Stream: terminology
Topic: ReferenceRange value set - type/meaning
John L Allen (Dec 13 2018 at 05:18):
In regards to the reference range type value set (http://hl7.org/fhir/valueset-referencerange-meaning.html), I have a few questions:
1. Is there no 'critical' type? (Technically, the reference range would be described as 'non-critical', as only the values outside of the range are considered critical). Perhaps I am not looking in the right place, but I feel critical (aka panic) ranges are both common and needed.
2. The online specification for the value set (Release 3 STU) states that 'normal' refers to 95th percentile--probably not technically correct, as it spans from 2.5th percentile to 97.5th percentile, which spans 95% of values.
3. Other percentiles - for whatever reason, the literature (eg Fourth Definition of Myocardial Infarction) frequently uses 99th percentile for troponin I's upper limit of normal. And the EMRs I use seem to use that as the main reference range (as opposed to 97.5 percentile) for this lab. I'm not suggesting a new code for this range, but maybe the definition on the value set's FHIR web page can add a little wiggle room. (Alternatively, this could be grouped under 'recommended' type like we do with lipids, I suppose).
Grahame Grieve (Dec 13 2018 at 09:01):
these questions really belong here: https://chat.fhir.org/#narrow/stream/103-Orders-and.20Observation.20WG. My take is that definition of normal is too tight, and I agree that some kind of panic / critical code is commonly encountered in lab reports
Rob Hausam (Dec 13 2018 at 11:34):
Discussion moved here https://chat.fhir.org/#narrow/stream/103-Orders-and.20Observation.20WG/subject/ReferenceRange.20value.20set.20-.20type.2Fmeaning
@John L Allen
Last updated: Apr 12 2022 at 19:14 UTC
