# Person State with History.

**URL:** https://discourse.openehr.org/t/person-state-with-history/14769
**Category:** Clinical (archive)
**Created:** [30 June 2008 11:02 UTC](https://discourse.openehr.org/t/person-state-with-history/14769 "2008-06-30T11:02:36Z")
**Posts on this page:** 7
**Page:** 1

<div class="post-metadata">

### Author: ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)
#### Post date: [30 June 2008 11:02 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/1 "2008-06-30T11:02:36Z")

</div>

Dear Richard,

For the best answers concerning the Clinical Modeling I refer you to the openEHR list for clinical discussions.  
Most persons actively involved in clinical modeling can be found here.

[http://www.openehr.org/community/mailinglists.html](http://www.openehr.org/community/mailinglists.html)

Gerard Freriks

> Dear Gerard,
> 
> Do you know of any existing OBSERVATION that uses the Person State with History?
> 
> I haven´t found any, and I try to understand the difference between Person State with History-events and the events that is mandatory within data History.
> 
> Regards  
> Richard
> 
> * * *

Electronic Record Company B.V.

_Distributor of_ _Ocean Informatics_

_for Europe and the Middle East_

Leidsevaart 594-596  
NL-2014HT Haarlem  
PO Box: 376, NL-2300AJ Leiden

the Netherlands

**M:** +31 620347088  
**E:** [g.freriks@e-RecordCompany.EU](mailto:g.freriks@e-RecordCompany.EU)

– –  
Gerard Freriks, MD  
Huigsloterdijk 378  
2158 LR Buitenkaag  
The Netherlands

T: +31 252544896  
M: +31 620347088  
E: [gfrer@luna.nl](mailto:gfrer@luna.nl)

Those who would give up essential Liberty, to purchase a little temporary  
Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

---

<div class="post-metadata">

### Author: ![Andersson\_Richard](https://discourse.openehr.org/letter_avatar_proxy/v4/letter/a/c77e96/32.png) [@Andersson\_Richard](https://discourse.openehr.org/u/Andersson_Richard)
#### Post date: [30 June 2008 11:41 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/2 "2008-06-30T11:41:56Z")

</div>

Hello everybody!

Do anyone know of any existing OBSERVATION that uses the Person State with History?

I haven´t found any, and I try to understand the difference between Person State with History-events and the events that is mandatory within data History.

Regards

Richard Andersson

University Hospital of Lund, Sweden

---

<div class="post-metadata">

### Author: ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)
#### Post date: [30 June 2008 12:07 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/3 "2008-06-30T12:07:16Z")

</div>

Andersson Richard wrote:

> Hello everybody!
> 
> Do anyone know of any existing OBSERVATION that uses the Person State with

History?

> I haven´t found any, and I try to understand the difference between Person

State with History-events and the events that is mandatory within data History.

Have a look at Page 57/58:  
[http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/architecture/rm/ehr\_im.pdf](http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/architecture/rm/ehr_im.pdf)

State information is optional, and is not needed if the data are meaningful on  
their own. If it is recorded, it can either be as a History of its own (i.e.  
using the OBSERVATION.state atttribute described above), or else as state  
values within the EVENT instances in the OBSERVATION.data History. Both  
methods are useful in different circumstances. A separate state history is  
more likely to be used in a correlation study such as a sports medicine study  
on heartrate with respect to specific types of exercise. In this method, the  
state information is a History of Events whose times and widths neednot match  
those of the History in the data attribute. The state data under this approach  
generally express the condition of the subject in absolute terms, i.e. they  
are standalone statements about the subjects state at certain points in time,  
such as walking on treadmill 10km/h, 10o incline. The other method will be  
used in most general medicine, e.g. for recording fasting and post glucose  
challenge states of a patient undergoing a glucose tolerance test. (See the  
Data Structures Information Model for more details). State values stored  
within the data History represent the situation in the subject at the time of  
the Event within the History and usually in relation to it, for example post  
8 hour fast. Recording the latter example in an independent state History  
would require an Event of 8 hours  
duration called fast. The latter would be technically still correct, but  
would be very unnatural to most clinicians. FIGURE 21 illustrates the two  
methods of recording state.

I hope that clarifies the differences, but I am not aware of an "official"  
openEHR archetype that uses the first approach.  
Sebastian

---

<div class="post-metadata">

### Author: ![Andersson\_Richard](https://discourse.openehr.org/letter_avatar_proxy/v4/letter/a/c77e96/32.png) [@Andersson\_Richard](https://discourse.openehr.org/u/Andersson_Richard)
#### Post date: [30 June 2008 12:33 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/4 "2008-06-30T12:33:47Z")

</div>

I have already read that section in [http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/architecture/rm/ehr\_im.pdf](http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/architecture/rm/ehr_im.pdf) some times 🙂

It´s just that I can´t grasp the practcal use. Why can I not use "post walking on treadmill 10km/h, 10o incline" in state within the data history, just like in the example of "post 8 hour fast"?

---

<div class="post-metadata">

### Author: ![thomas.beale](https://discourse.openehr.org/user_avatar/discourse.openehr.org/thomas.beale/32/35_2.png) [@thomas.beale](https://discourse.openehr.org/u/thomas.beale)
#### Post date: [1 July 2008 05:14 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/5 "2008-07-01T05:14:49Z")

</div>

Andersson Richard wrote:

> I have already read that section in [http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/architecture/rm/ehr\_im.pdf](http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/architecture/rm/ehr_im.pdf) some times 🙂
> 
> It´s just that I can´t grasp the practcal use. Why can I not use "post walking on treadmill 10km/h, 10o incline" in state within the data history, just like in the example of "post 8 hour fast"?

because the way doctors think is:

- for something like GTT, they just want to see one graph, of the data  
points (the glucose values), but each data point needs to know what the  
patient state way (post fast or whatever)  
- for sports medicine (as an example) they want to see two graphs, the  
heartrate versus the treadmill speed/inclination, or somesuch.

The latter therefore can be most easily modelled in 2 separeate  
HISTORYs, whereas the first is modelled as one, with each EVENT carrying  
a patient state indicator.

- thomas beale

---

<div class="post-metadata">

### Author: ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)
#### Post date: [1 July 2008 07:23 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/6 "2008-07-01T07:23:47Z")

</div>

Thomas,

What gets modeled where?

Reading your examples I have the following questions:

- GTT, “want to see one graph”. Are you talking about an Archetype or a Template?  
I think you are talking Templates where clinicians want to see something.  
They use in the template archetypes.

Archetypes are used to store information in the database.  
When I store 10 Glucose measurements and patient states obtained at 10 different dates and times in the data base each as single point measurement using an Archetype each time to store that measurement,  
and when I store 10 Glucose measurements and patient states obtained at 10 different dates and times as a times series in the data base using one Archetype,  
can I retrieve **all** glucose data and patient states using one version of the Archetype or do have have to use one Archetype version with all measurements modeled separately and one Archetype with all measurements modeled as a time series?

Gerard

– –  
Gerard Freriks, MD  
Huigsloterdijk 378  
2158 LR Buitenkaag  
The Netherlands

T: +31 252544896  
M: +31 620347088  
E: [gfrer@luna.nl](mailto:gfrer@luna.nl)

Those who would give up essential Liberty, to purchase a little temporary  
Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

---

<div class="post-metadata">

### Author: ![thomas.beale](https://discourse.openehr.org/user_avatar/discourse.openehr.org/thomas.beale/32/35_2.png) [@thomas.beale](https://discourse.openehr.org/u/thomas.beale)
#### Post date: [2 July 2008 03:43 UTC](https://discourse.openehr.org/t/person-state-with-history/14769/7 "2008-07-02T03:43:30Z")

</div>

Gerard Freriks wrote:

> Thomas,
> 
> What gets modeled where?

I would argue that since OGTT is a very common test, it is an archetype  
which it is - see the glucose result archetype. For the sports ones, I  
would expect to see some archetypes as well, but I know very little  
about this part of medicine.

I was not making any suggestions about which is used however, only  
saying why the underlying reference mode is the way it is.

> Reading your examples I have the following questions:  
> - GTT, "want to see one graph". Are you talking about an Archetype or  
> a Template?  
> I think you are talking Templates where clinicians want to see something.  
> They use in the template archetypes.
> 
> Archetypes are used to store information in the database.  
> When I store 10 Glucose measurements and patient states obtained at 10  
> different dates and times in the data base each as single point  
> measurement using an Archetype each time to store that measurement,  
> and when I store 10 Glucose measurements and patient states obtained  
> at 10 different dates and times as a times series in the data base  
> using one Archetype,  
> can I retrieve \*all\* glucose data and patient states using one version  
> of the Archetype or do have have to use one Archetype version with all  
> measurements modeled separately and one Archetype with all  
> measurements modeled as a time series?

this will be an application issue, since in reality more than one  
different time-series measurement has been made (even if some of the  
subsequent ones only have one sample). If one group of samples is indeed  
made using the same protocol, as a single test, then it should be  
represented as a single Observation with a single History containing N  
(usually 3) Events.

- thomas
