Hello,
We are working with the International prostate symptom score (IPSS) archetype from CKM. We have been asked to add the interpretation for the total score, which ranges from 0 to 35 and that is currently represented as a DV_COUNT:
- 0-7: Mild
- 8-19: Moderate
- 20-35: Severe
We have several options here.
-
Option 1. Maintain the total score as a DV_COUNT and just add the interpretation a part of the comment of that element. This has been seen in Moddified Barthel index
This approach also follows the recommendation of not adding additional elements to scores
The problem with this approach is that we lose the formalization of that knowledge.
-
Option 2. Maintain the total score as a DV_COUNT and add a new element for the interpretation. This has been seen in Waterlow score
In this specific example we see a problem with relying on an ad hoc interpretation of those ordinal values, as it defines a kind of ranges but not explicitly (it only includes an option for 10, 15 and 20). The alternative here would be to explicitly define a DV_ORDINAL for each of the possible values (for example, from 0 to 35 in the IPSS score), but this seems difficult to maintain.
- Option 3. Is defining the value of a total score as a DV_COUNT mandatory in current modelling patterns? If not, would it possible to define a total score directly as a DV_ORDINAL/DV_SCALE?
As an additional note, technically it would be possible to define a range as the constraint of the DV_ORDINAL value, as it is just an integer. We can do this in LinkEHR but I can’t see that possibility in the Archetype Editor. Something like this:
