Adding Terminologies to DV_Ordinal

Clinical
1

Hey,

Classical you would annotate them, i personally do not like that, since that information is lost the moment its serialized.
To have it in the composition, what we normally do is add mappings to a locatable.
Thats something i also find kind of dull, since thats not validated etc.

DV_Ordinal already has a Code and Text, since its an CODED_TEXT i can exchange the terminology_id with e.g. SNOMED as we usually do that with DV_CODED_TEXT (AD misses support for that).
Isn’t that the best option so far ?

2

storing a term binding on the DV CODED text would make most sense to me. I couldn’t find out how to do that in AD.
Neither on the Nedap tool. But since that tools uses adl2 I should be able to edit the adl for the template, but haven’t yet checked wether that validates. (And it also need support in apps/CDRs). It does seem like a regular feature btw.

3

Terminology tab - Bindings

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Any coded Text , including those associated with ordinals can carry a code biding.

however bindings are design-time ‘suggestions’ they do not
in any force the binding suggestions to be carried in the patient data as term mappings.

Which comes back to the same issue of how we might constrain those mappings to be ‘actioned’ at run-time (and indeed over-written in some cases).

4

In case of the DV_ORDINAL its quite simple as stated above, you can use the DV_CODED_TEXTs terminology_id and replace it with e.g. snomed-ct.
No need for mappings.
As you correctly mentioned (what i referred to as annotation in the first sentence), its not validated and does not appear in the composition.

5

I’m confused. For a DV_ORDINAL, if you are replacing the defining_code (atCoded) with a SNOMED-CT code your composition should not validate correctly as I understand things.

6

Its specified on template or archetype level in our case.
We just replace the at codes as we would normally do in a DV_CODED_TEXT and swap it for e.g. snomed.

7

Can you ping an example? Are you saying that you have something like an unconstrained DV_ORDINAL that you populate at template/ run-time with SNOMED terms?

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We just create a questionnaire in our case.

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You cannot (officially) replace atcodes in a DV_CODED_TEXT with SNOMED CT terms unless the archetype constraint is a DV_TEXT/DV_CODED_TEXT choice or ‘limit to list’ = false in the template

10

What does the archetype look like? We would not currently be able to use SNOMED-CT terms like this in international archetypes because of licensing restrictions

11

Sure, its just for internal use, i also havent tried it yet.
Could be also LOINC in some instances.
The archetype or template is still modeled currently.
But in theory that should work, about the limit to list in the archetype i have to check.

12

I see now. But I’m unable to add a term binding for a template. Is that a tool issue or an adl 1.4 issue?

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13

Tried it in the file, ehrbase didnt validate it (was to be expected).
Theory wise it should be valid as long as its not limit to list right ?!

14

You mean you hand edited the opt json file?

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15

Yeah, i mean there are not a lot of options left lol.

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16

Check. I’m not familiar with how adl1.4 templates work. In adl2 it’s just a specialised archetype, so you should be able to specialise an atcode and add a term binding in the template by righting it in ADL. I’m quite sure that validates, but will check once I’m back at my desktop. Working here btw: Sign In with Auth0 (sign up for free account)

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