Difference between revisions of "HCLS/ClinicalObservationsInteroperability/TermInfo"

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(example problem)
(coagulated into terminology model)
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=== coagulated into terminology model ===
 
=== coagulated into terminology model ===
  
Pole 1:  Single Observation with comma separated SNOMED codes:  wheal, ARD, LBP, severe/Grade IV, anaphylaxis <<and>> Penicillin (no Substance Administration Act)
+
Pole 1:  Single Observation with comma separated SNOMED codes:  wheal, ARD, LBP, severe/Grade IV, anaphylaxis '''and''' Penicillin (no Substance Administration Act)
  
 
One observation with this code:
 
One observation with this code:

Revision as of 18:44, 5 October 2012

Clinical data is mostly captured in a two-layer scheme where an information model expresses a network of generic things like observations, with the specifics coming from a terminology model. Many times, the information space of these two models overlaps, leading to multiple ways to express the same thing, and ambiguity about how to look for it or reason over it. (See also HL7 terminfo WG.)

example problem

Below are multiple representations of the diagnosis Grade 4 anaphylactic reaction to penicillin as evidenced by the combination of wheals (hives), acute respiratory distress (ARD) and systolic hypotension (LBP) following a penicillin injection. These are encoded in multiple syntactic forms using constructs from the HL7 Reference Information Model (RIM) and SNOMED terminology model be recognized as being semantically equivalent << if>> they are represented using Semantic Web technologies <<and>> if an ontological representation of <<both>> the RIM <<and>> SNOMED exists so that the various representations can be processed by a reasoner with access to the two ontologies. (NOTE: using standard HL7 XML serialization techniques for each of the various representations results in non-interoperable representations.)

coagulated into terminology model

Pole 1: Single Observation with comma separated SNOMED codes: wheal, ARD, LBP, severe/Grade IV, anaphylaxis and Penicillin (no Substance Administration Act)

One observation with this code:

241938005 | penicillin-induced anaphylaxis (disorder) | :
  246112005 | severity | = 423132009 | grade 4 out of 5 | ,
  363705008 | has definitional manifestation | = 247472004 | weal (disorder) | ,
  363705008 | has definitional manifestation | = 373895009 | acute respiratory distress | ,
  363705008 | has definitional manifestation | = 45007003 | low blood pressure (disorder) |

in between

Multiple Observations for wheal, ARD, LBP, additional Observation for Grade IV anaphylaxis, single Substance Administration Act with SNOMED code Penicillin

atomized into information model

Pole 2: Multiple Observations for each of: wheal, ARD, LBP, severity plus Substance Administration Act

  1. ActRelationship(isSuppBy, Observation (dx), Observation (wheal))
  2. ActRelationship(isSubbBy, Observation (dx), Observation (acute respiratory distress))
  3. ActRelationship(isSuppBy, Observation (dx), Observation (low blood pressure))
  4. ActRelationship(isDescribedAs, Observation (dx), Observation (severe))
  5. ActRelationship(hasGrade, Observation (dx), Observation (severe))
  6. SubstanceAdministration(penicillin)
  7. ActRelationship(isCausedBy, Observation (dx), SubstanceAdministration(penicillin))