Concept Model for observables, investigations, and observation results

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Concept Model forobservables, investigations,
and observation results

• For the IHTSDO Observables Project Group
• and LOINC Coordination Project
• Revision Date March 14, 2014

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The information model is used to link this result
to the Culture and specimen that came from the
patient.
Cultured E.coli serotype is O157

• Continue from Part-2 slide deck

property type
serogroup
E. Coli (organism)
inheres in
is about
quality
towards
hemoglobin
precondition
body states
observation result
scale
scales
units
units
has value
O157
technique
Bacterial serotyping
direct site
Microbial culture
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What about abilities?

• Able with respect to normal functioning and
  activities
• Ontologically these are realizables.
• Two types
• Sure-fire (dispositions) if you have the
  ability to feel pain, then when a painful
  stimulus is applied, you feel it (assuming you
  are conscious and actually even if you are
  unconscious with some exceptions based on
  threshold of intensity)
• Those abilities that depend on the bearers
  decision (ability to walk, talk, throw a ball,
  eat an apple, etc)

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Disposition type

• Possible replacement for property type where
  the value of is about is neither a quality nor
  a process, but instead is a disposition or
  function
• could consider expanding the domain/range for
  property type instead

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ability to hear (meaning the sure-fire
disposition for a hearing process to be
instantiated on exposure to sound)
disposition type
ability
auditory system
inheres in
disposition
towards
hearing (process)
precondition
body states
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Able to hear (as an observation result) (there
exists some observation result which has a
target of some disposition which is ability to
hear)
disposition type
ability
auditory system
inheres in
is about
disposition
towards
hearing (process)
precondition
body states
observation result
scale
scale types
units
units
has value
able
technique
techniques
direct site
body structures, specimens
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Able to hear (situation) Interpreted as
disposition present in situation, or ability to
hear present (the situation includes the
existence of some disposition which is ability to
hear)
disposition type
ability
auditory system
inheres in
includes
disposition
towards
hearing (process)
precondition
body states
situation
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Able to hear (observation result) Interpreted as
an observation result, using the VALUE attribute
disposition type
ability
auditory system
inheres in
is about
disposition
towards
hearing (process)
precondition
body states
observation result
scale
scale types
units
units
has value
able
technique
techniques
direct site
body structures, specimens
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Impaired ability to hear (as a disposition)
disposition type
Impaired ability
auditory system
inheres in
disposition
towards
hearing (process)
precondition
body states
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Impaired ability to hear (as an observation
result)
disposition type
ability
auditory system
inheres in
disposition
is about
towards
hearing (process)
precondition
body states
observation result
scale
scale types
units
units
has value
impaired
technique
techniques
direct site
body structures, specimens
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Impaired ability to hear (as disposition included
in situation, or impaired hearing present)
disposition type
Impaired ability
auditory system
inheres in
includes
disposition
towards
hearing (process)
precondition
body states
situation
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Other dispositions

• Antimicrobial sensitivity

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Antimicrobial susceptibility test (procedure)
disposition type
Resistance/sensitivity
Microbial isolate
inheres in
is about
disposition
towards
Antimicrobial
precondition
body states
observation procedure
TIME ASPECT
Time aspects
scale
scale types
units
units
technique
techniques
direct site
body structures, specimens
method
observation action
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Process observables/observations

• characterizes
• process duration
• other process attributes

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Left knee deep tendon reflex briskness
(observable)
property type
Briskness of response
inheres in
property of process
Neuromuscular structures of the left knee deep
tendon reflex
is about
characterizes
Deep tendon reflex (process)
precondition
body states
observable entity
scale
scale types
units
units
technique
techniques
direct site
body structures, specimens
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Left knee jerk reflex 2 (observation result)
property type
Briskness of response
inheres in
property of process
Neuromuscular structures of the left knee deep
tendon reflex
is about
characterizes
Deep tendon reflex (process)
precondition
body states
observation result
scale
scale types
units
units
has value
2 out of 4
technique
techniques
direct site
body structures, specimens
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Other question/answer pairs as quality / quality
region pairs
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Histologic type (of lesion)
property type
Histologic type
lesion
inheres in
quality
towards
functions, substances
precondition
body states
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Tumor site (located-in would be a relational
spatial quality)
property type
Located in
tumor
inheres in
quality
towards
functions, substances
precondition
body states
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Dealing with presence

• Disallow presence and absence as a value of
  property type
• But allow detected, present, absent as an
  observation result, if the is about is an
  independent continuant (not a dependent
  continuant).

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Methicillin-resistant staphylococcus
aureus (MRSA) present in abdominal wound, swab
specimen, by PCR rapid detection method (A)
is about
MRSA (organism)
has location
abd. wound
observation result
scale
qualitative
units
units
has value
detected
technique
PCR rapid detection method
direct site
abdominal wound swab (specimen)
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Mycoplasma pneumoniae detected
Mycoplasma pneumoniae
is about
observation result
scale
qualitative
units
units
has value
detected
technique
techniques
direct site
specimens
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Methicillin-resistant staphylococcus
aureus (MRSA) present in abdominal wound, swab
specimen, by PCR rapid detection method
is about
only/some
MRSA (organism)
has location
Abd. wound
observation result
scale
qualitative
units
units
has value
present
technique
PCR rapid detection method
direct site
Wound swab (specimen)
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Methicillin-resistant staphylococcus
aureus (MRSA) in abdominal wound, swab specimen,
by PCR rapid detection method (observable)
is about
only
MRSA (organism)
has location
Abd. wound
observable entity
scale
qualitative
units
units
technique
PCR rapid detection method
direct site
Wound swab (specimen)
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MRSA (methicillin resistant staph aureus) POC
(point-of-care) test (procedure)
is about
MRSA (organism)
observationprocedure
scale
scale types
units
units
has value
Numeric, ordinal, nominal
technique
MRSA POC detection technique
direct site
specimen
method
observation action
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Radial pulse palpability
is about
arterial pulsation
has location
radial artery at the wrist
observable entity
scale
scale types
units
units
technique
palpation
direct site
Ventral aspect of wrist over radial artery
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radial pulse present by palpation
is about
arterial pulsation
has location
radial artery at the wrist
observation result
scale
scale types
units
units
has value
present
technique
palpation
direct site
ventral aspect of wrist over radial artery
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abdominal wall stoma present (observation result)
is about
stoma
has location
Abdominal wall
observation result
scale
scale types
units
units
has value
present
technique
techniques
direct site
place
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colostomy present (observation result)
is about
colostomy
has location
Abdominal wall
observation result
scale
scale types
units
units
has value
present
technique
techniques
direct site
place
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adenocarcinoma of the colon present (observation
result)
is about
adenocarcinoma
has location
colon
observation result
scale
scale types
units
units
has value
present
technique
techniques
direct site
place
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adenocarcinoma of the colon present (situation)
adenocarcinoma of the colon (disorder)
situation
includes
adenocarcinoma
associated morphology
site
colon
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Determining contents

• observations that seek to answer
• What things are present as physical parts of a
  specimen (such as a fluid) or structure?
• What things are present and contained within a
  structure (but not part of it)?

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Contents of urine by light microscopy (observable)
Assumes having physical part is a valid
relation between discrete solid entities in a
fluid and the fluid substance.
property type
Having physical part
urine
inheres in
is about
quality
towards
functions, substances
precondition
body states
observable
scale
scale types
units
units
technique
Light microscopy
direct site
body structures, specimens
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Determining contents of urine by light
microscopy on urine sample (procedure) Synonym
microscopic urinalysis
property type
Having physical part
urine
inheres in
is about
quality
towards
functions, substances
precondition
body states
observationprocedure
scale
scale types
units
units
technique
Light microscopy
direct site
Urine sample
method
observation action
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Urine microscopy hyaline casts present
property type
Having physical part
urine
inheres in
is about
quality
towards
Hyaline casts
precondition
body states
observation result
scale
scale types
units
units
has value
Observed
technique
Light microscopy
direct site
Urine specimen
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What about counts?

• Count gt1 seems to mean the same as retinal
  hemorrhage present
• But does it?
• There is a difference between
• an observation result in which a count was made,
  and
• a phase of a subjects life during which the
  countable entity was present (or not present)
• And this difference matters because
• counts can be incorrect
• a count of zero can be made when the situation is
  that there is a hemorrhage present
• and a count of 1 can be mistakenly made when the
  situation is that there is no hemorrhage
• and we may need to be able to record and do
  quality assurance based on the difference between
  the count and the actual situation

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4 retinal hemorrhages present (observation result)
property type
entitic number
retina
inheres in
is about
quality
towards
hemorrhages
precondition
body states
observation result
scale
quantitative
units
units
has value
4
technique
techniques
direct site
body structures, specimens
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retinal hemorrhage present (observation result)
property type
entitic number
retina
inheres in
is about
quality
towards
hemorrhage
precondition
body states
observation result
scale
quantitative
units
units
has value
gt 1
technique
techniques
direct site
body structures, specimens
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Retinal hemorrhage present (situation) Retinal
hemorrhage (finding)
situation
includes
hemorrhage
associated morphology
site
retina
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Which models are preferred and why?

• Several different options have been presented
• Criteria for choosing among options
• 1) semantic consistency
• 2) simplicity
• 3) interoperability
• 4) reproducibility of modeling individual
  concepts
• 5) lower degree of disruption of existing
  implementations and content
• 6) lower comparative cost of the change
• 7) computability