openEHR Clinical Knowledge Manager

Updated archetype: Symptom (openEHR-EHR-CLUSTER.symptom.v1)

ian.mcnicoll — Sun, 15 Apr 2012 10:40:47

An archetype has been updated: Symptom (openEHR-EHR-CLUSTER.symptom.v1)
Log message: Corrected errors due to duplicate at-codes in ar-sy translation.

New comment: Party Relationships Slot

heath.frankel — Tue, 10 Apr 2012 03:27:39

A new comment has been posted by heath.frankel:
Party Relationships Slot
The Third Party Payer and Patient Relationships only allow an identifier element associated with these relationship, there are likely to be additional details that need to be represented in certain circumstances. This could be done using either a Item slot with the details structure, but I would suggest that having a slot for Party Relationships would allow us to use specialised party relationship archetypes and add additional relationships as required.

New comment: Re: Re: Re: Strange characters on some atxxxx

ian.mcnicoll — Tue, 03 Apr 2012 09:14:38

A new comment has been posted by ian.mcnicoll:
Re: Re: Re: Strange characters on some atxxxx
I have no idea what happened there. I have removed the weird characters and uploaded the new archetype (along with credit to Diego) + some other minor stylistic changes.

Updated archetype: Microscopic findings - Breast cancer (openEHR-EHR-CLUSTER.microscopy_breast_carcinoma.v1)

ian.mcnicoll — Tue, 03 Apr 2012 09:12:28

An archetype has been updated: Microscopic findings - Breast cancer (openEHR-EHR-CLUSTER.microscopy_breast_carcinoma.v1)
Log message: Correction of corrupt characters and content style errors. No significant change of content. Updated other contributors of the archetype.

New comment: Re: Re: Strange characters on some atxxxx

diego.bosca — Tue, 03 Apr 2012 09:07:18

A new comment has been posted by diego.bosca:
Re: Re: Strange characters on some atxxxx
yeah, the same happened in LinkEHR. When I was looking through the archetype I saw the '1075%' and went to the CKM to get the unaltered version. Weird thing is that Java supposedly supports UTF8, so no clue why this character is not printing well

New comment: Re: Re: Strange characters on some atxxxx

sebastian.garde — Tue, 03 Apr 2012 09:03:57

A new comment has been posted by sebastian.garde:
Re: Re: Strange characters on some atxxxx
Ah, Ian bet me to it. But I think there is a problem of some sort with Ian's way of writing a "-", which then is displayed as this character or not at all. Maybe the font used here doesn't support Ian's (Mac's) way of coding a "-" ??

New comment: Re: Strange characters on some atxxxx

sebastian.garde — Tue, 03 Apr 2012 09:01:39

A new comment has been posted by sebastian.garde:
Re: Strange characters on some atxxxx
Hi Diego, That's one weird character. 1075% of invasive carcinoma forming tubular or glandular structures. In the archetype editor, this appears as "10- 75%" before you click on it, and once you click on it displays as "1075%" Maybe Ian can shed some light whether there is a problem in CKM or if this is a problem in the original archetype. Cheers Sebastian

New comment: Re: Re: Strange characters on some atxxxx

diego.bosca — Tue, 03 Apr 2012 08:59:04

A new comment has been posted by diego.bosca:
Re: Re: Strange characters on some atxxxx
For some reason I still see the same character on your reply (but not on the email notification... weird)

New comment: Re: Strange characters on some atxxxx

ian.mcnicoll — Tue, 03 Apr 2012 08:56:01

A new comment has been posted by ian.mcnicoll:
Re: Strange characters on some atxxxx
Hi Diego, I think these are just typos, missing '-' in both cases Should be ["at0045"] = < text = <"Tubular formation score 2"> description = <"10-75% of invasive carcinoma forming tubular or glandular structures."> > ["at0047"] = < text = <"Grade 1"> description = <"Total score of 3-5."> >

New comment: Strange characters on some atxxxx

diego.bosca — Tue, 03 Apr 2012 08:42:26

A new comment has been posted by diego.bosca:
Strange characters on some atxxxx
looking at some text and description of this archetype seems that some characters show up wrong. this is the case of at0045 and at0047. ["at0045"] = < text = <"Tubular formation score 2"> description = <"1075% of invasive carcinoma forming tubular or glandular structures."> > ["at0047"] = < text = <"Grade 1"> description = <"Total score of 35."> > I suppose wrong character is '< >' or something similar

New comment: Relationships slot

heath.frankel — Mon, 26 Mar 2012 02:04:45

A new comment has been posted by heath.frankel:
Relationships slot
It is likely that we will want to specify additional relationship details elements, so it would be better to provide a slot for archetyped PARTY_RELATIONSHIP and provide a generic archetype. The Type element specified in this PARTY_RELATIONSHIP details structure should be represented using the existing Type attribute of PARTY_RELATIONSHIP.

New comment: Use DV_IDENTIFIER

heath.frankel — Mon, 26 Mar 2012 01:36:18

A new comment has been posted by heath.frankel:
Use DV_IDENTIFIER
As is done in the person_identifier cluster, and Identifier element should be provided as type of DV_IDENTIFIER rather than have its individual attributes represented as separate elements.

New comment: Name Identifier element

heath.frankel — Mon, 26 Mar 2012 01:24:59

A new comment has been posted by heath.frankel:
Name Identifier element
I am assuming the identifier element in the Organisation name PARTY_IDENTITY details is intended to describe the type of organisation name, suc as trading name, business name, company name etc. The existing Type attribute should be used for this rather than an archetyped element.

New comment: 'Ttumour' Typo

diego.bosca — Tue, 20 Mar 2012 12:33:02

A new comment has been posted by diego.bosca:
'Ttumour' Typo
There is a typo on one of the descriptions of the codes from 'Marginal involvement'. Description from 'present' code should be 'Tumour' and not 'Ttumour'

New comment: Spoken Language

heath.frankel — Tue, 20 Mar 2012 12:11:36

A new comment has been posted by heath.frankel:
Spoken Language
There should be somewhere to record the language a person normal speaks. Another common field is an indicator that an intepreter is required.

New comment: Re: MultiMedia

ian.mcnicoll — Mon, 19 Mar 2012 01:22:46

A new comment has been posted by ian.mcnicoll:
Re: MultiMedia
Hi Leysan, The answer is Yes. The DV_MULTIMEDIA data type supports storing both an embedded image or a link to that image. Remember that what you see in the Archetype or Template Editor is only a subset of what may be available to you via the Reference model The browsable UML pages are a good way of getting to grips with the Reference model, particularly if you have a technical background. http://www.openehr.org/uml/release-1.0.1/Browsable/_9_0_76d0249_1109067811717_939588_3517Report.html Ian

New comment: MultiMedia

leysan.sabiryanova — Mon, 19 Mar 2012 12:28:38

A new comment has been posted by leysan.sabiryanova:
MultiMedia
Hello. Is there any possibility to embed multimedia in the template (image, for example)? I can use "Add -> New Element -> MultiMedia" in the Archetype Editor, but I don't understand it's meaning. Thank you, Leysan

New comment: Re: Re: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.

katarina.kralj — Mon, 19 Mar 2012 12:09:40

A new comment has been posted by katarina.kralj:
Re: Re: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.
Had I known the replies on CKM form are as fast as the bullet,I would have used this general discussion before and get answers to all of my questions...;) Thank you both. I have sent an Ian a image of the sheet for diabetic foot exam as used in Slovenia. I hope you'll find it useful. Our team at this point is two IT guys (and one guy is a woman) so we don't really have a lot of input from the medical world. We are cooperating with a GP that can give us a more insight in this. Do you think that this would basically be a very elementary archetype - a bit like BMI (we did something like that) or is the information about the exact location and the type o device, the state of patient also important. Heather's idea that this is basically two blood pressures on two locations is OK but we want to tie them together with a bow and maybe add fields for evaluation - what is Ok and what is not..... Tipically this can be measured by a nurse and a doctor is only interested in the final score (the ratio). If you think that our involvement could be helpful, we definitely are willing to give it a try......

New comment: Re: Re: Multiple observation

ian.mcnicoll — Mon, 19 Mar 2012 09:48:42

A new comment has been posted by ian.mcnicoll:
Re: Re: Multiple observation
Hi Katarina, One thing that is not clear from the Archetype Editor, is that elements which are modelled in Data and State, are actually child elements of each Event. One way to make this clearer is to drag-drop the blood glucose archetype into the Template Designer, where the correct relationships are shown. You can also right-click on the 'Any Event' node and clone it to produce a series events, such as 'Fasting', 'One Hour' , 'Two hour. etc. This is how the various stages in an OGTT would actually be captured. Don't worry if this seems confusing, modelling OGTT is actually about as complex as it gets because of the varying combinations of Event times, patient state and different glucose loading regimes. Ian

New comment: Re: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.

ian.mcnicoll — Mon, 19 Mar 2012 09:42:31

A new comment has been posted by ian.mcnicoll:
Re: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.
Hi Katarina, I see Heather has beaten me to it!! I am sure there would be interest in co-developing an archetype for diabetic foot examination. I have certainly does some preparatory mind-mapping of this based on UK standards and it would be interesting to compare these with Slovenian standard practice. I think you might be surprised at the level of difference in 'standard' clinical practice!! Do you have a document which describes the Slovene standards? As Heather says, we feel that pressure difference calculations really require a new archetype http://en.wikipedia.org/wiki/Ankle_brachial_pressure_index Would your team be interested in leading this? I/we would be happy to back you up with advice/ editorial input.

New comment: Re: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.

heather.leslie — Mon, 19 Mar 2012 09:24:08

A new comment has been posted by heather.leslie:
Re: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.
Hi again Katarina - I have responded separately on the glucose archetype discussion. Specific feet related archetypes have not been developed to my knowledge. To be consistent with current modelling I would anticipate using the CLUSTER.inspection, CLUSTER.palpation family of archetypes nested within the OBS.exam entry archetype as the underlying pattern. The Blood Pressure archetype is designed for all BP measurement use cases. It is possible to record Systolic and Diastolic pressures at different anatomical locations. The ration is not included as it is an additionl concept (similar in nature to the relationship of BMI with hieght and weight - all separate archetypes) Does that make sense? Regards Heather

New comment: Re: Multiple observation

heather.leslie — Mon, 19 Mar 2012 09:20:03

A new comment has been posted by heather.leslie:
Re: Multiple observation
Hi Katarina, This archetype has been designed to cater for all use cases for a glucose measurement, including Glucose Challenges and Glucose Tolerance tests. Check out the State within this archetype - it has the ability to record the glucose load. Specific times event can be derived from the 'Any event' at run-time. Take another look. The intent is that it will cater for the requirements for this whole family of tests. It is very likely that this archetype and all related lab tests will be reviewed in the future in accordance with the reviews and evolution of the same generic Pathology Test OBS parent archetype on the NEHTA CKM - http://openehr.org/knowledge/OKM.html#showarchetype_1013.1.564 Hope this helps Heather

New comment: Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.

katarina.kralj — Mon, 19 Mar 2012 08:40:34

A new comment has been posted by katarina.kralj:
Blood glusoce, Diabetic foot and Blood pressure - arm/ankle ratio.
Hello everybody. I'm trying to find archetypes that would cover: 1. a test (it's called OGTT test in Slovenia) that would cover the initial measurement of blood glucose, a patient then drinks a certain amount (50g) of glucose (in water), measurements of glucose are then repeated at a certain time offset (1 hour, 2hours, 3 hours..). Glucose levels at a certain time are an important information for the clinicians. 2. a test for a foot inspection that is done regularly to diabetic patients in order to early catch all the changes and prevent serious damage. It's a pretty structured test and I find it hard to believe that no one has done an archetype already. 3. An archetype that covers th investigation where blood pressure is measured ata arm and again at an ankle. The ratio is calculated, if it doesn't exceed 0.9, then it is a good indicator of a certain disease (peripheral oclusion...). Can anyone help me with suggestions. Thank you in advance.

New comment: Multiple observation

katarina.kralj — Mon, 19 Mar 2012 08:32:04

A new comment has been posted by katarina.kralj:
Multiple observation
As far as I can see, this archetype can not be used to capture data about an OGTT test (it's called so in Slovenia). The procedure for this test is is: 1. measure the glucose level in blood of patient 2. patient drinks a certain amount of glucose 3. glucose level s masured at a certain time offset (exactly one hour later, two hours later,three hours later) one or more times. 4. Blood guoselevel after a certain time is important for the clinician to possibly discover glucose inolerance or other conditions of the patient. Is there already a special archetype that can cover that or should we do it by ourselves... Thank you for your answers...

New comment: Re: Re: Re: Re: Re: Re: Re: Multiple dates of birth

heath.frankel — Fri, 16 Mar 2012 10:51:15

A new comment has been posted by heath.frankel:
Re: Re: Re: Re: Re: Re: Re: Multiple dates of birth
I agree, I think using the element name is sufficient to record the type or source of additional birth dates

New comment: Re: Re: Re: Re: Re: Re: Multiple dates of birth

ian.mcnicoll — Fri, 16 Mar 2012 07:33:05

A new comment has been posted by ian.mcnicoll:
Re: Re: Re: Re: Re: Re: Multiple dates of birth
Thanks Chunlan, I would prefer to keep it simpler. Alternative date of birth can always be renamed as part of specialisation or templating. I am not sure that many of these alternative dates will have any kind of formal type. Ian

New comment: Re: Re: Re: Re: Re: Multiple dates of birth

chunlan.ma — Fri, 16 Mar 2012 01:22:50

A new comment has been posted by chunlan.ma:
Re: Re: Re: Re: Re: Multiple dates of birth
I would suggest to have a CLUSTER (Other birth data) in "Birth data" cluster. The "Other birth data" cluster may have two ELEMENTS: one is other birth date and the other one is type of other birth date. Thoughts?

New comment: Identities, relationships, contacts and addresses occurrences are limited to 1..1

heath.frankel — Wed, 14 Mar 2012 10:33:01

A new comment has been posted by heath.frankel:
Identities, relationships, contacts and addresses occurrences are limited to 1..1
We need to be able to represent multiple identities, relationships, contacts and address so we need to allow accurrences > 1

New archetype: Nine Hole Peg Test (openEHR-EHR-OBSERVATION.nine_hole_peg_test.v1)

michael.braun — Thu, 08 Mar 2012 05:58:32

A new archetype has been uploaded: Nine Hole Peg Test (openEHR-EHR-OBSERVATION.nine_hole_peg_test.v1)
Log message: Initial Upload

Updated archetype: Timed 25-Foot Walk (openEHR-EHR-OBSERVATION.timed_25_foot_walk.v1)

michael.braun — Thu, 01 Mar 2012 02:22:25

An archetype has been updated: Timed 25-Foot Walk (openEHR-EHR-OBSERVATION.timed_25_foot_walk.v1)
Log message: Changes made after review round 1. Updated other contributors of the archetype.

New comment: Re: Re: Re: Re: Re: Multiple dates of birth

heath.frankel — Mon, 20 Feb 2012 05:53:45

A new comment has been posted by heath.frankel:
Re: Re: Re: Re: Re: Multiple dates of birth
The "alternative date of birth" (or "other dates of birth") was the kind of solution I had imagined, as I originally stated, there is a registration date of birth that is consider the most official/legal date but then others that are used by the subject on various occassions perhaps in other systems in a distributed/shared environment. I had considered a type of date of birth but initially I think we just need an optional description as you have suggested, my requirement doesn't have any such description although one could possibly be synthesises based on the source system

New comment: Re: Re: Re: Re: Multiple dates of birth

heath.frankel — Mon, 20 Feb 2012 05:45:24

A new comment has been posted by heath.frankel:
Re: Re: Re: Re: Multiple dates of birth
The later comment is more the kind of feedback I am looking for.

New comment: Re: Re: Re: Re: Multiple dates of birth

ian.mcnicoll — Fri, 17 Feb 2012 10:11:02

A new comment has been posted by ian.mcnicoll:
Re: Re: Re: Re: Multiple dates of birth
Interesting! I understand Heath's problem and I think that is it very likely to be a much wider issue than just Australia, so I do think we need to tackle it in this international archetype. OTOH I agree with Diego's concern that simple making Date of Birth multiple is potentially misleading, since I would think that in most circumstances an institution or service provider will want to settle on one 'official' Date of Birth' as part of the the patient's identification for clinical safety purposes. Perhaps the answer is to add an 'Alternative Date of Birth' element 0..* with a description to explain the usage. This would meet both requirements,I think. Ian

New comment: Re: Re: Re: Multiple dates of birth

diego.bosca — Fri, 17 Feb 2012 09:04:18

A new comment has been posted by diego.bosca:
Re: Re: Re: Multiple dates of birth
I would bet here that the clinical knowledge is that you can only be born once. There is already an slot for country specific data

New comment: Re: Re: Multiple dates of birth

heath.frankel — Fri, 17 Feb 2012 08:43:49

A new comment has been posted by heath.frankel:
Re: Re: Multiple dates of birth
No, none of the dates of birth are considered wrong, this is why we need to record them all.

New comment: Re: Multiple dates of birth

diego.bosca — Fri, 17 Feb 2012 08:32:47

A new comment has been posted by diego.bosca:
Re: Multiple dates of birth
So, an archetype with only one birth date would allow you to check if patient data is wrong and allow you to solve that situation

New comment: Multiple dates of birth

heath.frankel — Fri, 17 Feb 2012 08:06:07

A new comment has been posted by heath.frankel:
Multiple dates of birth
In an Australian jursidiction with a high indigenous population it necessary to record multiple dates of birth, for whatever reason it is common for a different date of birth to be provided at different healthcare presentations. In a shared health record environment, although it is preferred to have a single registration date of birth, additional dates need to be tracked when contributions are received from feeder systems which may have a different date of birth registered.

New comment: Re: Re: Loading error

andrej.zlender — Thu, 09 Feb 2012 11:19:07

A new comment has been posted by andrej.zlender:
Re: Re: Loading error
thx Andrej

New comment: Re: Loading error

ian.mcnicoll — Thu, 09 Feb 2012 11:09:28

A new comment has been posted by ian.mcnicoll:
Re: Loading error
Hi Andrej, The Ocean archetype editor does not support Demographic class archetypes. You can use the LinkEHR editor at linkehr.com Ian

New comment: Loading error

andrej.zlender — Thu, 09 Feb 2012 11:02:49

A new comment has been posted by andrej.zlender:
Loading error
When I open Archetype I get: Error loading: ITEM_STRUCTURE = PARTY_IDENTITY -- > ITEM_TREE

New archetype: Fetal Heart Monitoring (openEHR-EHR-OBSERVATION.fetal_heart-monitoring.v1)

heather.leslie — Wed, 25 Jan 2012 12:44:32

A new archetype has been uploaded: Fetal Heart Monitoring (openEHR-EHR-OBSERVATION.fetal_heart-monitoring.v1)
Log message: Initial Upload

New archetype: Fetal Heart Rate (openEHR-EHR-OBSERVATION.fetal_heart.v1)

heather.leslie — Wed, 25 Jan 2012 12:05:17

A new archetype has been uploaded: Fetal Heart Rate (openEHR-EHR-OBSERVATION.fetal_heart.v1)
Log message: Initial upload

Updated archetype: Measurement of chest and expansion (openEHR-EHR-OBSERVATION.chest_expansion.v1)

heather.leslie — Fri, 20 Jan 2012 02:37:52

An archetype has been updated: Measurement of chest and expansion (openEHR-EHR-OBSERVATION.chest_expansion.v1)
Log message: Translated archetype from English to Arabic (Syria) & Spanish (Argentina).

New comment: Feedback on Review Round #2 from Jobst Landgrebe

heather.leslie — Fri, 20 Jan 2012 01:39:00

A new comment has been posted by heather.leslie:
Feedback on Review Round #2 from Jobst Landgrebe
Normal 0 false false false EN-AU X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Comment from Jobst Landgrebe received via email; and my response: Dear Heather, I had some problems with the tool (no intermediate saving of a review session possible, or I did not understand how it works, maybe Thomas' team can check). Therefore, I would like to summarise my findings here: Overall, the Adverse Reaction archetype is too exclusively focused on primary and secondary care (for which it is now very good) and does not sufficiently support requirements for adverse event management as requested by the FDA AERS ( http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/default.htm ). To realise these requirements, s.o. would need to analyse the data fields requested by the FDA (which is roughly equivalent to EMA and PMDA requirements). The usability of this architeype would increase beyond the primary/secondary care into the regulated pharmaceutical space, which feeds on reports from health care professionals; they need electronic forms to communicate to the FDA and other regulators ... Hope you can take the input in this form. Sincerely, Jobst Normal 0 false false false EN-AU X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Hi Jobst, It is currently possible to save during a review – but you do need to register a Recommendation on the last tab in order to save it. Thus it will be counted in reviews and counts of reviewers etc in the same way as a fully completed review – we can’t differentiate and it will puts the onus on the user to come back and complete it. Then you can subsequently modify the review by accessing it from the Completed Reviews list in the CKM dashboard. It is a little clunky, but to implement the notion of partial saves is actually incredibly complex from an admin and governance point of view, and so we have implemented the current practice as a starting point, knowing that at some time we will tackle it better. The review is not aiming at Primary/Secondary care so much as being a pragmatic core of commonly used data (and this is what makes it seem focussed on primary and secondary care). To have a full maximal data set would make it unwieldy and overly complex and so a line was drawn to make explicit in this core archetype only the common data elements. The intent is to extend the archetype for the reporting scenario that you are flagging by use of additional Cluster archetypes in SLOTs that capture additional details for the Reaction, Exposure and Reporting – as explained in the ‘Use’ area of the metadata. We don’t have those extension archetypes on CKM yet. I have them scoped out, but haven’t built them. Clearly it will be helpful if I can scramble the time together to create them as draft candidates – it will make the design intent more transparent. My scoping for the full model, including the extension archetypes, did take into account the FDA/ICH requirements, althought it appears that at least the website has been updated since then. I will revisit it in detail ready for the next review round to make sure there are no content changes required. I’m glad this core archetype is looking OK at present. We have compared it to ones from VA, HL7, Canada Infoway and Intermountain Health and I was pleased to see it catered for all the usecases they brought up and often seemed to exceed them. But then I’m biased J Please keep in touch. I will let you know when the CLUSTERS are ready and will provide some documentation about the design to make it clearer to all. I appreciate your efforts and value your input enormously. We certainly have the same intent for the final output of this family of models. Regards Heather

Updated archetype: Poisoning or overdose (openEHR-EHR-CLUSTER.health_event-poisoning.v1)

heather.leslie — Fri, 20 Jan 2012 12:17:12

An archetype has been updated: Poisoning or overdose (openEHR-EHR-CLUSTER.health_event-poisoning.v1)
Log message: Translated archetype from English to Spanish (Argentina) and Arabic (Syria).

New comment: Re: Re: Pregnancy Test

leo.derja — Wed, 18 Jan 2012 04:09:10

A new comment has been posted by leo.derja:
Re: Re: Pregnancy Test
Hi Heather: I think what you say is right. I compared this situation with, by example: openEHR-EHR-OBSERVATION.lab_test-blood_gases.v1 , that has a slot to openEHR-EHR-CLUSTER.ambient_oxygen.v1 . This explicit reference vía a slot, allows correctly interpret the lab test. I thought it could be useful to use this attribute [ Date of LMP ] in openEHR-EHR-OBSERVATION.pregnancy_test.v1 , as it was also used in openEHR-EHR-EVALUATION.pregnancy.v1 You correctly suggested that an implicit reference between archetypes pregnancy-test and menstruation, putting both together in a composition should be the correct way to record the information. I am comfortable with that. I am just trying to apprehend the logic of this system of archetypes. Thank you. Best regards, Leonardo DJ

Updated archetype: Adverse Reaction (openEHR-EHR-EVALUATION.adverse_reaction.v1)

heather.leslie — Mon, 16 Jan 2012 11:03:10

An archetype has been updated: Adverse Reaction (openEHR-EHR-EVALUATION.adverse_reaction.v1)
Log message: **Major changes** - this archetype has been fundamentally reworked based on previous review comments, research and inclusion of input from HL7, ICH and statutory requirements and feedback from NEHTA CKM reviews. In addition, the archetype ID was updated to be clear of intent and follow recent editorial practice. Changes include: - Significant enhancement of Concept Description, Purpose, Use, Misuse, Keywords and References. - 'Agent' is now referred to 'Substance/Agent' throughout - Addition of Absolute Contraindication; Future Use; Overall Comment; Slots for Additional Reaction Detail, Additional Exposure Detail and Reporting Details; Exposure description; Earliest Exposure; Clinical Management Description; Multimedia; & Reaction Comment - Addition of Protocol containing Reaction Reported?; Report Comment; Adverse Reaction Report and Supporting Clinical Record Information - Removal of Agent Category; Reaction Severity - Modification of "Probability of Causation' to 'Certainty' - Inclusion of Translation - Arabic (Syrian) and German (Standard) where data elements/descriptions are consistent with original translations. - Inclusion of NEHTA reviewers as contributors

New comment: Re: Pregnancy Test

heather.leslie — Sun, 15 Jan 2012 11:45:55

A new comment has been posted by heather.leslie:
Re: Pregnancy Test
Hi Leonardo, The translation process that you participated in, using CKM, only allows for upload of translation to the data elements already existing in the archetype. It is not allowed for non-Editors to add new elements or edit the existing ones. Any changes to the scope/details of the archetype is only done with Editorial oversight. However your issue is noted - that you thought the archetype incomplete. And in isolation there will be many that appear that way. However the intent of the archetype is only to record the result of a commercial pregnancy test and there are a number of other pieces of information that may be useful when interpreting the result, including more details about the woman's menstrual history including LNMP, but also pattern etc which can be captured using the OBSERVATION.menstruation archetype. I think that the two of these together within a COMPOSITION for a specific clinical encounter would provide the information that you are seeking. Are you comfortable with that? Regards Heather

New comment: Re: Languages / Cultures in translation

domingo.liotta — Sat, 14 Jan 2012 05:12:43

A new comment has been posted by domingo.liotta:
Re: Languages / Cultures in translation
Hello CKM members: The translations of archetypes were part of the final evaluation of Ing. Pablo Pazos first online course of openEHR in Spanish. I was rather shocked to see so few archetypes in Spanish, so hands on task I´ll translate myself, as many as possible. So I started with archetypes in English. I found previously David’s translation and I think there is another from Chile. I looked at both; they look fine to me, so I didn’t make any variations. I believe Ian´s approach to using a root language is correct. I couldn´t find any impediment to use my es-ar translation for es-es (for the body temperature archetype). I know a fellow classmate Leonardo will also be translating archetypes, we will work together and not overlap. I do have a suggestion that may be useful in this discussion: Our School of Medicine at the UM works extensively with a Languages Lab (many languages even oriental), so I can do a small research about the variability in different variations of languages and if it impacts the meaning of a clinical concept. I hope to be able to tap this resource into the openEHR community somehow too. Hope this can be helpful Best regards (PS: When I´m knowledgeable enough to create archetypes myself they will be done in both Spanish and English) Dr. Domingo Liotta (h) Director Cátedra Abierta de Bienestar Médica, Universidad de Morón http://argentinawellness.org My profiles: Contact me: domingo.liotta dliotta domingo_liotta@hotmail.com domingo_liotta@yahoo.com.ar

New comment: Pregnancy Test

leo.derja — Sat, 14 Jan 2012 01:34:29

A new comment has been posted by leo.derja:
Pregnancy Test
Hi for all: In a recent review, I added to archetype [openEHR-EHR-OBSERVATION. pregnancy_test .v1] => " Last menstruation date " because I think it is needed for correctly interpret the test. Best regards, Dr. Leonardo Der Jachadurian

Updated archetype: Ambient oxygen (openEHR-EHR-CLUSTER.ambient_oxygen.v1)

ian.mcnicoll — Fri, 13 Jan 2012 04:55:53

An archetype has been updated: Ambient oxygen (openEHR-EHR-CLUSTER.ambient_oxygen.v1)
Log message: Translated archetype from English to Spanish (Argentina). Google Translate checked

New comment: Languages / Cultures in translation

ian.mcnicoll — Fri, 13 Jan 2012 11:22:03

A new comment has been posted by ian.mcnicoll:
Languages / Cultures in translation
Hi all, It is great to see increasing numbers of translations being offered for archetypes but I have a question for those of us working in languages which have national/cultural variants e.g English, UK English, US English or Spanish , Argentinian Spanish. Creating and maintaining translations will be quite onerous. At the moment, each translation of every sub-language is separately maintained within ADL, although it is actually quite easy to hack the ADL to copy/paste from a different language variant i.e to create en-us from en-gb. Although implementations may vary, I suspet most would work similar to the Ocean tools and will look for and make use of a parent or neutral language if possible e.g. if the tools native operating system culture is 'en-gb' it will look for 'en-gb' translation and if not found look for the parent 'en', finally defaulting to the primary archetype language if necessary. This 'default to parent' mechanism means that we could potentially simplify translation by using the parent/neutral culture if at all possible e.g translate to en rather than en-gb or es rather than es-ar. This would work pretty well in English where there few examples of clinically important spelling differences which might cause confusion between language variants. I am happy to tolerate a few American 'z' spellings instead of 's', if it reduces the translation burden. If people feel strongly they can always create the sub-language variant. My question to an international audience is whether this would be equally acceptable for other languages and cultures, appreciating that this can be a touchy subject!! One thing that might also help is to allow the sub-language variant to be expressed a a differential on the parent language within ADL i.e. rather than the es-ar variant being a complete list of translated terms, just carry those that differ from the parent language terms. So my suggestion is that when translating we use the parent language, rather than a local variant unless there are compelling reasons, and even then it may make sense to create the parent AND the variant, where the parent does not already exist. I will copy this to the openEHR clinical list to get a wider spread of opinion. Ian

New comment: Re: Re: Event offset restriction

diego.bosca — Fri, 13 Jan 2012 11:05:10

A new comment has been posted by diego.bosca:
Re: Re: Event offset restriction
Ok, I will do that right now

New comment: Re: Event offset restriction

ian.mcnicoll — Fri, 13 Jan 2012 10:58:51

A new comment has been posted by ian.mcnicoll:
Re: Event offset restriction
Hi Diego, I know the discussion on constraining functions is ongoing on the lists but it might be worthwhile highlighting the other issue re the syntax of the DV_DURATION constraint on the technical list. I think you will get a better response there. Ian

Updated archetype: Blood gas assessment (openEHR-EHR-OBSERVATION.lab_test-blood_gases.v1)

sebastian.garde — Tue, 10 Jan 2012 01:06:53

An archetype has been updated: Blood gas assessment (openEHR-EHR-OBSERVATION.lab_test-blood_gases.v1)
Log message: Translated archetype from English to Spanish (Argentina) by Leonardo Der Jachadurian.

Updated archetype: Follow up action (openEHR-EHR-ACTION.follow_up.v1)

sebastian.garde — Tue, 10 Jan 2012 01:04:16

An archetype has been updated: Follow up action (openEHR-EHR-ACTION.follow_up.v1)
Log message: Translated archetype from English to Arabic (Syria) by Monah Saleh. Translated archetype from English to Spanish (Argentina) by Leonardo Der Jachadurian.

Updated archetype: Height/Length (openEHR-EHR-OBSERVATION.height.v1)

heather.leslie — Tue, 10 Jan 2012 03:35:59

An archetype has been updated: Height/Length (openEHR-EHR-OBSERVATION.height.v1)
Log message: Translated archetype from English to Farsi, Arabic (Syria) and Spanish (Argentina).

Updated archetype: Respirations (openEHR-EHR-OBSERVATION.respiration.v1)

heather.leslie — Tue, 10 Jan 2012 12:11:45

An archetype has been updated: Respirations (openEHR-EHR-OBSERVATION.respiration.v1)
Log message: Translated archetype from English to Farsi, Arabic (Syria) and Spanish (Argentina).

Updated archetype: Intravenous fluid administration (openEHR-EHR-ACTION.intravenous_fluid_administration.v1)

heather.leslie — Mon, 09 Jan 2012 11:37:15

An archetype has been updated: Intravenous fluid administration (openEHR-EHR-ACTION.intravenous_fluid_administration.v1)
Log message: Translated archetype from English to Arabic (Syria) and Spanish (Argentina).

New comment: Event offset restriction

diego.bosca — Mon, 09 Jan 2012 11:51:43

A new comment has been posted by diego.bosca:
Event offset restriction
I have started also a discussion on the mailing list about this topic. Offset is not an attribute in the reference model an thus shouldn't be restricted as it is now on this archetype. It should be an assertion. While we decide if we change this or not, there is another error regarding offsets. Durations are described as ranges, not as a default values. so all the restrictions as this: offset existence matches {1..1} matches { DV_DURATION[at0040] occurrences matches {0..1} matches { -- value existence matches {1..1} matches {|PT10M|} } } should be changed to this: offset existence matches {1..1} matches { DV_DURATION[at0040] occurrences matches {0..1} matches { -- value existence matches {1..1} matches {PT10M} } }

Updated archetype: Body temperature (openEHR-EHR-OBSERVATION.body_temperature.v1)

heather.leslie — Fri, 06 Jan 2012 06:11:35

An archetype has been updated: Body temperature (openEHR-EHR-OBSERVATION.body_temperature.v1)
Log message: Translated archetype from English to Spanish (Spain).

Updated archetype: Clinical Synopsis (openEHR-EHR-EVALUATION.clinical_synopsis.v1)

heather.leslie — Fri, 06 Jan 2012 05:14:22

An archetype has been updated: Clinical Synopsis (openEHR-EHR-EVALUATION.clinical_synopsis.v1)
Log message: Translated archetype from English to Arabic (Syria), Syrian and Spanish (Argentina).

New comment: Pulmonary Function Archetype

domingo.liotta — Sat, 31 Dec 2011 01:41:31

A new comment has been posted by domingo.liotta:
Pulmonary Function Archetype
Dear Ian: Sorry it took me some days to get back to you. I´m also sending this mail to the Clinical Discussion List as it may benefit others. The proposed pulmonary function archetype is also adequate for adult use, I took some extra time to have it checked by the Chief of Intensive Care at my Hospital. The archetype is detailed enough for international use. Your assumption is correct VO2max does merit a separate archetype included as a subset of a more detailed " Exercise Stress Testing " arquetype. The VO2max has its clinical fundamentals for assessment of cardiovascular function which may or may not have a pulmonary component. So the pulmonary function test archetype could take the value from the Exercise Stress Test arquetype and also if a cardiac patient also have a Lung impairment the Exercise Stress Testing should read the values pre & post bronchodilation. The reason for showing the archetypes at my Hospital (and it worked as planned) was to get more Clinical experts into the Clinical Modelling process. I will be meeting next week the Chief of Acute Coronary Unit to discuss the modelling of the more General "Stress Exercise Testing" I´ll keep the list informed. Wow! For me an excellent way to finish 2011 :) Happy new years to all :=) Domingo Hi Domingo, Thanks for offering to have a look at this archetype. It was developed for use in a Paediatric EMR in Slovenia but very much as a candidate for international use. One of the issues I suspect you might challenge is whether V02max merits a separate archetype. Ian Dr Ian McNicoll office +44 (0)1536 414 994 fax +44 (0)1536 516317 mobile +44 (0)775 209 7859 skype ianmcnicoll ian.mcnicoll@oceaninformatics.com Clinical Modelling Consultant, Ocean Informatics, UK Director/Clinical Knowledge Editor openEHR Foundation www.openehr.org/knowledge Honorary Senior Research Associate, CHIME, UCL SCIMP Working Group, NHS Scotland BCS Primary Health Care www.phcsg.org

New comment: Re: Re: Translated Body Temperature to Spanish AR

domingo.liotta — Fri, 30 Dec 2011 06:34:53

A new comment has been posted by domingo.liotta:
Re: Re: Translated Body Temperature to Spanish AR
Hello Ian: How are you doing, as 2011 is ending... :) Oh! The Archetype can perfectly go as a generic "es" translation. The are no variants in the Argentinian version. I´ll edit the (es) tags off the keywords and it will be good to go. Have a very Happy New Year! Domingo

New comment: Re: Translated Body Temperature to Spanish AR

ian.mcnicoll — Fri, 30 Dec 2011 01:56:38

A new comment has been posted by ian.mcnicoll:
Re: Translated Body Temperature to Spanish AR
Hi Domingo, Thanks for this. It looks good to me (as far as any reverse translation with Google Translate goes). You do not need the (es) tags on the keywords as these are language specific - these could be removed. To what extent would the Argentinian variant of Spanish vary for this archetype - would it be possible to use this for a generic "es" translation? Ian

New comment: Translated Body Temperature to Spanish AR

domingo.liotta — Fri, 30 Dec 2011 03:57:55

A new comment has been posted by domingo.liotta:
Translated Body Temperature to Spanish AR
Dear Editors: How did the translation go? Does it need any uptate or editing in your opinion? Best regards Domingo

New comment: Exercise Presciption Arquetype

domingo.liotta — Fri, 23 Dec 2011 01:45:09

A new comment has been posted by domingo.liotta:
Exercise Presciption Arquetype
Hello Community: There is an ongoing discussion on the email list but I´ll post it here too, I hope the community may find it interesting. I work as a general practitioner and medical informatics at a public hospital in Argentina, in a Cardiology Service. Specifically in Cardiac Rehabilitation. Physical Activity is very important as the means to reinsert our patients into society after a cardiovascular event. A very quick database search revealed that the Arquetype: Level of exertion to be useful as you will need to register the patients “level of fitness” pre and post training. Also the related clinical observations: blood pressure, heart rate, ECG recording It would be useful to create a Borg perception of exercise (subjective) as it correlates well with level of exertion. I can be bold and try to make an Arquetype for: VO2max Testing which is my expertise but I´m a real newbie in clinical modelling. I didn’t find any “exercise prescription” Arquetype. ( I´d like to see that too). I´ll re post some very helpful suggestions from the mailing list members. Be well Domingo Liotta

Updated archetype: Body mass index (openEHR-EHR-OBSERVATION.body_mass_index.v1)

heather.leslie — Tue, 20 Dec 2011 01:49:39

An archetype has been updated: Body mass index (openEHR-EHR-OBSERVATION.body_mass_index.v1)
Log message: Added translation from English to Spanish (Argentina). Added translation from English to Arabic (Syria). Updated translation from English to Farsi.

Updated archetype: Blood Pressure (openEHR-EHR-OBSERVATION.blood_pressure.v1)

heather.leslie — Mon, 19 Dec 2011 05:07:09

An archetype has been updated: Blood Pressure (openEHR-EHR-OBSERVATION.blood_pressure.v1)
Log message: Translated archetype from English to Spanish (Argentina). Traducción del arquetipo del Inglés al Español

New comment: Re: Re: Error in "braden scale" total score

rui.coutinho — Wed, 07 Dec 2011 12:21:12

A new comment has been posted by rui.coutinho:
Re: Re: Error in "braden scale" total score
Thank you

New comment: Re: Error in "braden scale" total score

heather.leslie — Wed, 07 Dec 2011 02:50:56

A new comment has been posted by heather.leslie:
Re: Error in "braden scale" total score
Thanks for pointing this out. I've corrected it and uploaded the latest revision Regards Heather

Updated archetype: Braden Scale (openEHR-EHR-OBSERVATION.braden_scale.v1)

heather.leslie — Wed, 07 Dec 2011 02:50:13

An archetype has been updated: Braden Scale (openEHR-EHR-OBSERVATION.braden_scale.v1)
Log message: Correct Total Score to max of 23. Minor changes to Use, Misuse

New comment: Error in "braden scale" total score

rui.coutinho — Wed, 07 Dec 2011 12:25:55

A new comment has been posted by rui.coutinho:
Error in "braden scale" total score
Please review the maximum tota score for the braden scale. As you can easily notice, the possible maximum score is 23 not 20.

New comment: Re: Re: Re: wrong regular expression?

ian.mcnicoll — Fri, 02 Dec 2011 03:20:24

A new comment has been posted by ian.mcnicoll:
Re: Re: Re: wrong regular expression?
Thanks. I am hoping Sergio Friere might respond as he is the main author and might have a different perspective but here is my view. As I understand the original slot constraint it means "Use any archetype which is an address.v1 archetype or any specialisation thereof." What is the purpse of your prefixed regex? What does that add? Also regarding the fixed v1 suffix, I would probably agree that in the context of EHR content, we would probably leave the structural version identifier open, but Sergio may argue that in the much slower-moving world of Demographics models, that it is reasonable to require any slotted archetypes to be fixed to a particular version, so that the query semantics are closely defined. I suppose it comes down to the tightness of the binding/coupling between the 2 archetypes. This is generally a bad idea in clinical content because it enforces too much inter-locked dependency, but might not be a bad strategy in Demographic models where the main purpose of slotting out e.g Address cluster, is to allow some limited local specialisation. Definitely worth discussion .. any other views? Ian

New comment: Re: Re: wrong regular expression?

diego.bosca — Fri, 02 Dec 2011 02:50:19

A new comment has been posted by diego.bosca:
Re: Re: wrong regular expression?
well, this kind of expressions archetype_id/value matches {/(address)([a-zA-Z0-9_-]+)*\.v1/} archetype_id/value matches {/(electronic_communication)[a-zA-Z0-9_-]*\.v1/} would change to something like this archetype_id/value matches {/([a-zA-Z0-9_-]+)(address)([a-zA-Z0-9_-]+)*\.v1/} archetype_id/value matches {/([a-zA-Z0-9_-]+)(electronic_communication)[a-zA-Z0-9_-]*\.v1/} and I believe that ([a-zA-Z0-9_-]+)* is equivalent to this ([a-zA-Z0-9_-]*) version shouldn't be fixed to 'v1'

New comment: Re: wrong regular expression?

ian.mcnicoll — Fri, 02 Dec 2011 02:16:48

A new comment has been posted by ian.mcnicoll:
Re: wrong regular expression?
Hi Diego, I am not sure I understand. Can you give me a specific example of how you think the current slot constraints need to be changed. Ian

New comment: wrong regular expression?

diego.bosca — Wed, 30 Nov 2011 10:00:51

A new comment has been posted by diego.bosca:
wrong regular expression?
Maybe I am wrong, but I think all slot includes need [A-Za-z0-9_-]+ to be added to the start of current regular expression