More generic reference model

Ian McNicoll ian at freshehr.com
Tue Sep 6 11:01:52 EDT 2016


Thanks Diego,

This would of considerable interest. I have a feeling that AQL and SCT
query expressions are a pretty neat fit (plus of course the validation
use-case you have mentioned).

Ian

Dr Ian McNicoll
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Co-Chair, openEHR Foundation ian.mcnicoll at openehr.org
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On 6 September 2016 at 15:57, Diego Boscá <yampeku at gmail.com> wrote:

> By the way, this kind of things you describe is one of our group main
> research areas right now. We have implemented a service to evaluate
> the Snomed Expression Constraint Syntax (engine available at
> http://snquery.veratech.es/) and we are already using it for data
> validation (e.g. is the provided code in the subset) and
> transformation/query (e.g. if diagnosis is one of X then put this
> value). I hope we can release an online demo or paper soon enough.
>
> 2016-09-03 18:34 GMT+02:00 Bert Verhees <bert.verhees at rosa.nl>:
> > On 03-09-16 18:17, Thomas Beale wrote:
> >
> > Bert,
> >
> > doing most of what you want should come in AQL, e.g. the following in a
> > WHERE clause is already possible.
> >
> > SELECT
> >     e/ehr_status/subject/external_ref/id/value,
> > diagnosis/data/items[at0002.1]/value
> > FROM
> >     EHR e
> >         CONTAINS Composition c[openEHR-EHR-COMPOSITION.problem_list.v1]
> >             CONTAINS Evaluation
> > diagnosis[openEHR-EHR-EVALUATION.problem-diagnosis.v1]
> > WHERE
> >     c/name/value='Current Problems'
> >     AND diagnosis/data/items[at0002.1]/value/defining_code matches {
> > http://snomed.info/id/42570301000090487|cancer Dx refset|}
> >
> >
> > That is a very OpenEHRish way to do it, is comparing the code.
> >
> > But what if you also want to find the subtypes, lungcancer (30
> sub-types),
> > etc, if you want to know about SNOMED attributes.
> > For that purpose is the Expression Constraint language, and you need to
> > query the terminology to know what you need to compare your data with.
> >
> > The best way to do it is not invent another way to do it, but embed that
> > language.
> > http://doc.ihtsdo.org/download/doc_ExpressionConstraintLanguageSp
> ecificationAndGuide_Current-en-US_INT_20150820.pdf
> > When that is done well, you have the full power in one move.
> >
> > One interesting question is whether 'inline' refset definitions would be
> > allowed, e.g. using the SNOMED constraint grammar. We probably should add
> > this to AQL as a plug-in syntax, since IHTSDO standardised it. What the
> > solution is for ICDx I don't know.
> >
> >
> > I don know either.
> >
> > There is more then just a plugin which does some separate work. Because
> the
> > ECL also works on subtypes and attributes, and the attributes are not
> > available. AQL must deliver them to the SNOMED engine, because they are
> on
> > another path. There is code infrastructure needed.
> >
> > For example: Find systolics higher then 165, in the archetype the type of
> > the measurement can be in another element then the value of the
> measurement.
> > This mapping between SNOEMD attributes and where they are in the
> archetypes
> > must be done in some elegant way.
> >
> > The main thing to understand is that if a SNOMED or ICD code for say
> > leukaemia is found in EHR data, the code alone doesn't tell you the
> > epistemic status, i.e. the kind of statement being made - i.e. current
> > diagnosis, no risk of, risk of, fear of ... etc. Querying properly means
> > understanding where in the data you are looking, and the archetypes help
> > with that.
> >
> >
> > That will be one of the added values of archetypes.
> >
> > Bert
> >
> > _______________________________________________
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