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One issue that we probably should address in this document is that the 'binding' to terminology addressed here (and called semantic tagging) is just that. It is at present a tag of a code from a terminology to aid in determination of the meaning if it is ambiguous. On further reflection in discussions with Eric Browne, I wonder if this relationship should always be "Records" as an archetype is a structure for recording information about things in the world. This archetype records that. This might help us with the ambiguity that arises when trying to semantically tag the blood pressure archetype. I have retrieved the terms that have an IS_A relationship with 'Blood pressure (observable entity)' as one would expect that we could say:
openEHR-EHR-OBSERVATION.blood_pressure.v1 _records_ "Blood pressure (observable entity)", SNOMED-CT, 75367002
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Term | Recorded using blood pressure archetype | Note |
|---|---|---|
24 hour blood pressure (observable entity) | Yes | The time series will allow this |
Arterial blood pressure (observable entity) | ? | It is really systemic arterial, local should use intravascular pressure |
Arterial pulse pressure (observable entity) | Yes | Core data element |
Arterial wedge pressure (observable entity) | No | I do not think this is ever used for systemic arterial |
Diastolic blood pressure (observable entity) | Yes | Core data element |
Invasive blood pressure (observable entity) | ? | Is this the site of measurement? Not when someone is invading? |
Lying blood pressure (observable entity) | Yes | Position at the time of measurement |
Mean blood pressure (observable entity) | Yes | Mean Arterial pressure (per cycle) and average blood pressure over a period of time |
Post-vasodilatation arterial pressure (observable entity) | Yes | Need a state model to cover this |
Segmental pressure (blood pressure) (observable entity) | No | To measure limb pressure and covered by intravascular pressure |
Sitting blood pressure (observable entity) | Yes | Position at the time of measurement |
Standing blood pressure (observable entity) | Yes | Position at the time of measurement |
Systemic blood pressure (observable entity) | Yes | This is what the archetype measures in the broadest sense |
Systolic blood pressure (observable entity) | Yes | Core data element |
Venous pressure (observable entity) | No | Covered by intravascular pressure measurement |
Comparison with the mindmap image of the archetype might be helpful:
In conclusion, there is much work to be done to maximise the benefit from a close association between the data structures to be shared, the terminology that provides the content for these structures (value sets) and the semantic links with the data points themselves (semantic tagging). Forging a strong working relationship between the IHTSDO and the openEHR Foundation will assist greatly in this process.
References
David Markwell's work for UK NHS CFH program
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