Stream: implementers
Topic: Reference range with mean in Observation
Morten Ernebjerg (Apr 08 2021 at 09:04):
I have a case where a measurement value comes not only with a reference range (high/low) but also an additional single reference value/mean somewhere inside this interval (this could also be seen as a central value + non-symmetric deviations above and below). Is there a standard way of capturing this in an Observation? - I did not see any standard extension for this.
(BTW I think there was a discussion about a similar topic a while back, but I couldn't find it again)
Eric Haas (Apr 08 2021 at 14:29):
Sounds like an extension on reference Range to me
Lloyd McKenzie (Apr 08 2021 at 15:26):
Or even an extension on the Range data type in general. Two extensions actually - one for 'mean' and one for 'contains'.
Morten Ernebjerg (Apr 09 2021 at 05:29):
The thing is that Observation.referenceRange is a BackboneElement that directly includes high and low fields and does not use the Range type at all. Hence, like @Eric Haas, I was thinking along the lines of a direction of an extension (say "centralValue") on Observation.referenceRange, similar to the high and low elements. In fact, I am wondering whether there might be cases where measurements come with only a single reference value and no interval at all, meaning that one would only want to give the extension and neither high nor low (but possibly still the type, age, and appliesTo fields). However, that is currently precluded by the constraints on the referenceRange element (low.exists() or high.exists() or text.exists()).
Tilo Christ (Apr 09 2021 at 11:17):
In my line of work (chronic care) I have seen reference values from literature that are being displayed as comparison points, such as "the average value within males above 65 is 6.8 mg/dL". This would not have an interval. Would this rather be a topic for an extension, or can the means of the referenceRange be bent to fit? The type is only "preferred", so adding something like "literature" or "mean" as a type would be possible (albeit undesirable?), and the low/high could be set to an identical value. The text could then further explain what is meant.
Morten Ernebjerg (Apr 09 2021 at 11:53):
@Tilo Christ That actually sounds like the kind of reference value I also have (except I also have an interval).
Tilo Christ (Apr 09 2021 at 13:45):
I think nothing would stop you from attaching several different reference ranges to the same observation, it is 0...*.
Morten Ernebjerg (Apr 12 2021 at 13:33):
Yes, indeed. I my case, the single reference value actually belongs together with the interval ("interval with a central value"), but I guess there could be cases where they are alternatives or apply in different situations.
Last updated: Apr 12 2022 at 19:14 UTC
