design description of lab archetypes

Thomas Beale thomas.beale at openehr.org
Fri Jul 14 09:22:39 EDT 2017



On 13/07/2017 19:02, GF wrote:
> Hi,
>
> Panels have a specific name

Stan tells me that LOINC can code most/all standard panels.

> And can have an associated result describing the panel as a whole.
> Plus context data pertaining to the panel and all its items.
> E.g. /Haematology panel: normal./
> Both the /Panelresult/ and the results of the individual items can to 
> be queried.

there is a linguistic thing going on here where we use the word 'panel' 
to mean two things:

  * something like 'battery result', e.g. the set of analyte test
    results for a complete blood test (maybe 10 things), plus the
    overall test meta-data, interpretation and so on
  * just a group of items, e.g. the 10 CBC items.

I'd like to see a better agreement on the real meaning of this word. Or 
maybe it is just me who needs a better understanding.


>
> Remarks:
> - The individual /Itemresults/ are the result of a process and 
> therefor Observations (ENTRIES)

It has not been modelled like this, but scientifically it's a reasonable 
view. It's a bit heavy in terms of information structures though. I'm 
inclined to still allow grouping of analytes in a single Observation for 
practical reasons - e.g. at least for groups of analytes that are 
obtained by the same method, etc. But the more I learn about path lab 
results, maybe it is worth revisiting this question.

> - The /Panelresult/ is the result of an EVALUATION

I'm not sure I agree on this, unless you are talking about the a data 
point like 'pathological interpretation' but I think this has to be 
understood not as a Dx on the patient but a standard Dx that should be 
inferred from the path value e.g. high Potassium => possible kidney 
compromise. I have no expertise in this, so could be wrong, but from a 
common sense point of view, I don't see how a lab can provide a Dx on 
the actual patient without examining the patient history / EHR.

I don't think 'normal' should be understood as an evaluation on the 
patient - it's just the lab saying: all the analytes are within normal 
ranges for the patient type (adult male or whatever).

Interested to know if others disagree violently...!

- thomas

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