Re: [Gnumed-devel] Re: GNUmed and FreeDiams

[Jim Busser]

On 2011-01-01, at 11:48 AM, Karsten Hilbert wrote:

>> However… FreeDiams has columns
>> 
>>      route
>>      global_strength
>> 
>> lacking in GNUmed ref.branded_drug. We should add them, yes?
> 
> No.

I find myself disagreeing here… at least, on the question of strength. There is 
little point to capture that a Brand exists, without capturing its strength, 
because each Brand makes its drug (or drug combo) available only in discrete 
strengths. Even when a range of strengths is available, not all Brands provide 
all strengths. Therefore:

        say Brand A happens to be available in strengths of 5, 10 and 20mg

        say Brand B happens to be available in only 10mg

but we do not keep this information in ref.branded_drug, then it is entirely 
easy to input into GNUmed that the patient is to take

                Brand B 5mg 1-0-0-1

when Brand B is not even available as 5mg therefore when you send the patient 
with prescription to the druggist, they will maybe give

                Brand B 10mg 0.5-0-0-0.5

and may confuse the patient and/or your instructions as you later unpuzzle at a 
future visit what the patient is doing if they did not bring their pill bottles.

This example becomes even more clear when you would prescribe a *combo* drug 
whose combination strengths you cannot arbitrarily vary and which arbitrary 
action the druggist cannot fix.

If instead we would support strength in Brand, then that value can pre-populate 
the strength or (if empty) need not impede the widgets.

If we do *not* support strength-in-brand

1) won't

        ref.lnk_substance2brand

still need to link to each replicate in ref.branded_drug, or is there some 
argument to link only to *some* replicates, and on what basis to choose the 
"some"?

2) as far as listings of brands-in-phrasewheel (Adding substance intake)

        are you thinking each brand should be offered only once and, even if a 
phrasewheel in GNUMed would collapse the otherwise-replicated values, wouldn't 
the phrasewheel lose any linkage to distinct external_codes  (or an arbitrary 
value from among several available)?