Re: [Gnumed-devel] Fwd: Lab data support in OSCAR

[Jim Busser]

On May 6, 2004, at 1:41 PM, Hilmar Berger wrote:
> Shouldn't the clinician's decision go into a different parameter ? And 
> shouldn't technically_abnormal rather than being binary hold something 
> like "normal" (=within ranges), low, high, extremely low, extremely 
> high ?
> The information "abnormal" just forces you to look at the value to 
> find out agan in what direction and to what extent the lab parameter 
> was abnormal. I think if technically_abnormal could be automatically 
> filled, it should be a meaningful value that gives you an idea of what 
> clinical importance it might have.

My postings are either inconsequential, or slow through the network --- 
I prefer to think the latter ;-)

The clinician can decide a patient's potassium really is high 
(technically_abnormal at 5.1 gets coded "true") but that it is not 
clinically relevant (requires no action) in a patient with known 
chronic renal failure whose potassium fluctuates between 4.8 and 5.3.

I am open to whether clinically_relevant means the same thing as 
"requires action". I am not sure if you can have something 
technically_abnormal and clinically_relevant that requires no action - 
maybe it required action at its first occurrence but having been dealt 
with the repeat occurrences require no action.

The information "abnormal" is only possibly helpful to set a priority 
for what needs to be looked at first. I do prefer "low, high, extremely 
low, extremely high" and I would like to see "extremely" equated to 
'critical" i.e. requiring immediate communication from the lab to the 
doctor and _possible_ immediate action by the doctor.