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

> [AR] I don't know if you've had a look at a short paper I was a coauthor  
> on [1]. In it we distinguish between the record level, the statement  
> level, and the domain level. I think that the situation in clinical  
> informatics might be similarly partitioned. 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.

> [1]

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. 

- 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? 


1) "... one confuses real-world phenomena (which might make you sick) with information captured during the observation of such phenomena which sits inside computers."

"On the one hand there is your blood pressure itself, the real-world phenomenon which obeys the laws described in a medical textbook (which will tell you about systemic arterial pressure, about systolic and diastolic phases, about fluid dynamics, etc., etc. complicated physics and physiology that will be of practical importance e.g. when designing an instrument that can accurately measure blood pressure or when dealing with a patient who has atrial fibrillation). On the other hand there is a blood pressure observation, another real-world phenomenon, but of an entirely different sort, involving factors such as:

- the position of the patient at the time of measuring (sitting, lying, etc.), 
- the tilt of the surface on which the person is lying, 
- the variation in measured blood pressure with respiration, 
- the instrument used to measure the blood pressure, 
- the size of the cuff if a sphygmomanometer is used, 
- and so forth, as well as the units in which measurements are taken"


Received on Sunday, 4 November 2007 21:43:09 UTC