Nonlab observables The Observables project is supposed to

Non-lab observables The Observables project is supposed to develop a/the model for non-lab observables during 2012 Non-lab → unlimited scope Need for determining scope principles

Examples of current observables Vital signs Scores and indexes Device settings observables Drug-related observables Imaging observables (imaging technique) Date/Time, duration observables

Examples of current observables Overlap with SNOMED CT attributes Specimen laterality (observable entity) Site observables Biopsy site (observable entity) – Procedure site - Direct Method observables Method of drug administration (observable entity) – Route of administration

Vital signs Blood pressure How to represent systolic and diastolic phase? Mean Arterial Pressure? Jugular Venous Pressure? Cuff size? Device? Body temperature Where is the core body temperature? Device?

Vital signs Respiratory rate Heart rate

Symptoms (and scores) • Pain (e. g. VAS) • Fatigue, Shortness of Breath, Anxeity, . . .

Pain ”an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” [IASP] ”an unpleasant experience on the part of a human subject that is both sensory and emotional and that is of a type that is either canonical pain (PCT) or phenomenologically indistinguishable from canonical pain. ” [Smith]

Pain Types of pain and non-pain [Smith] – – – Pain due to disorder (disordered structure) Pain behaviour discordant with disorder Neuropathic pain Pain behaviour without pain Disorder without pain

Pain Clinical use cases – – VAS Intensity – – Localisation – … Sensory characteristics Temporal characteristics Condition or Observation result?

Pain – a condition Pain assessment – an observation/observable What to represent?

Pain observables Pain observable Ability to sense pain Characteristic of pain at anatomical site Characteristics of pain of head and neck region Characteristic of headache Headache character Characteristics of pain of truncal structure Abdominal pain characteristic Site of gastrointestinal tract pain Type of gastrointestinal tract pain Homans' sign location Pain intensity Feature of present pain intensity Pain score Brief pain coping inventory score Brief pain inventory score Dallas pain questionnaire score Pain self efficacy questionnaire score Visual analogue scale pain score Pain threshold Pattern of pain Pain character Affective dimension of pain Sensory dimension of pain Pain control behavior Pain level Acceptable pain level status Pain level: disruptive effects Pain level: psychological effects Pain tolerance level Response to pain Type of abdominal pain