We’re looking for an “ankle brachial pressure index” archetype.
We did not find anything in CKM. But we did find such an archetype in norwegian ckm by @siljelb.
I wondered why the pressure measurements are part of the archetype. In my opinion the brachial pressure would best be recorded as observation.blood_pressure. And the ankle pressure as OBSERVATION.intravascular_pressure (since it’s not a surrogate for the systemic arterial pressure). Similar to BMI.
I would be interested to discuss adding references to the values used to the observation.ankle brachial index archetype, probably as DV_EHR_URI, under the protocol section?
Hi Joost! This archetype was imported based on this proposal back in 2017, and has been sitting there untouched since then.
I don’t have any strong feelings about the modelling pattern, other than the fact that both the upper arm and the ankle are measurement locations included in the OBSERVATION.blood_pressure archetype, and should therefore both be possible locations to measure a surrogate for the systemic arterial pressure? I’m not sure what the difference is between an ankle systolic blood pressure which is measured as a surrogate for the systemic arterial pressure, and one which isn’t?
Yeah, I saw the obs.bloodpressure has an ankle measurement location.
The (main?) indication for taking a ‘ankle brachial pressure index’ is suspected low (regional) blood pressure in the foot, as part of suspected peripheral arterial disease. So the ankle pressure has a high chance of not adequately reflecting the systemic blood pressure when taken as part of a ankle brachial index.
If we agree on this, maybe we should add a comment to the obs.bloodpressure. (if even one of the most experienced modellers doesn’t think of this, we can’t assume regular modellers do.)
I agree. Though also perfectly valid to use the ankle pressure as a systemic pressure (assuming we are confident that it is not compromised by peripheral; disease).
I bet the banks don’t have to think of this sort of thing!!