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Re: [Gnumed-devel] GNUmed support for coding systems


From: Karsten Hilbert
Subject: Re: [Gnumed-devel] GNUmed support for coding systems
Date: Mon, 18 Apr 2011 10:05:26 +0200
User-agent: Mutt/1.5.21 (2010-09-15)

On Fri, Apr 15, 2011 at 12:13:11PM +0200, Hilbert, Sebastian wrote:

> I would like to see support of of coding systems in GNUmed.

...

> One score to decide this ist the CHA²DS²-VASC-Score and the HASBLED-Score:
> 
> Both these scores are highly computable by looking at the patients diagnoses.
> 
> I would like GNUmed to automatically calculate the score by looking at
> diagnoses:

...

> By having e.g. ICD coding available this should be manageable.

...

> It could then 
> check for the ATC code of aspirin, or vitamin k antagonists or the newer 
> anticoagulant substances and make the user aware of a potential problem.
> 
> Furthermore upon detection of Aspirin it might check for gstric ulcer, reflux 
> esophagitis and friends and recommend PPI treatment :-)
>
> While at it it could look for renal insufficiency and recommend a dose 
> reduction of e.g. dabigatran.

The described scenario clearly is a case for an expert
system. The "proper" way to do that is to interface with,
say, Protege. The hardcore way (conceptually, not
technically) is to integrate PyCLIPS and feed rules to that.

> I am not talking about a decision support systems here

You are, except you maybe wouldn't like to do so.

The rules will change. Rules will need to be open to local
interpretation. It'd be madness to implement this ourselves.

> http://www.dimdi.de/dynamic/de/klassi/downloadcenter/icd-10-
> gm/version2010/systematik/ 
> 
> Is there anything I can do (research etc.) to get this into GNUmed ?

1) licenses of the above

2) exact workflows

Karsten
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