Re: [Gnumed-devel] chronic vs acute, was: Turtorials

[Karsten Hilbert]

On Mon, Jul 05, 2010 at 12:25:48AM -0300, Rogerio Luz Coelho wrote:

> > > We already sort of support this except from a different
> > > angle:
> > >
> > >       clin.health_issue.is_active
> >
> > This flag cannot tell which of the active problems is
> > chronic but it can tell that inactive problems are NOT
> > chronic :-)
> >
> > Does that suffice ?
> >
> > After all, any problem that is thought active warrants
> > attention, regardless of being chronic or not.
> >
> >
> I don´t think it sufices, and I was REALLY hoping for a PHYSICAL separator
> in the problem list
> 
> like  :
> 
> Chronic:
> 
> x
> y
> z
> ____________
> 
> Acute
> 
> e
> f
> z - acute episode

I sure understand the use case - it seems useful to be able
to sort things like this.

Let's see. Currently we have the following on clin.health_issue:

        .is_active
        .is_clinically_relevant

You want to add

        .is_chronic

Would the following hold true ?

.is_chronic = true

        .is_active can be true or false
                - true: Diabetes mellitus
                - false: genetically diagnosed, not yet clinically apparent, 
Chorea Huntington
        .is_clinically_relevant must be true

.is_chronic = false (in other words it is acute)

        .is_active can be true or false
                - true: yesterdays cut into 3rd finger right hand
                        - this wouldn't rise to the level of health issue
                - false: last years flu
                        - this wouldn't rise to the level of health issue
        .is_clinically_relevant can be true or false
                - pretty much mirrors .is_active
                - acute, active problems are relevant
                - (previously) acute, inactive problems are not

        .is_active = false
                .is_clinically_relevant must be false


Rogerio, can you give me good examples of non-chronic/acute
conditions that would make it obvious they should be health
issues rather than episodes (standalone or under another
health issue).

I am tempted to equate chronic with health issue and episode
with acute.

Mind you, all this is just the foundation of the problem
list sorting you want. When we straighten out the
foundations we can likely do the sorting/displaying you
wanted. Your example would appear to me like this:

Chronic:

        x: issue, active
        y: issue, active
        z: issue, inactive

Acute:

        e: episode, open, standalone
        f: episode, open, standalone
        z: episode, open, under issue z

Would that make sense ? This would mean that, by definition,
health issues are considered chronic conditions.

Issue/episode tree and problem list are somewhat orthogonal:

The tree organizes/categorizes by importance and
relationship while the list flattens out into what is
(currently) relevant and what is not. This we already do.

Karsten
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