HL7 and negation

Grahame Grieve grahameg at gmail.com
Sat Jun 11 06:44:17 EDT 2016

> Aside: apparently the FHIR approach to representing things like 'no known allergies' is to infer it by seeing if an allergies list is empty or not. That sounds like a bad idea to me. If 'no known allergies' is understood as a clinically meaningful statement made by e.g. a GP (based on reliable knowledge about the patient), checking for a list being empty in some EMR system isn't at all the same thing. All that latter does is establish that no allergies have been recorded on this particular system.

Well, that would be a bad idea. But that's ok because that's not what we do ;-)

There is a specific flag on list for noting the clinically meaningful statement, but what we've found is that almost all systems treat the statement of no allergies in an allergy record as an explicit statement 

Btw, I don't think that the statement of no allergy is a case of a negation statement

> - thomas
>> On 08/06/2016 07:54, GF wrote:
>> Dear Colleagues,
>> HL7 is thinking about the problem of negation.
>>  http://wiki.hl7.org/index.php?title=Negation_Requirements
>> The group discussing it created a document with negation use cases.
>> My questions are:
>> - Can you let us know your reaction to this list of use cases?
>> And
>> - How should ‘negation’ be handled the best in respect of semantic interpretability?
>> My personal opinions:
>> - the boolean should not be used
>> - try to translate the ‘negation’ problem into ‘presence and absence’. A concept is or is not present, a numeric result is of is not present.
>> - do not use pre- and post co-ordinated concepts using SNOMED but use the SNOMED primitives.
>> I’m curious to learn what your opinion is.
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