openEHR and PROMS, PREMS and patient self reported questionnaires

Clinical Ask an editor
21

Hi Jean-Pierre,

You are stepping into a hotly contested area!!

See Natural language based FLAT format and long container/element names - #22 by siljelb

but there was also a very long discussion ‘hosted’ by the openEHR tem at Basel which got a bit stuck on the same topic.

The Apperta archetypes were an earlier attempt to solve the problem but were also driven by a particular openOutcomes application requirement, and a current specific limitation in webTemplates so I would not use these as exemplars.

Fundamentally, there are several compelling requirements that are in-conflict.

  1. We need to be able to represent and easily show the full original text, both to help implementers and to help the CKM editors satisfy PROMS licence-holders that the archetypes are compliant

  2. This tends to go against previous CKM guidance that archetype node names should be kept short, as we are not directly trying to represent UI names. The use of long names also complicates the generation of downstream technical artefacts which use human language e.g. Web templates/FLAT format. The dev community is getting more interested in this because FHIR has shown that using tokenised English has a lot of advantages vs e.g atCodes, in terms of ease of use and e.g FHIRPath

We went round the houses quite a few times and it really came down to a choice between…

  1. Imposing a burden on archetype authors/editors to create appropriate short names, along with some changes in tooling to allow long names to be displayed, if these were held in e.g archetype node ‘description’.

  2. Imposing a burden on developers in potentially having very long tokenised paths in various artefacts esp in FLAT Composition formats

Until recently, I was very much in favour of using short names for archetype nodes but I can see the other argument, and I’m now coming round to the idea that perhaps the place for shortened node names is at template level. i.e if you need/want a short version of a node name, overwrite the original long name in the template, or otherwise direct the short path generator to use a short name carried in the archetype/template.

Either way, we will need some changes in tooling to allow this all to work smoothly for all parties.

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