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

[Karsten Hilbert]

> > a) we can't rely on the technically_abnormal information being
> >    there - it needn't be a requirement in other countries
> > b) we can't rely on the range info being there (if it is and
> >    the technically_abnormal flag is missing we try to
> >    calculate the abnormal flag though)
> > c) when a clinician reviews the data she IS able to ascertain
> >    whether the value is technically abnormal, so we enforce
> >    that relation, this may be a little tough on the poor
> >    clinician, however

> Shouldn't the clinician's decision go into a different
> parameter ?
It does: clinically_relevant. However, tying
technically_abnormal to reviewed_by_clinician allows us to
enforce a meaningful value for the former in those cases where
preceding processing (lab, import logic, etc) did not come up
with a value.

> And shouldn't technically_abnormal rather than
> being binary hold something like "normal" (=within ranges),
> low, high, extremely low, extremely high ?
It should and the LDT files that we are importing are
providing this information. For some reason I used the wrong
datatype. Nevertheless, the same logic applies: to only allow
technically_abnormal be null if reviewed_by_clinician is
false...

> 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.
That is a valid concern and suggestion. I'll change
technically_abnormal to TEXT and use the following logic:

- NULL means unknown, can only be NULL if reviewed_by_clinician is false
- trim_whitespace(<col>) = '' means normal
- of course, 'normal' also means normal :-)

LDT files provide + ++ +++ - -- --- etc.

Sounds fair ?

Karsten
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