Seeking clarification regarding Assumed value

Ian McNicoll ian at freshehr.com
Tue Oct 9 06:05:41 EDT 2018


Thanks Sebastian,

You summarised my views much better than me.

As policy, I think we should stop using it for future archetypes, and
simply use the metadata to declare 'assumptions' where they make sense,
although I agree it is very risky to assert 'x' where data is simply
missing.

Ian

Dr Ian McNicoll
mobile +44 (0)775 209 7859
office +44 (0)1536 414994
skype: ianmcnicoll
email: ian at freshehr.com
twitter: @ianmcnicoll


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


On Tue, 9 Oct 2018 at 10:29, Sebastian Garde <
sebastian.garde at oceaninformatics.com> wrote:

> Assumed value was a slick idea at the time, but I do agree with your
> sentiments now:
>
>    - it is hardly or not at all processable,
>    - where there is widespread consensus on something it may well be
>    assumed automatically by clinicians – but this is not because someone put
>    the assumed value in the archetype or not.
>    - Elements where such consensus exists across professions/sectors are
>    probably rare anyway and universal consensus on an assumption is hard to
>    ascertain
>    - challenges for UI
>    - challenges for querying (assuming you even dare)
>    - challenges for anybody to understand it, including the difference to
>    a default value (and what happens if there is both).
>
>
>
> Not sure about the implications for dropping/deprecating this at this stage
>
>
>
> Sebastian
>
>
>
> *Von:* openEHR-technical <openehr-technical-bounces at lists.openehr.org> *Im
> Auftrag von *Ian McNicoll
> *Gesendet:* Montag, 8. Oktober 2018 14:43
> *An:* For openEHR clinical discussions <openehr-clinical at lists.openehr.org
> >
> *Cc:* For openEHR technical discussions <
> openehr-technical at lists.openehr.org>
> *Betreff:* Re: Seeking clarification regarding Assumed value
>
>
>
> I asked for this to be changed as we had dropped inspired oxygen into a
> cluster archetype (intended to sit in state and wanted to be able to state
> the assumed value of 23% (or whatever).
>
>
>
> I have come round to thinking that Assumed value is actually unhelpful. It
> is only a statement on the archetype and never ends up in the data, and
> completely non-processable. I think it can be easily misunderstood and is
> often very difficult to assert reliably. I would not be unhappy it see it
> dropped.
>
>
>
> We will however definitely need default values in specialisations e.g the
> lab series.
>
>
>
> Ian
>
>
>
>
>
> Ian
>
>
>
>
> Dr Ian McNicoll
> mobile +44 (0)775 209 7859
> office +44 (0)1536 414994
> skype: ianmcnicoll
> email: ian at freshehr.com
> twitter: @ianmcnicoll
>
>
>
> Co-Chair, openEHR Foundation ian.mcnicoll at openehr.org
>
> Director, freshEHR Clinical Informatics Ltd.
> Director, HANDIHealth CIC
> Hon. Senior Research Associate, CHIME, UCL
>
>
>
>
>
> On Mon, 8 Oct 2018 at 13:23, Peter Gummer <peter.gummer at gmail.com> wrote:
>
> > On 8 Oct 2018, at 23:09, Peter Gummer <peter.gummer at gmail.com> wrote:
> >
> > ...Attached to this email is the CLUSTER that Ian attached to the Jira
> issue.
>
> Hmmm, I don’t think this mailing list accepts attachments. Here is the
> CLUSTER as ADL.
>
> Peter
>
>
> archetype (adl_version=1.4)
>         openEHR-EHR-CLUSTER.ambient_oxygen.v1
>
> concept
>         [at0000]        -- Ambient oxygen
> language
>         original_language = <[ISO_639-1::en]>
>         translations = <
>                 ["de"] = <
>                         language = <[ISO_639-1::de]>
>                         author = <
>                                 ["organisation"] = <"University of
> Heidelberg, Central Queensland University">
>                                 ["name"] = <"Jasmin Buck, Sebastian Garde">
>                         >
>                 >
>         >
> description
>         original_author = <
>                 ["name"] = <"Ian McNicoll">
>                 ["organisation"] = <"Ocean Informatics">
>                 ["email"] = <"ian.mcnicoll at oceaninformatics.com">
>                 ["date"] = <"08/06/2009">
>         >
>         details = <
>                 ["en"] = <
>                         language = <[ISO_639-1::en]>
>                         purpose = <"To record the amount of oxygen being
> delivered to the subject at the time of observation.  Assumed values of 21%
> O2, Fi02 of 0.21 and Oxygen flow rate of zero.">
>                         use = <"May be used within an ACTION archetype to
> specificy oxygen therapy , or within OBSERVATION archetypes such as Blood
> gases or Respirations, as part of patient state, where knowledge of ambient
> oxygen status is critical to interpretation of the observation.
>
>
> ">
>                         keywords = <"breathing", "oxygen">
>                         misuse = <"">
>                         copyright = <"copyright (c) 2009 openEHR
> Foundation">
>                 >
>         >
>         lifecycle_state = <"AuthorDraft">
>         other_contributors = <"Heather Leslie Ocean Informatics",
> "Sebastian Garde Ocean Informatics", "Andrew James University of Toronto",
> "Sundarasan Jaganathan NHS Scotland", "Omer Hotomargolu Turkey", "Marja
> Buur Medisch Centrum Alkmaar Netherlands", "Gregory Caulton PatientOS
> Inc.", "Anne Harbison CPCER", "Sam Heard Ocean Informatics">
>         other_details = <
>                 ["references"] = <"">
>                 ["MD5-CAM-1.0.1"] = <"1FCF286B5D47164C5D89907DF332BC65">
>         >
>
> definition
>         CLUSTER[at0000] matches {       -- Ambient oxygen
>                 items cardinality matches {0..*; unordered} matches {
>                         ELEMENT[at0051] occurrences matches {0..1} matches
> {    -- Oxygen flow rate
>                                 value matches {
>                                         C_DV_QUANTITY <
>                                                 property = <[openehr::126]>
>                                                 list = <
>                                                         ["1"] = <
>                                                                 units =
> <"l/m">
>                                                                 magnitude
> = <|0.0..50.0|>
>                                                                 precision
> = <|1|>
>                                                         >
>                                                         ["2"] = <
>                                                                 units =
> <"ml/min">
>                                                                 magnitude
> = <|0.0..50000.0|>
>                                                                 precision
> = <|1|>
>                                                         >
>                                                 >
>                                                 assumed_value = <
>                                                         magnitude = <0.0>
>                                                         units = <"l/m">
>                                                         precision = <1>
>                                                 >
>                                         >
>                                 }
>                         }
>                         ELEMENT[at0052] occurrences matches {0..1} matches
> {    -- FiO2
>                                 value matches {
>                                         DV_PROPORTION matches {
>                                                 numerator matches
> {|0.0..1.0|}
>                                                 is_integral matches {False}
>                                                 type matches {1}
>                                         }
>                                 }
>                         }
>                         ELEMENT[at0053] occurrences matches {0..1} matches
> {    -- Percent O2
>                                 value matches {
>                                         DV_PROPORTION matches {
>                                                 numerator matches
> {|0.0..100.0|}
>                                                 is_integral matches {False}
>                                                 type matches {2}
>                                         }
>                                 }
>                         }
>                 }
>         }
>
> ontology
>         term_definitions = <
>                 ["de"] = <
>                         items = <
>                                 ["at0000"] = <
>                                         text = <"*Ambient oxygen(en)">
>                                         description = <"*The amount of
> oxygen being delivered to the subject at the time of observation.  Assumed
> values of 21% O2, Fi02 of 0.21 and Oxygen flow rate of zero.(en)">
>                                 >
>                                 ["at0051"] = <
>                                         text = <"*Oxygen flow rate(en)">
>                                         description = <"*Flow rate of
> inspired oxygen.(en)">
>                                 >
>                                 ["at0052"] = <
>                                         text = <"*FiO2(en)">
>                                         description = <"*Fraction of
> inspired oxygen.(en)">
>                                 >
>                                 ["at0053"] = <
>                                         text = <"*Percent O2(en)">
>                                         description = <"*Percentage of
> inspired oxygen.(en)">
>                                 >
>                         >
>                 >
>                 ["en"] = <
>                         items = <
>                                 ["at0000"] = <
>                                         text = <"Ambient oxygen">
>                                         description = <"The amount of
> oxygen being delivered to the subject at the time of observation.  Assumed
> values of 21% O2, Fi02 of 0.21 and Oxygen flow rate of zero.">
>                                 >
>                                 ["at0051"] = <
>                                         text = <"Oxygen flow rate">
>                                         description = <"Flow rate of
> inspired oxygen.">
>                                 >
>                                 ["at0052"] = <
>                                         text = <"FiO2">
>                                         description = <"Fraction of
> inspired oxygen.">
>                                 >
>                                 ["at0053"] = <
>                                         text = <"Percent O2">
>                                         description = <"Percentage of
> inspired oxygen.">
>                                 >
>                         >
>                 >
>         >
>
>
>
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