We are currently working on an application for palliative care. The base is ESAS-R (Edmonton Symptom Assessment System Revised). In addition to this the hospitals use a form for pain evaluation/assessment. A typical solution for this is a paper form presented to the patient to record their pain. The patient is asked to mark on this image:
The original her: https://oslo-universitetssykehus.no/seksjon/kompetansesenter-for-lindrende-behandling-helseregion-sor-ost-kslb/Documents/ESAS%20skjema%20med%20kroppskart.pdf
The following characters of the pain is used:
- Irregular (uneven)
- Triggered by movement
- A. Aching
- B. Pulsating
- C. Stinging
- D. Cutting
- E. Tearing
- F. Pressing
- G. Burning
- H. Radiant
- I. Scorching
- J. Ilende (hurrying?)
- K. Other
The patient is, AFAIK, asked to represent pain on the image using numbers and letters. The result will be a dataset with pain-symptoms located to different regions of the body.
To model this I think we we will use the following archetypes:
- Story - https://ckm.openehr.org/ckm/archetypes/1013.1.68
- Symptom - https://ckm.openehr.org/ckm/archetypes/1013.1.195
I have looked at SNOMED-CT to specify the anatomical regions and to describe the pain.
The anatomical regions is a combination of regions in vertical plans (frontal/dorsal) and laterality (left/right). I have found the following terms:
Regions with vertical plan and laterality:
419605007 |Structure of ankle and/or foot| 53840002 |Calf of leg| 68367000 |Thigh structure| 85562004 |Hand| 14975008 |Lowerarm| 40983000 |Upperarm|
Regions with only vertical plan:
Frontal 26893007 | Inguinal region structure (body structure)| 22943007 |Trunk structure| 774007 |Head and neck| Dorsalt 46862004 | Buttock structure| 22943007 |Trunk structure| 304036007 |Neck region|
Some design thinking:
- Should I go with a generic (approved) archetypes using SCT as terminology?
- Should I develop a “domain-specific” cluster archetype for the purpose?
- Should it be developed as anatomy first?
- or maybe pain characteristic first?
I have not yet had detailed dialogue with the clinic. This is of course needed to make the requirements right.
Sharing the initial thoughts and would be happy to know if anyone already have been working in this use-case (or similar).