Severity range scale archetype

Hello everyone!

Since it is my first time posting, I will introduce myself. My name is Laura and work for the Catalan Healthcare system as a clinical modeler. We are trying to archetype some of our scales that we have in something called “Shared Healthcare Record”, and we are curious about something related with the archetype “severity range scale”. We realized that in this archetype you have the possibility to use either an item called “Numeric rating scale 0-20” or “Numeric rating scale 0-100”. Since both items are count and optional, the only difference that we found is the punctuation, which can be either to 20 or 100. We thought that this is curious since, by using the element “Numeric rating scale 0-100” it is already possible to include scales from 0 to 20… then we were wondering if there is any specific reason to have the element “Numeric rating scale 0-20” for this archetype.

I hope I explained myself properly, otherwise let me know, and I will try to clarify myself in another way. Thank you very much in advance for your help!

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I was not involved in building this archetype but I would guess that the thinking was that it was very important not to confuse a 1-20 scale with a 1-100 scale, as the same value of e.g 5 would have a very different meaning, and maximal ranges.

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That makes sense! Thank you so much for your answer, Ian!

Hi Laura, good to see you, and I’m happy to see the Catalonian group start using the international CKM!

@ian.mcnicoll is right, there are variations of 0-10, 0-20 and 0-100 in use. Probably also others, 1-6 could be one - even though I don’t have any examples of that.

Note that this severity rating scale still is in draft status. @KanikaK, the author, is on vacation I think. It CAN be changes made to it, so be aware of that. Adopt it, and you will be notified when something happens to it, and invited to the review. We need people involved who are planning to use it :grinning:.

Cheers from Vebjørn
(also vacationing, but it’s raining and cold! :disappointed:)

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Thanks a lot for your answer @varntzen ! I will adopt the archetype, as you suggested, in case there are some changes in the future!

I hope I could send some warm weather to you from Spain! Enjoy your holidays! :slight_smile:

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I came across this archetype this week. One of my modellers suggested it for a spine related use-case. Here the clinicians used a typical 5 point Likert scale. The archetype did not include such a range and we added it.

After the modelling session I have been reflecting if it is best practice to have such a generic archetype covering multiple ranges. It could be that this is a case for specialisation. i.e creating specialized archetype for 5,10 and 20 point ranges.

Not sure if this thread is suited for a new discussion, but really interested in some perspectives on this :wink:

We discussed that use case and we suspect that the 5 point scale may be a specific, published scale for paralysis. We need more info before deciding on a structure here.

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Exactly:

  • what are the criterias for using a specific scale archetype or to use the generic?

  • what is the benefits of using a generic structure at all (since we have the DV_COUNT or DV_ORDINAL data types)?

If a scale or grading is a published named scale with specific criteria for each value, it needs to be modelled specifically to be able to be predictably identified and retrieved.

The “Severity rating scale” archetype isn’t a “get out of jail free” card for any generic scale, it’s specifically for a likert or visual analog scale where:

  • the rated concept is defined in the archetype in which the scale archetype is nested (usually Symptom/Sign or Problem/Diagnosis)
    AND
  • the rating is a subjective evaluation, not based on objective criteria
    AND
  • the scale is oriented where a lower number is the least severe and a higher number is the most severe
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