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Re: [Gnumed-devel] basic test types


From: J Busser
Subject: Re: [Gnumed-devel] basic test types
Date: Sun, 26 Sep 2004 16:11:29 -0700

How might records in test_type be most easily populated other than by manual creation? The latter is fine for a test_type that is created within the office, but where the labs are being fetched/imported, would it work like this:

- importer maps the source of the results to the correct test_org.pk, probably it would always already exist unless the labs were received through a service bureau to which a new lab had subscribed. If there were difficulty verifying which test_org.pk a log alert would need to be generated for a human user.

- assuming the test_org.pk is identified, the test code that accompanies each result must be matched to a code in test_type but when first beginning to use electronic labs and later when any test result is received back for the first time, a row must be created / inserted to contain the "new" code. I do not know if my lab provides as part of each result a tag identifying the coding system (as LOINC). If not, a default coding system that is stored in test_org may be helpful.

- test_result rows can then be inserted into the test_result table

while I am on the subject of the table test_type I will point out a concern over basic_unit which, within the same lab organization and for the same LOINC coded test, can change over time --- say from mg/L to g/L or from an absolute measurement to a percent - for a discussion of how the problem can affect an EMR see http://emruser.typepad.com/canadianemr/2004/07/changes_in_lab_.html

However any one lab test_org is unlikely to switch back and forth so that any time it changes units, it is likely to adhere to the changed value for some time.

Might it therefore be useful for basic_unit to be overwritten / updated at each import by whatever is the most recent unit used by the lab whose results are being imported?

If yes, the value in even maintaining this field basic_unit is less clear, but would it be mainly to help in the creation of new measurements which are generated (and/or input) from within the office for example blood pressure, weight etc so that the units are automatically carried over into test_result?




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