Hi,
In Region Östergötland, Sweden, we have resumed work on modeling echocardiography measurements. We have been in contact with Basel but sadly their work is on hold for the time being. But their work has inspired us a lot.
We have some questions that we hope to get answers or guidance on here.
Regarding anatomical localization, how deep should we go with specialization archetypes? That a measurement concerns the left ventricle, where is this best expressed? With a new specialized cluster archetype for the left ventricle or in an attribute in a more general imaging examination of the heart cluster archetype or with precoordinated concepts?
Then regarding different modes/views/methods for each measurement. Each measurement can be done in different ways, in different modes such as 2D, from a specific view such as PLAX and with a special method such as biplane. Where should this be expressed? In the observation archetype one level up from the cluster archetype? This is specific information for each individual measurement parameter, not to the examination as a whole. Can it be expressed as a separate cluster under each measurement parameter? Or should we stop trying to model it and use pre-coordinated codes to express this more detailed information.
A related question concerns how to specify which phase the heart is in during the specific measurement? Or if this also is better handled by a specific attributes tied to precoordinated concepts.
Another avenue we have considered is whether we can take inspiration from the spirometry archetype that uses runtime name constraint. But maybe this is outside of the current design pattern of imaging archetypes?
Measurement example:
IVSd - Interventricular septum thickness at end-diastole, measured with M-mode, PLAX
IVSd - Interventricular septum thickness at end-diastole, measured with 2D, PLAX
A standard examination in Sweden might contain about 20-30 measurements and there are about 80 measurements that are could be of interest for our clinicians.
Kind regards,
David