Stream: implementers
Topic: Absence of Family History
Richard Kavanagh (Dec 11 2019 at 12:49):
When making assertions over the absence of Family History
e.g. 249724011 | No FH: Cardiovascular disease | (SNOMED)
Is the correct approach just to use the code as per FamilyHistort.condition.code?
As such there is no information model way in differentiating between "Patient has FH of ..." vs "Patient has no FH of ..."
Lloyd McKenzie (Dec 11 2019 at 13:15):
FamilyMemberHistory captures the conditions of a single family member. To capture a generic "family history of" or "no family history of", use Observation.
Richard Kavanagh (Dec 11 2019 at 13:55):
Hmm OK - so the "API user" just needs to know to look in two places then?
Richard Kavanagh (Dec 11 2019 at 13:56):
As a further example - what about "No Family History of Cardiovascular disease for mother"?
Lloyd McKenzie (Dec 11 2019 at 14:12):
That use-case hasn't been raised, to my knowledge. Suggest submitting a change request
Halina Labikova (Mar 11 2020 at 14:02):
@Richard Kavanagh did you end up submitting a ticket? "Suspicion of" would be another usecase for expanding this resource. Maybe using ConditionVerificationStatus values could be suitable for capturing the negative/preliminary results?
Richard Kavanagh (Mar 11 2020 at 15:59):
@Halina Labikova I don't think I did in the end as I did not see it as a means to address the issues I had.
In an existing clinical system we have the following:
- Patient X reports family member Y had condition Z
- Patient X reports family member Y did not have condition Z
- Patient X reports a family history of condition Z
- Patient X reports no family history of condition Z
For me the issues are:
- Inability to assert the absence of a condition
- "Family History" and "Family Member History" residing in two different resources
Lloyd McKenzie (Mar 11 2020 at 16:27):
FamilyHistory and FamilyMemberHistory are going to definitely end up in two different resources. General assertions of "family history of X" or "no family history of X" are going to be in Observation, while tracking exactly what Uncle Joe vs. Aunt Sue had or did not have is what FamilyMemberHistory is for. There should be a change request submitted to allow FamilyMemberHistory.condition to definitively capture conditions that are "known absent". (You could do it now with a custom modifier extension, but that seems like something that should be in core, particularly given that it's a modifier.)
Last updated: Apr 12 2022 at 19:14 UTC
