Tuesday, May 07, 2013

TermInfo Discussion at HL7 WGM Atlanta 2013 (SIM&A)



Okay, HL7's RIMBAA Working Group hasn't changed their name to SIM&A yet ("Simba"), but it looks like that is the name that is going to stick to reflect the group's broadened scope.

One issue that this and other working groups are determined to put to bed is that of negation, particularly with TermInfo vocabulary sets like SNOMED CT. The problem is that not all vocabulary sets support negation implicitly, by providing vocabulary terms that are already negated. SNOMED CT does. The big question then is, should you always use the implied negation in the vocabulary set if it is available; or should you sometimes, or never use it.

The alternative, for HL7 v3 at least, is to use a negation indicator, messaged as a negationInd attribute on the element in question... so this is effectively metadata, and the problem with metadata is that there is no guarantee that the receiver interprets it correctly, if at all. For many use cases, this probably doesn't matter much, but for clinical diagnosis and decision making, for allergies, for drug interactions, and even in the context of non-health applications like Corrections and Defense, Person-of-Interest queries need to properly take into account null flavours and negations; so there is a strong Public Health and Public Safety aspect to this discussion as well.

So it is an important concept, and people need to reach agreement on the correct way to do this; however, this issue goes back a number of years, so I'm curious to see where it goes. My own thoughts are that a better way to do this from the start would have been to use a tri-state negation indicator, which indicates "positive", "requires negation", or "implictly negated"... but it's too late for that now, and it always has been.

Here are the details from the RIMBAA forum (via Rob Hausum, MD, Hausum Consulting):
The TermInfo negation discussion at the Atlanta WGM will be held in Q1 Tuesday (tomorrow).  Following a brief introduction, we intend to devote the remainder of the quarter to this topic.  We would like to come away from the quarter with a concrete plan to create and provide guidance on this important topic.  That may involve a focused TermInfo ballot on negation, but the specific form and scope is still open for discussion.

For those who aren't in Atlanta, we expect to have remote participation capability via GoToMeeting (details below).  Please join the discussion, or, if you are unable to attend either in person or remotely, feel free to pass along any comments/questions/concerns.

Rob

GTM details:

1.  Please join my meeting.

2.  Use your microphone and speakers (VoIP) - a headset is recommended.
Or, call in using your telephone.

Denmark: +45 (0) 69 91 89 33
Australia: +61 2 8355 1031
Austria: +43 (0) 7 2088 1033
Belgium: +32 (0) 28 08 4342
Canada: +1 (647) 497-9371
Finland: +358 (0) 942 41 5770
France: +33 (0) 182 880 159
Germany: +49 (0) 811 8899 6925
Ireland: +353 (0) 19 030 050
Italy: +39 0 693 38 75 50
Netherlands: +31 (0) 208 080 208
New Zealand: +64 (0) 9 925 0481
Norway: +47 21 54 82 21
Spain: +34 911 82 9890
Sweden: +46 (0) 852 500 179
Switzerland: +41 (0) 435 0167 65
United Kingdom: +44 (0) 207 151 1806
United States: +1 (213) 493-0619

Access Code: 912-947-024
Audio PIN: Shown after joining the meeting

Meeting ID: 912-947-024

GoToMeeting®
Online Meetings Made Easy®

Thursday, May 02, 2013

Loose boats and gliders

loose boats and gliders
children floating
away over rocks
under supervision still
throwing stones at the
waves over time
here they come; there they go
turn and they play
face down the ocean
now overconfident
perhaps, tiny creatures
intertidal safety zones
safe in untidy interzones
carrying with them
nets and shrimp
pockets and stones