The current Symptom/sign archetype was first published in October 2015 following a seven month review process.
Since then the archetype has had several breaking changes applied, and has been sitting in the ‘Reassess’ state since April 2018.
The COVID-19 related work of early 2020 led to the creation of the new ‘screening questionnaire’ family of archetypes, of which Symptom/sign screening questionnaire is one of the most central members. The creation of this archetype also means we can rectify one of the most awkward modelling choices of the original Symptom/sign archetype; the ‘Nil significant’ element. This was intended to support structured questioning where the subject could respond whether they experienced a symptom or not. In effect it was a kind of negation element in an otherwise positive presence archetype, which leads to potential safety issues when querying the data. In the latest revision of the ‘Symptom/sign’ archetype the ‘Nil significant’ element has been removed, to be replaced by the ‘Symptom/sign screening questionnaire’ archetype where appropriate.
Other significant changes include:
- Revision of the ‘Occurrence’ element (breaking change)
- Separation of the ‘Precipitating/Resolving factor’ cluster into two separate clusters, removing the need for the run-time name constraint (breaking change).
- Addition of the ‘Character’ element (non-breaking change)
- Various non-breaking updates and corrections
- Corrections to SNOMED CT bindings
We’d like to publish the current trunk revision as v2 of the archetype, but would like community input first, to make sure we catch any errors or other suggestions that would need breaking changes.