Pattern description and scope

Gradings and classifications that are closely associated with specific diagnoses, physical examinations, imaging results, lab results, pathology results, etc. For example: TNM, Gleason, Gustilo-Anderson.

This pattern does not concern stand alone scores and scales that are performed for the patient in general, such as NEWS2 or Glasgow Coma Scale. These stand alone scores or scales are generally modelled as OBSERVATION archetypes.

Modelling pattern

Variants

1. Distinct, fixed gradings or classifications

• Modelled as specific CLUSTER archetypes for each grading or classification

• The CLUSTER can be nested within different ENTRY archetypes depending on the intended context

• The version of the grading or classification, if available, is defined in metadata

Examples

• Gleason scale for prostate cancer

• Gustilo-Anderson classification for open fractures

2. Larger classifications dependent on knowledge bases

• Modelled as more generic CLUSTER archetypes to be populated with value sets at run time or in templates

• The CLUSTER can be nested within different ENTRY archetypes depending on the intended context

• The version of the classification needs to be defined in a specific element

Examples

• TNM

• CTCAE

Avoid

• Generic archetypes for any gradings or classifications, to be constrained in templates - this pattern only moves complexity from archetype modelling to template modelling

• Classifications as inline clusters in larger archetypes - this pattern precludes the usage of the classifications in multiple contexts

To be discussed

• Do we need to add “Date of assertion” to CLUSTER archetypes, or is this covered by the ENTRY?