Is there an existing archetype that expresses Hypersensitivity examination? How are test results, as part of an Hypersensitivity examination, expressed, such as results of elimination test of food, results of provocation test and results of skin prick-test? Is there any specific archetype that expresses information about the results of food elimination test, results of provocation test and results of skin prick?
Hi Per!
The āAdverse reaction monitoringā archetype is fairly new and still very basic, but I suspect this is the concept youāre looking for: Clinical Knowledge Manager
It may need to be fleshed out for more detailed recording needs.
Edit: I just noticed you also asked for elimination tests, which I think would be different from this concept. @heather.leslie, can you think of any existing archetype which could be used to express the result of an elimination test?
Silje, Per,
If we are talking about recording the results of skin prick tests my first thought was that we need a new archetype, something along the lines of the draft Mantoux test, where we record the reaction and size of wheal to each substance.
I have no personal knowledge about how to record the results of a food elimination or provocation test. Per, if you can provide some insights into clinical requirements it would help, although I doubt that we have an archetype pattern ready to go. I will add that it is good to be looking at this family of models at the same time as we are likely to identify some commonality in recording requirements for each that may inform the design of all.
The Adverse reaction monitoring that Silje suggested was triggered by a need to record that a patient was observed post-vaccination or similar, and that there was or wasnāt a reaction. The reaction and allergen would still be recorded using EVAL.adverse_reaction_risk. Without understanding the recording requirements it is hard to see if we can bring this all together, but this is one of the joy of smart modelling, so Iām interested to explore this with you further.
Cheers
Heather
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Perhaps a new archetype for this purpose could be generalised as āProvocation testā, of which a skin prick test is one example?
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Hi and thanks,
That was my thought as well @siljelb, I belive thereās a number of provocation tests that could be described similar, Iāll try to investigate the Mantoux Test arketype and respond again after that @heather.leslie.
Hey,
I would like to re-open this discussion. Has there been any updates on archetypes to model e.g. the skin prick test? I am guessing that recording allergies could be otherwise modelled via OBSERVATION.adverse_reaction_screening.v0 in a simple yes/no fashion. The rather new Archetype OBSERVATION.adverse_reaction_monitoring.v1 also seems suitable. However, in the Misuse section it explicitly states that for a skin prick test other suitable Archetypes should be used, without referencing any.
I am happy for any input on this!
Thanks in advance
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Id still suggest that the initial testing is some kind of observation and not directly a risk of allergy record as such.
As an example i had a bunch of allergy tests done years ago which listed all sorts of positive results but which i know for certain do not cause me any issues. I would not regard a positive test as the same as a statement of future risk.
If this is a typical skin prick test result it might well be easiky captured with standard Cluster Laboratory Analyte archetype though i can also see an argiment for a specific cluster as Heather suggested.
Certainly IgE tests are easily handled by the typicsl lab archetypes.
If a positive test was detected and clinically thought to be validthen the Risk of adverse reaction Evsluation archetype is, i think ybe correct place to record the definitive record probably as part of an allergy list composition.
I would only use the Adverse reaction screrning archetype in the context of an assessment questionaiire eg by a patient or junior stsff member or where very specific protocol driven allergies are involved eg are you allergic to iodine? In the context of imaging. A positive response there, confirmed by a clinician should result in that too bring added to the authoritative allergy list, if it exists.
I agree that this is more observational data than the āalert statementā that is the āAdverse reaction riskā archetype. However, Iām not sure I agree that skin prick tests are lab tests in the way we think of them in the context of the Lab test OBSERVATION archetype: Theyāre performed directly on the patient and not on a collected specimen.
Additionally, there are several other similar tests that are carried out on the patient themselves, like the nasal spray provocation test for dust mite allergy, or oral food challenge tests. The details may be too different, but Iād like to try to generalise them into a kind of āProvocation testā OBSERVATION.
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Having explored a little I agree that Provocation test is a better approach other than for IgE tests which are def lab tests.
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