological Entity (Domain Level)
- Blood Pressure Observation = Epistemological Entity (Statement + Domain as it
refers to the Blood Pressure Phenomena)

- When both these are mapped into an implementation using tables as in the SDTM,
then we have an "implementation" at the record level...

Look forward to comments and feedback on this.

---Vipul


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Received on Sunday, 4 November 2007 22:22:25 UTC

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