RE: An argument for bridging information models and ontologies at the syntactic level

 
> [[[
> 	* Clinical care - what we do to the patient based on our
> assessments of the pathophysology of the patient
> 	*	I'm not sure if Alan is deliberately saying that this
> "clinical care" level addresses actions taken *based on*
> assessments/observations, but that assessments/observations themselves
> *do not* fall into this category, but belong elsewhere (in 
> the "record"
> category below?) 
> ]]]
> 
> My understanding is that the distinction here is between the
> characteristics of the patient (pathophysiology) and the clinical
> actions that are part of the provision of care (diagnostic actions,
> therapeutic actions, etc..).  Following this distinction, I would
> consider an assessment to belong to this category, but I would not
> consider an observation or a finding to fall in this category.  The
> former is an action (or what BFO would call a Process), the latter are
> data points recorded as a result of a clinical action.

I agree with the proposal that assessment, diagnosis belong to the domain of
clinical care.

> [[[
> 	*	Here we have a "hypertension"
> observation/finding/diagnosis. 
> 		*	A hypertension observation may be a subclass of
> a more generic "observation" 
> 			*	It *makes reference to* the
> "hypertension" of the pathophysiologic realm above, but is not
> equivalent to that hypertension. 
> ]]]
> 
> Yes, this separation is critical IMHO.  Findings, diagnoses, 
> measurement
> data, and observations are sections of a medical record
> (representational artifacts) that are *disjoint* from what 
> they refer to
> (in the pathophysiologic realm).

Do you intend to differentiate an obsevation in the pathophysiological realm 
and the representation of that observation in a medical record?

Isn't that the difference between what is an observation and how it is
represented in a document?
So Clinical Care realm would contain models such as CCD, CDA, etc?

> [[[
> 	* The record of that care and those assessments
> 	*	At this level, the hypertension record and the heart
> rate record speak of RIM- or Archetype- or Clinical Element
> Model-specific data structures. 
> 		*	It models from data capture/data exchange/data
> retrieval use cases, which differs from the above levels 
> 			*	e.g., it allows a heart rate measurement
> without a measurement location, even though in reality every 
> heart rate
> measurement is taken from some location. 
> 		*	Significantly, it is here that codes and code
> systems are introduced -- the records reference these codes and code
> systems, which as Alan says are "meta" to the pathophysiology realm
> above, i.e., they're data structures that attempt to represent that
> realm. 
> ]]]
> 
> I agree, however, with the caveat that I would group observations,
> measurement data, and findings here (as a record of care and in the
> realm of information models such as RIM, Archetypes, etc..).  The term
> measurements is a bit ambiguous, so I wonder if what you had 
> in mind was
> the process (or action) of measurement or the resulting data.   


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Received on Wednesday, 16 April 2008 15:33:00 UTC