# Possible change request for Ocean Archetype Editor

**Category:** [Clinical (archive)](https://discourse.openehr.org/c/clinical-archive/153)
**Created:** 2006-12-11 17:13 UTC
**Views:** 71
**Replies:** 36
**URL:** https://discourse.openehr.org/t/possible-change-request-for-ocean-archetype-editor/14603

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## Post #1 by @Dipak_Kalra

Dear Sam,

I personally feel that the publication status is not obvious enough to be well-used, and would suggest that this goes onto the front screen.

I have a less strong view about the other descriptive information being moved, since the tab for it is clearly visible at all times, but the feedback I have had recently suggests that a clear description of the purpose/use is a headline item that might also be nice on the first screen. However, I could understand if you would not wish to separate this from the other descriptive information (misuse, evidence etc.).

With best wishes,

Dipak

---

## Post #2 by @sebastian.garde

Dear Sam,

I would like to see purpose, use, misuse and life-cycle on the first screen. Maybe:

Purpose, Use, Misuse on the left side and Specialisation, Authorship lifecycle and Subject of data (I have never really seen this in use?) on the right side.

If you don't want to, then I would simply leave the description tab where it is now, I believe the entry model should be second.

The lifecycle/publication status is not very clear to me to be used consistently: Submitted (to whom?), Candidate (for what?) etc.
I believe this will become clear over time, once the process for the development itself is clearer.

Regards
Sebastian

---

## Post #3 by @PPOUDEL

Good day,
It would be interesting and may be more powerful if we could add operators (multiply, devide, substract and additions) in the Ocean Archetype editors.

Regards,
Pratima

---

## Post #4 by @Sam

Do you mean calculated fields? Sam

Pratima Poudel wrote:

---

## Post #5 by @system

Hi,

If calculated fields are requested, taking the square is needed.
And perhaps more.

Gerard

-- <private> --
Gerard Freriks, MD
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The Netherlands

T: +31 252 544896
M: +31 653 108732

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Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

---

## Post #6 by @sebastian.garde

Pratima, Sam,

One example where I miss these operators would be the Barthel archetype - the total score could then explicitly be expressed as the sum of the other scores and automatically calculated.
You probably can do this with invariants somehow? They are just not very user-friendly...

Apart from the four basic operators Pratima mentioned, you could have others like max, min: e.g. an assessment where you take the maximum of several scores to e.g. indicate the severity of a condition.

Sebastian

---

## Post #7 by @PPOUDEL

Good day,
I would like to give some example here what I actually mean. It is may be better to have operators and min, max etc all. People will have flexibility.

**1.I am using Ocean Archetype in desigining EHRs may be guidelines**
**Senerio 1: For example**
**Alcohol wihdrawl Protocol: guideline for assessment and initiate treatment**
**Criteria 1: Perspiration**
0 = no abnormal sweating
1 = Moist skin
2= Localised sweat (face/chest)
3 = Whole body wet
4 = Profusing sweating (includes linens)

**Criteria 1: Tremor**
0 = No tremer
1 = Slight intentional
2 = Constant slight in uppper extremities
3 = Constant marked tremor

so on
Clinician can choose appropriate number and criteria based on the objective data (data from the assessment or observation). At the end of the assessment, text box ( square box) should show the sum (sevirity index . Based on the sum we can initiate three plan
1. mild - continue 4 hrly observation
2. Mod. - Oral diazepam such dose and such interval
3. Severe: IV diazepam such dose and such interval
To do this doctor does not need to be presented nurse can assess and initiate plan as agreed by multidiscplinary team.

**2. Senerio 2: For example**
I need operators to calculate certain values using observational data and lab test results. Thus, multiple text box need using along with the operators (This should be based on the reserch articles though).This gives sevirity index. Based on this we can create individual based plan. It is more decision making but data input can be done using openEHR archetypes if the calculation ability is incorporated. The data collected through this will be utilize for reserch too (vertual randomise trials). Because these data are complete, accurate and based on the clinical literatures. Again you can modify as reserch changes.
This will help in EBP, research and guideline development. What is your opinion?

Regards,
Pratima

---

## Post #8 by @Sam

Invariants are, on the whole, the way we would like to express this. This means for example, that you can say if all the scores are present, then the score is the sum of all the ordinals. It is clear, in apgar, that only the total is recorded in many instances - so it cannot just be a calculated field.

I agree that they are not user friendly and hard to write - is there a syntax for calculation we could use for the calculation aspect which many would be happy to use?

Sam

Pratima Poudel wrote:

---

## Post #9 by @Sam

Sebastian

Just to say that we have to be careful not to try and include decision support in the archetype itself - it just beeds to support DS engines.

Cheers, Sam

Sebastian Garde wrote:

---

## Post #10 by @PPOUDEL

Good morning,
My clinical experiences is:
Clinician does clinical assessment first before initiating plan and intervention. SOAPIE (Subjective data, objective data, assessment, Plan, intervention & Evaluation) are helping in critiical thinking leading to decision making at the end of the day.
From the reality point of view (how we perform our work): Social workers (normally write story about patient's social life in the clinicial notes) and all other clinician ( physio, doctor, nurses, occupational therapist, specialits ) collects clinical data using SOAPIE to execute intervention (eventually simple way of creating clinical decision). SOAPIE can be the standard way of writing clinical notes. Here in Middlemore hospital, they have been using this method for writing clinical notes. In Auckalnd city hospital doctors and physios writies using SOAPIE. Nurses uses Foci methods. I guess, EHR always helps in making clinical decisions in the most of the clinical situations and some of the decision requires decision engines.

Regards,
Pratima

---

## Post #11 by @Andrew_Patterson

> hospital doctors and physios writies using SOAPIE\. Nurses uses Foci methods\.
> I guess, EHR always helps in making clinical decisions in the most of the
> clinical situations and some of the decision requires decision engines\.

Pratima, I don&#39;t think anyone is suggesting that decision support
wouldn&#39;t be delivered at the pointy end of the clinical process, just
that archetypes aren&#39;t the best spot to define the decision support\.

Archetypes really are about the &quot;data&quot; that can be stored \- by
defining the types of data, the meaning of the data and the
rules which say whether the data is valid\. The archetype shouldn&#39;t
define what happens when the data matches a certain condition\.

So in the case of your alcohol protocol

The system would define an archetype &quot;AlcoholEval&quot; with

\- a perspiration criteria \(defined to be a number between
0\-4, potentially with bindings to external terminology to give
the numbers more universal meaning\)
\- a tremor criteria \(defined to be 0\-3 etc\)
\- a protocol score \(defined to be an integer between 0\-7,
with an invariant in the archetype starting that it is the addition
of the other scores\)

Some user interface would be presented to the clinician to
allow them to fill this data in\.

Elsewhere, a decision support engine would have some rules
that says if I encounter a &quot;AlcoholEval&quot; archetype, to recommend
different actions\.

1\. mild \- continue 4 hrly observation
2\. Mod\. \- Oral diazepam such dose and such interval
3\. Severe: IV diazepam such dose and such interval

But the standards for defining formats for protocol guidelines
and interoperable decision support engines are still a way
off \(i\.e\. your local implementation of openehr will probably have
a way of doing this decision support but its not part of the
standard\)\.

\(btw this is my understanding of the situation \- others with
more clinical expertise or openehr expertise may disagree :\)

Andrew

---

## Post #12 by @Andrew_Patterson

>  I agree that they are not user friendly and hard to write \- is there a
> syntax for calculation we could use for the calculation aspect which many
> would be happy to use?

I don&#39;t think its possible to go down the road of having computation
in the archetypes unless it is very strictly controlled \(even then I&#39;m
not sure its possible\)\. As soon as you have invariant statements
with sideeffects \(i\.e\. the ability to calculate the value of a field rather
than just check its validity\) you then introduce problem with ordering
\(the order the invariants are executed now matters\), cycles \(an
invariant changes a value that was previously ok&#39;ed by another
invariant \- do we go back to check it again\) and indeed whether all
this checking will ever terminate\.

Whilst it may seem like a subtle difference between an invariant
that says &quot;the scores must sum up to the total&quot;, and &quot;make this total
be the sum of the scores&quot;, it is a huge difference computationally\.
It may be possible to write code that analyses invariants and
tries to construct corresponding code for calculation that is useable in the
user interface &quot;template&quot; for that archetype\.

Andrew

---

## Post #13 by @PPOUDEL

Thank you Andrew for your clearification. I was wondering whether I could do both storing EHR and sinple DS through the archetypes therefore I was looking for the calculation field etc. etc. This means that EHR must be linked with separate DS engine. This helps heaps for my thesis.

Regards,
Pratima

---

## Post #14 by @Koray_Atalag

Hi to all,

While revising my MST archetypes, I came across some confusion on the
use of cardinality and occurences\. And when I reread ADL 1\.4 and ADL2,
inspected the sample archetypes and then created new ones with Archetype
Editor and also tested with the Workbench my confusion got even more
increased\. Here is the problem description and some questions:

As stated in ADL 1\.4: &quot;Cardinalities indicate limits on the number of
members of instances of container types such as lists and sets&quot;\. From a
simpler point of view, what I understand it tells the min and max
allowed number of beads \(same or different beads\) in a box\. From a more
sensible way in the realm of clinical archetypes written in ADL, it is
used to constrain the min and max allowed number of run\-time instances
of child nodes of attributes which can be a container such as  CLUSTER,
ITEM\_TREE, ITEM\_LIST, HISTORY and so on\.

So far so good but I have a practical problem to model a situation like
the following:
PARENT\_NODE \(A container type and might not exist or repeat up to  2 times\)
&nbsp;&nbsp;&nbsp;&nbsp;a\) CHILD\_NODE \(Must appear once\)
&nbsp;&nbsp;&nbsp;&nbsp;b\) CHILD\_NODE \(May appear 0 to 8 times\)

So this roughly can be expressed as:
CLUSTER occurences \{0\.\.2\}
&nbsp;&nbsp;&nbsp;&nbsp;any container attribute cardinality \{1\.\.9\}
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;QUANTITY occurences \{1\.\.1\}
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;ELEMENT   occurences \{0\.\.8\}

PROBLEM\-1: As understood from above description that cardinality simply
depicts the number of instances of subchilds \- REGARDLESS of their type
\(i\.e\. QUANTITY or ELEMENT\), then above cardinality can be \{1\.\.9\} or
simply \{1\.\.\*\}\. When I examine some sample archetypes such as Line 67 in
autopsy\.v1, Line 33 in respiration\.v1 and Line 103 in microbiology\.v1
the cardinality of container node is \{0\.\.1\} and they have a number of
child nodes with occurences &gt;0 and it is clear clinically that almost
ALL of those nodes should appear in runtime data\. So there is either a
misunderstanding of the use of cardinality here among most of us or I am
totally lost here :\)

The above model is expressed in those archetypes roughly as follows:

CLUSTER
&nbsp;&nbsp;&nbsp;&nbsp;any container attribute cardinality \{0\.\.2\}
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;QUANTITY occurences \{1\.\.1\}
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;ELEMENT   occurences \{0\.\.8\}

QUESTION\-1: What is the correct approach for above problem?

QUESTION\-2: Assume in some other place in the archetype you reference
the ELEMENT node with occurences \{0\.\.8\} by use\_node\. And in this
particular place you do not want to have up to 8 instances and but also
you want it to be mandatory \(i\.e\. 1\.\.\) or even want \{3\.\.5\}\. What is the
solution? \(other than writing the whole thing once again\)

QUESTION\-3: Related with second question, I also need to disallow usage
of some values when referencing by use\_node entries\. This I believe is
not an uncommon requirement in clinical medicine\.For me I have an
element with a long list of  values of sites of an organ \(Esophagus,
stomach, colon and so on\) and in many places of an observation these
sites repeat without change so I can reference original\. But in some
cases selection of certain site\(s\) is not logical and should better be
restricted or selection of only one site makes sense\. What is the solution?

Thanks and happy new year to all\.\.\.

\-koray

---

## Post #15 by @Sam

Thanks Koray

Your expression of cardinality and occurrences is exactly correct - there are clearly some errors in the archetypes.

The only reason to limit cardinality in the archetype is to force a choice when there are more than one child e.g.

container x with cardinality 1..2
has children a (occurrences 1..1)
b (occurrences 0..1)
c (occurrences 0..1)

This forces a choice between b and c.

Cheers, Sam

Cheers, Sam

Koray Atalag wrote:

---

## Post #16 by @Stap_R.E_Roel

Hello Koray,

Reading your issues around cardinallity, perhaps you can solve this issue with help of constrains/business rules. E.g. if you consider in the Archetype model the ability to have a cardinality between A and B of (0..N), you can constrain practically this cardinality to a maximum of e.g. 4. The risk of modelling you cardinalities so precise in the archetype model is that if in future this is changed, your system (e.g. database schema's or applications) needs to be updated if this cardinality changes. If you are able to define the reason of this cardinality in rules you may create the flexibility in future to adapt this without changing systems or applications. I am not sure if this will help you, but consider this mechanism to handle cardinalities issues.
I hope this may help you in finding a solution for your issue,

regards
Roel

Roel Stap

TNO-ICT
Colosseum 27
7521 PV Enschede
+31 53 4835212
+31 6 10968787

[http://www.tno.nl/ict](http://www.tno.nl/ict)

DISCLAIMER
[http://www.tno.nl/disclaimer/email.html](http://www.tno.nl/disclaimer/email.html)

---

## Post #17 by @Koray_Atalag

Stap, R\.E\. \(Roel\) wrote:
> Hello Koray,
>
> Reading your issues around cardinallity, perhaps you can solve this
> issue with help of constrains/business rules\. E\.g\. if you consider in
> the Archetype model the ability to have a cardinality between A and B
> of \(0\.\.N\), you can constrain practically this cardinality to a maximum
> of e\.g\. 4\. The risk of modelling you cardinalities so precise in the
> archetype model is that if in future this is changed, your system
> \(e\.g\. database schema&#39;s or applications\) needs to be updated if this
> cardinality changes\. If you are able to define the reason of this
> cardinality in rules you may create the flexibility in future to adapt
> this without changing systems or applications\. I am not sure if this
> will help you, but consider this mechanism to handle cardinalities issues\.
> I hope this may help you in finding a solution for your issue,
>
> regards
> Roel
>

Hi Roel,

Thanks for the information you provided; especially the one about the
effect of archetype design on the resulting software and database
schema\. I would still like to take your attention to my specific
questions 2 and 3\. These point out to very detailed aspects of archetype
design \- ones that most probably will never encounter while designing
their archetypes\.

Best regards and Bedankt\!

\-koray

---

## Post #18 by @Koray_Atalag

Sam Heard wrote:
> Thanks Koray
>
> Your expression of cardinality and occurrences is exactly correct \-
> there are clearly some errors in the archetypes\.
>
> The only reason to limit cardinality in the archetype is to force a
> choice when there are more than one child e\.g\.
>
> container x with cardinality 1\.\.2
> &nbsp;&nbsp;&nbsp;&nbsp;has children a \(occurrences 1\.\.1\)
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b \(occurrences 0\.\.1\)
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;c \(occurrences 0\.\.1\)
>
> This forces a choice between b and c\.
>
> Cheers, Sam

Hi Sam,

Thanks for your kind answer and simple explanation; I just needed that
:\) Regarding the errors in the archetypes \(and possibly others as well\)
I think it would be nice to have this kind of &quot;semantic/validity&quot; check
built into ADL parser or the tools\. Currently both the Editor and the
Workbench allow these type of errors\.

Also if you take a look at my previous questions 2 and 3, they are
pointing out to some other aspects of ADL and archetype design\. I would
highly appreciate some guidance here though not urgent at the time\.

Best regards,

\-koray

---

## Post #19 by @Mattias_Forss1

2007/1/8, Koray Atalag <[atalagk@yahoo.com](mailto:atalagk@yahoo.com)>:

> Currently both the Editor and the
> Workbench allow these type of errors.

Hi Koray,

The latest code of the Java Archetype Editor now validates cardinalities. It also has support for all but the demographics archetypes now. Lots of new improvements and features have been added and version 0.5 of the editor (including the source code) will be released before the end of this month.

Regards,

Mattias Forss

---

## Post #20 by @Stap_R.E_Roel

Hi Koray,

I am not sure if I understand the detailed questions fully, however, I
think that you should keep in mind that the archetypes should be
&quot;generic&quot; as possible\. Archetypes are intended to be reused, and if I
read e\.g\. your issues for a \{3\.\.8\} cardinality I get the impression that
this could be valid for a specific application\. In this situation I
would suggest to make the archetype generic e\.g\. \{0\.\.N\}, and configure
your application in terms of \(business\) rules \(constrains on the
association\)\.

If you need more information please provide a little more information
about your requirements and the application in which you need this\.\.\.

regards
Roel

Roel Stap

TNO\-ICT
Colosseum 27
7521 PV Enschede
\+31 53 4835212
\+31 6 10968787

http://www.tno.nl/ict

DISCLAIMER
http://www.tno.nl/disclaimer/email.html

---

## Post #21 by @thomas.beale

>
> Koray Atalag wrote:
>> QUESTION\-1: What is the correct approach for above problem?
>>&nbsp;&nbsp;&nbsp;&nbsp;

as Sam has said your understanding is correct and the archetype is in error\.
>> QUESTION\-2: Assume in some other place in the archetype you reference
>> the ELEMENT node with occurences \{0\.\.8\} by use\_node\. And in this
>> particular place you do not want to have up to 8 instances and but also
>> you want it to be mandatory \(i\.e\. 1\.\.\) or even want \{3\.\.5\}\. What is the
>> solution? \(other than writing the whole thing once again\)
>>&nbsp;&nbsp;&nbsp;&nbsp;

the current semantics are that the occurrences of the referenced node
are what takes effect\. However, I agree that a preferable approach would
be if the occurrences could be overridden at the origin point of the
use\_node reference\. This would not be incompatible with the current
semantics, and would probably be a useful change\. What do others think?
\[Particularly the Archetype tool authors\]? Note that in the AOM, an
ARCHETYPE\_INTERNAL\_REF inherits occurrences from C\_OBJECT, so in theory
our archetype parsers should handle them, but I have just looked at
mine, and it doesn&#39;t\.\.\.Rong, how about the Java parser? \(So much for
having complete test archetype coverage;\-\)
>> QUESTION\-3: Related with second question, I also need to disallow usage
>> of some values when referencing by use\_node entries\. This I believe is
>> not an uncommon requirement in clinical medicine\.For me I have an
>> element with a long list of  values of sites of an organ \(Esophagus,
>> stomach, colon and so on\) and in many places of an observation these
>> sites repeat without change so I can reference original\. But in some
>> cases selection of certain site\(s\) is not logical and should better be
>> restricted or selection of only one site makes sense\. What is the solution?
>>&nbsp;&nbsp;&nbsp;&nbsp;

I actually think there are various solutions here\.\.\.
\* the most obvious would be that at the point of reference, you create a
CLUSTER node, and then individually reference the subset of paths of
items from the target CLUSTER that you want, but not others\.
\* another one would be to make a number of ITEM\_TREE or ITEM\_LIST
archetype of the relevant piece of content as separate archetypes, and
use slots to include particular subsets\.
\* a third possibility is to use invariants to prevent certain paths from
existing that would otherwise be allowed by the main part of the
definition of the archetype\.

\- thomas beale

---

## Post #22 by @system

> >
> > Koray Atalag wrote:
> >> QUESTION-1: What is the correct approach for above problem?
> >>
> as Sam has said your understanding is correct and the archetype is in error.
> >> QUESTION-2: Assume in some other place in the archetype you reference
> >> the ELEMENT node with occurences {0..8} by use_node. And in this
> >> particular place you do not want to have up to 8 instances and but also
> >> you want it to be mandatory (i.e. 1..) or even want {3..5}. What is the
> >> solution? (other than writing the whole thing once again)
> >>
> the current semantics are that the occurrences of the referenced node
> are what takes effect. However, I agree that a preferable approach would
> be if the occurrences could be overridden at the origin point of the
> use_node reference. This would not be incompatible with the current
> semantics, and would probably be a useful change. What do others think?
> [Particularly the Archetype tool authors]? Note that in the AOM, an
> ARCHETYPE_INTERNAL_REF inherits occurrences from C_OBJECT, so in theory
> our archetype parsers should handle them, but I have just looked at
> mine, and it doesn't...Rong, how about the Java parser? (So much for
> having complete test archetype coverage;-)

I also noticed the lacking of support for occurrencies in some of the C_OBJECT subclasses including ARCHETYPE_INTERNAL_REF. It's no problem to add that. I just need an example archetype for this.

Yes, we _really_ need a common test archetype coverage for all the parsers. :-)

/Rong

---

## Post #23 by @Mattias_Forss1

2007/1/8, Thomas Beale <[Thomas.Beale@oceaninformatics.biz](mailto:Thomas.Beale@oceaninformatics.biz)>:

> >
> > Koray Atalag wrote:
> >> QUESTION-1: What is the correct approach for above problem?
> >>
> as Sam has said your understanding is correct and the archetype is in error.
> >> QUESTION-2: Assume in some other place in the archetype you reference
> >> the ELEMENT node with occurences {0..8} by use_node. And in this
> >> particular place you do not want to have up to 8 instances and but also
> >> you want it to be mandatory (i.e. 1..) or even want {3..5}. What is the
> >> solution? (other than writing the whole thing once again)
> >>
> the current semantics are that the occurrences of the referenced node
> are what takes effect. However, I agree that a preferable approach would
> be if the occurrences could be overridden at the origin point of the
> use_node reference. This would not be incompatible with the current
> semantics, and would probably be a useful change. What do others think?
> [Particularly the Archetype tool authors]?

Hi Thomas,

I think it would be a good idea to let the users of the archetype editors override occurrences of referenced nodes.

Regards,

Mattias

---

## Post #24 by @Jose_Alberto_Maldona

Hi all,

we have a doubt regarding the possibility of overriding occurrences of referenced node. The main concern has to do with the fact that a occurrence constraint is "part" of the semantics of the node being constrained. If it is true, when overriding the occurrences of referenced nodes, do we change the meaning of the original node and therefore the description (and even terminology binding) might become erroneous?.

best regards

Mattias Forss escribió:

---

## Post #25 by @Sam

I think the best response to #3 is to reuse the codes at that point but not a reference. If there is a reference then it has to be the same concept and use the same codes - otherwise it is clearly a slightly different concept (or the archetype is too big and has overlapping concepts)

Cheers, Sam

Thomas Beale wrote:

---

## Post #26 by @Koray_Atalag

Mattias Forss wrote:
> The latest code of the Java Archetype Editor now validates
> cardinalities\. It also has support for all but the demographics
> archetypes now\. Lots of new improvements and features have been added
> and version 0\.5 of the editor \(including the source code\) will be
> released before the end of this month\.

Hi Mattias and others,

I am sorry I did forget to specify which tools I was mentioning about,
it is not the Java one\. In fact I haven&#39;t studied the Java work yet but
will do soon\. To tell you the truth, while writing down 4 monstrous
archetypes \(each having 1500\-2000 lines\!\), I did not use an editor \-
just the good old vi\(m\)\.

In writing my first archetype \(MST\-Colon\) in 2003, there were no useful
editors at all\. But while writing others more recently, I tried with
Ocean Editor first but then decided to write them manually\. This is
possibly due to my previous experience and also the nature of my
archetypes: they contain similar and highly repetitive blocks where just
copy &amp; paste &amp; modify is easy\.

However I think an archetype editor is very handy for domain experts
\(similar to people without in depth technical skills using high level
programming languages like Visual Basic, Fox Pro or Clipper\) while the
ICT professionals or computer freak MDs like myself like to have more
control \(Like people writing C\+\+ or even assembly language\) and thus
prefer the manual way\.

BTW I was wondering if the Java editor supports Unicode as I desperately
need it\.

Best regards,

\-koray

---

## Post #27 by @Mattias_Forss1

Hi Jose,

I don't think the meaning of the node will not change, but it depends on how you define it. If we think of the reference node (use_node) as a shortcut to an entry form. Also think of it as if that shortcut decided how many times the same entry form would show up. If we override the occurrences we don't change the meaning of the entry form.

However, if the original meaning of having for example 2 occurrences of a node we're referencing is to enter observations about two different sites (say internal and external) and if we are allowed to override those occurrences, then the original purpose of the node is not fulfilled because it allows entry to be made less or more times.

This was probably not a full answer to your question.

Regards,

Mattias

2007/1/8, Jose Alberto Maldonado <[jamaldo@upvnet.upv.es](mailto:jamaldo@upvnet.upv.es)>:

---

## Post #28 by @Mattias_Forss1

2007/1/8, Koray Atalag <[atalagk@yahoo.com](mailto:atalagk@yahoo.com)>:

> Mattias Forss wrote:
> > The latest code of the Java Archetype Editor now validates
> > cardinalities. It also has support for all but the demographics
> > archetypes now. Lots of new improvements and features have been added
> > and version 0.5 of the editor (including the source code) will be
> > released before the end of this month.
> Hi Mattias and others,
>
> I am sorry I did forget to specify which tools I was mentioning about,
> it is not the Java one. In fact I haven't studied the Java work yet but
> will do soon. To tell you the truth, while writing down 4 monstrous
> archetypes (each having 1500-2000 lines!), I did not use an editor -
> just the good old vi(m).

Oh, that must have taken a lot of time, but maybe you're an expert on all the keyboard shortcuts in vi ;-)

> BTW I was wondering if the Java editor supports Unicode as I desperately
> need it.

Java supports Unicode and hence the editor does. There are some issues in the ADLSerializer and ADLParser for different encodings and ADLs which don't have UTF-8 encoding may become scrambled on view because the ADLParser uses Unicode and also on serialization because the ADLSerializer currently only serializes to UTF-8. I also think there may be problems with quoted Unicode. I think Rong Chen knows better what issues there are. The editor mainly relies on the status of the Java reference implementation when it comes to Unicode support.

Regards,

Mattias

---

## Post #29 by @Mattias_Forss1

*Corrected first sentence*

/Mattias

2007/1/8, Mattias Forss <[mattias.forss@gmail.com](mailto:mattias.forss@gmail.com)>:

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## Post #30 by @Koray_Atalag

Thomas Beale wrote:

> ```
> the current semantics are that the occurrences of the referenced node
> are what takes effect. However, I agree that a preferable approach would
> be if the occurrences could be overridden at the origin point of the
> use_node reference. This would not be incompatible with the current
> semantics, and would probably be a useful change. What do others think?
>
>
> ```

Hi again,

I am happy that the issue of overriding occurrences will not create to much trouble. I really would like to see that in upcoming releases soon. Here is an interesting practical situation I had come across recently which I wanted to share with you.

The problem is: CLUSTER[at3100) may appear >0 but when it appears Site(s) attribute represented bye use_node as the third item can not exist by itself. It may only exist >1 times if either one or both ELEMENTs are selected. If I can override the occurrences of use_node (which is default {0..*}) at the referencing point and make as {1..*} then the problem can be resolved. Note that is the number of items of the CLUSTER were only two, then it would be possible to handle the issue by Cardinality {2..*}.

Clinically speaking during endoscopic observation of stomach if physician visualizes an Hyperemic Mucosa he may further describe its extent and presence of bleeding (if any) by depicting site(s) it is observed. It may well be the case that in one site he sees a lesion without bleeding and in three other sites he sees lesions (With same extent or none at all) with bleeding. So the CLUSTER instance will repeat itself two times in runtime.

CLUSTER[at3100] occurrences matches {0..*} matches { -- Erythematous (Hyperemic)
items cardinality matches {0..*; ordered} matches {
ELEMENT[at3110] occurrences matches {0..1} matches { -- Extent
name matches {
CODED_TEXT matches {
code matches {[ac3110]} -- Extent
}
}
value matches {
CODED_TEXT matches {
code matches {
[local::
at3111, -- Localised
at3112, -- Patchy
at3113, -- Striped
at3114] -- Diffuse
}
}
}
}
ELEMENT[at3120] occurrences matches {0..1} matches { -- Bleeding
name matches {
CODED_TEXT matches {
code matches {[ac3120]} -- Bleeding
}
}
value matches {
CODED_TEXT matches {
code matches {
[local::
at1121, -- Yes
at1122, -- No
at3123] -- Stigmata of bleeding
}
}
}
}
use_node ELEMENT /data[at0001]/events[at0002]/data[at0003]/items[at0050]/items[at0100]/items[at0110] -- Site(s)
}
}

In shorter words when two or more items exist (with {0..y} occurrences) under a container structure together with one or more use_node references (at the original location having occurrences {0..x}, currently there is no way (other that writing the references nodes possible with same codes) to constrain conditional existence or number of instances of these items.

Best regards,

Koray Atalag, M.D.
METU Informatics Institute
Ph.D. Candidate on Information Systems

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## Post #31 by @thomas.beale

We have created a new issue for occurrences in an ARCHETYPE\_INTERNAL\_REF
overriding the occurrences in the target \-
http://coruscant.chime.ucl.ac.uk:8200/openEHR_Collector/projects/specifications/CR/233

The specifications in the Release 1\.0\.1 candidate area have been changed
to reflect how the proposed change would look\.

\- AOM \-
http://svn.openehr.org/specification/BRANCHES/Release-1.1-candidate/publishing/architecture/am/aom.pdf
\- ADL \-
http://svn.openehr.org/specification/BRANCHES/Release-1.1-candidate/publishing/architecture/am/adl.pdf

\- thomas

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## Post #32 by @Seref

Hi,
The following link contains a MUST see speech of Hans Rosling\. Rosling
is a professor of international health, and as you can see, he has some
excellent points about the way we perceive certain things\.
I believe his wonderful presentation has very good points for many of
us\. And here we go
http://video.google.ca/videoplay?docid=4237353244338529080

Ps: If you feel that this is not relevant to this list, I apologize, I
wanted to share it with you

Regards
Seref

---

## Post #33 by @William_E_Hammond

Seref,

Thanks for sharing this great presentation\.  I enjoyed watcing the
presentation and I was excited about thinking how to use that approach in
presenting data about a patient to a provider\.

Ed Hammond

> \-\-\-\-\-\-\-\-\-\+\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-&gt;
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           Seref Arikan              |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           &lt;serefarikan@kurumsaltekno|
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           loji\.com&gt;                 |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           Sent by:                  |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           openehr\-technical\-bounces@|
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           openehr\.org               |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;                                     &gt;
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;                                     &gt;
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           01/30/2007 02:43 AM       |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           Please respond to For     |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           openEHR technical         |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           discussions               |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;                                     &gt;
> \-\-\-\-\-\-\-\-\-\+\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-&gt;

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&nbsp;&nbsp;&gt;       To:       For openEHR technical discussions &lt;openehr\-technical@openehr\.org&gt;                                                                |
&nbsp;&nbsp;&gt;       cc:                                                                                                                                        |
&nbsp;&nbsp;&gt;       Subject:  So you think you know the solution?                                                                                              |
&nbsp;&nbsp;&gt;\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-|

Hi,
The following link contains a MUST see speech of Hans Rosling\. Rosling
is a professor of international health, and as you can see, he has some
excellent points about the way we perceive certain things\.
I believe his wonderful presentation has very good points for many of
us\. And here we go
http://video.google.ca/videoplay?docid=4237353244338529080

Ps: If you feel that this is not relevant to this list, I apologize, I
wanted to share it with you

Regards
Seref

---

## Post #34 by @Seref

Hi Ed,
My pleasure\. Maybe you&#39;d like to take a look at http://www.gapminder.org
? \(since you&#39;ve mentioned using the approach\.\.\.\)

Regards
Seref

William E Hammond wrote:

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## Post #35 by @William_E_Hammond

Thanks\.  I did some downloads\.

Ed

> \-\-\-\-\-\-\-\-\-\+\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-&gt;
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           Seref Arikan              |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           &lt;serefarikan@kurumsaltekno|
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           loji\.com&gt;                 |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           Sent by:                  |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           openehr\-technical\-bounces@|
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           openehr\.org               |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;                                     &gt;
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;                                     &gt;
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           01/30/2007 04:56 AM       |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           Please respond to For     |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           openEHR technical         |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;           discussions               |
> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&gt;                                     &gt;
> \-\-\-\-\-\-\-\-\-\+\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-&gt;

&nbsp;&nbsp;&gt;\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-|
&nbsp;&nbsp;&gt;                                                                                                                                                  &gt;
&nbsp;&nbsp;&gt;       To:       For openEHR technical discussions &lt;openehr\-technical@openehr\.org&gt;                                                                |
&nbsp;&nbsp;&gt;       cc:                                                                                                                                        |
&nbsp;&nbsp;&gt;       Subject:  Re: So you think you know the solution?                                                                                          |
&nbsp;&nbsp;&gt;\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-|

Hi Ed,
My pleasure\. Maybe you&#39;d like to take a look at http://www.gapminder.org
? \(since you&#39;ve mentioned using the approach\.\.\.\)

Regards
Seref

William E Hammond wrote:
> Seref,
>
> Thanks for sharing this great presentation\.  I enjoyed watcing the
> presentation and I was excited about thinking how to use that approach in
> presenting data about a patient to a provider\.
>
> Ed Hammond
>
> &gt;\-\-\-\-\-\-\-\-\-\+\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-&gt;
> &gt;         &gt;           Seref Arikan              |
> &gt;         &gt;           &lt;serefarikan@kurumsaltekno|
> &gt;         &gt;           loji\.com&gt;                 |
> &gt;         &gt;           Sent by:                  |
> &gt;         &gt;           openehr\-technical\-bounces@|
> &gt;         &gt;           openehr\.org               |
> &gt;         &gt;                                     &gt;
> &gt;         &gt;                                     &gt;
> &gt;         &gt;           01/30/2007 02:43 AM       |
> &gt;         &gt;           Please respond to For     |
> &gt;         &gt;           openEHR technical         |
> &gt;         &gt;           discussions               |
> &gt;         &gt;                                     &gt;
> &gt;\-\-\-\-\-\-\-\-\-\+\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-&gt;
>
> \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-|

> &nbsp;&nbsp;&gt;
>
> &nbsp;&nbsp;&gt;       To:       For openEHR technical discussions

&lt;openehr\-technical@openehr\.org&gt;

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## Post #36 by @thomas.beale

Seref Arikan wrote:
> Hi,
> The following link contains a MUST see speech of Hans Rosling\. Rosling
> is a professor of international health, and as you can see, he has some
> excellent points about the way we perceive certain things\.
> I believe his wonderful presentation has very good points for many of
> us\. And here we go
> http://video.google.ca/videoplay?docid=4237353244338529080
>

This is indeed brilliant stuff\. I think what Rosling does here and what
Al Gore has done in his film simply by putting facts on the big screen
in a way that any person can grasp is really to be applauded\. One lesson
for openEHR: we can aspire to make to make openEHR as friendly as
possible to future &#39;open data&#39; initiatives\.\.\.

\- thomas beale

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## Post #37 by @Seref

Hi Thomas,
My own impressions from this presentation also concern openEHR, and I&#39;d
like to take the contributors opinions if it is possible\.
The thing that struck me most in terms of facts provided is; in terms
of  certain points, how fragmented and differantiated a geographical
location can be in itself\. I at least, have a bulk perception of EU and
USA, and in terms of requirements, policies etc, I consider a prototype
set of requirements\. However, what I get from this presentation is;
there are not locations, there are levels of healhtcare IT, which cut
across the locations, and it would be interesting to know the weights of
these levels\.
Why you may ask; well, when I look at openEHR, I see this pretty strong
idea and work gone to it; and it seems like it has the potential to be
implemented in many ways\. It can be either embedded in a vendor&#39;s
solution, be a product by itself\( a core repository functionality with
added services around it\), a central solution for a government project etc\.\.
What I am trying to say is; when implementing a solution \(whatever it
is\) based on openEHR, the most crowded level I mentioned above, the one
with most population that has a potential impact on world level health
IT is the one to watch\. USA market for example provides an interesting
example\. Many google searches return results showing me that somehow,
Microsoft has been providing CDA related functionality to its
products\(Infopath seems to be hot\)\. Now that&#39;s an implementation to
watch for; since &quot;for USA market&quot;, giving the common practitioner \(sorry
for the lack of detail for the definition\) an everyday tool fit for
him/her, and capability to use data based on a standard, is a strong
support for the standard\.
What I want to say is; without a doubt there are many brilliant people
working on guiding the implemantations based on openEHR, and while doing
that, choosing that first point of contact with health IT, is a critical
decision to make\. Maybe thinking about the wide and potentially high
impact stereotype user can accelerate the implementation of openEHR? And
\(if not done before\) such a consideration of critical point of entry can
give clues about the &quot;favored&quot; implementation\.
Well, just my two cents; but in the context of openEHR and similar work,
the presentation gave me these thoughts\.

Best Regards
Seref

Thomas Beale wrote:

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**Canonical:** https://discourse.openehr.org/t/possible-change-request-for-ocean-archetype-editor/14603
**Original content:** https://discourse.openehr.org/t/possible-change-request-for-ocean-archetype-editor/14603