ARCHETYPE ID | openEHR-EHR-OBSERVATION.investigation_screening.v0 |
Concept | Diagnostic investigation screening questionnaire |
Description | Series of questions and associated answers used to screen whether diagnostic investigations, either imaging examinations or laboratory tests, have been carried out. |
Use | Use to create a framework for recording answers to pre-defined screening questions about the use of any specified diagnostic investigation or grouping of investigations. Common use cases include, but are not limited to: - Systematic questioning in any consultation related to patterns of investigation administration, for example: --- Have you ever had your cholesterol level tested? Yes, No, Unknown. --- Have you been tested for rubella antibodies? Yes, No, Unknown. --- Have you ever been screened for sickle cell disease? Yes, No, Unknown. - When was your last Chest X-ray? - When was your most recent INR test? The semantics of this archetype are intentionally loose, and querying this archetype would normally only be useful or safe within the context of each specific template. In a template, each data element would usually be renamed to the specific question asked. Where value sets have been proposed for common use cases, these can be adapted for local use by using the DV_TEXT or the DV_BOOLEAN datatypes choice to match each specific use case. The EVENT structure from the reference model can be used to specify whether the questions relate to a point in time or over a period of time. Use a separate instance of this archetype to distinguish between a questionnaire recording information about a medication that has been used at any time in the past and information about a medication used within a specified time interval - for example the difference between "Have you ever had an INR test?" compared to "Have you had an INR test during the last four weeks?". The source of the information in a questionnaire response may vary in different contexts but can be specifically identified using the 'Information provider' element in the Reference Model. This archetype has been designed to be used as a screening tool or to record simple questionnaire-format data for use in situations such as a disease registry. If the screening questionnaire identifies an investigation has been carried out, it is recommended that the clinical system record and persist the specific details about the investigation using a relevant archetype. |
Misuse | Not to be used for recording an order for an investigation - use INSTRUCTION.service_request for this purpose. Not to be used for recording the progress of activities performed as part of an investigation - use ACTION.laboratory_test for this purpose. Not to be used to record formal diagnostic test results - use the OBSERVATION.laboratory_test_result or OBSERVATION.imaging_examination_result for this purpose. |
Purpose | To create a framework for recording answers to pre-defined screening questions about the use of any specified diagnostic investigation or grouping of investigations. |
References | |
Copyright | © openEHR Foundation, Apperta Foundation |
Authors | Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2022-10-21 |
Other Details Language | Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2022-10-21 |
OtherDetails Language Independent | {licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=Apperta UK, original_namespace=uk.org.clinicalmodels, original_publisher=Apperta UK, custodian_namespace=uk.org.clinicalmodels, MD5-CAM-1.0.1=253D67D92010BEB2F153CC700E4A9575, build_uid=ad2413ca-895a-4cfc-ae99-2e76dbda9fde, ip_acknowledgements=This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/snomed-ct/get-snomed or info@snomed.org., revision=0.0.1-alpha} |
Keywords | investigation, screening, questionnaire, prevention, imaging, laboratory, pathology, blood, sample, sputum |
Lifecycle | in_development |
UID | aceb6ad0-81a4-4d7f-a66c-c69ca4550503 |
Language used | en |
Citeable Identifier | 1051.32.1201 |
Revision Number | 0.0.1-alpha |
All | Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Series of questions and associated answers used to screen whether diagnostic investigations, either imaging examinations or laboratory tests, have been carried out., archetypeConceptComment=The answers may be self-reported., otherContributors=Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor) Astrid Askeland, Dips AS, Norway Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor) SB Bhattacharyya, Bhattacharyyas Clinical Records Research & Informatics LLP, India Randi Brendberg, Helse Nord RHF, Norway Yexuan Cheng, 浙江大学, China Are Edvardsen, SKDE, Helse Nord RHF, Norway Alexander Eikrem-Lüthi, Lovisenberg Diakonale Sykehus, Norway Kåre Flø, DIPS ASA, Norway Grant Forrest, Lunaria Ltd, United Kingdom Anca Heyd, DIPS ASA, Norway Joost Holslag, Nedap, Netherlands Evelyn Hovenga, EJSH Consulting, Australia Mikkel Johan Gaup Grønmo, Regional forvaltning EPJ, Helse Nord, Norway Gunnar Jårvik, Helse Vest IKT AS, Norway Anjali Kulkarni, Karkinos, India Kanika Kuwelker, Helse Vest IKT, Norway Jörgen Kuylenstierna, eWeave AB, Sweden Liv Laugen, Oslo University Hospital, Norway, Norway Øygunn Leite Kallevik, Helse Bergen, Norway Heather Leslie, Atomica Informatics, Australia (openEHR Editor) Mikael Nyström, Cambio Healthcare Systems AB, Sweden Jussara Rotzsch, Hospital Alemão Oswaldo Cruz, Brazil Andre Smitt-Ingebretsen, Sørlandet sykehus HF, Norway Natalia Strauch, Medizinische Hochschule Hannover, Germany Norwegian Review Summary, Norwegian Public Hospitals, Norway John Tore Valand, Helse Bergen, Norway (openEHR Editor) Marit Alice Venheim, Helse Vest IKT, Norway (openEHR Editor) Ina Wille, Helse-Vest RHF, Norway, originalLanguage=en, translators=
All not explicitly excluded archetypes, extendedValues=null]], other_participations=[], items=[], details=[], provider=[], source=[], ism_transition=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0022]/events[at0023]/data[at0001]/items[at0040], code=at0040, itemType=ELEMENT, level=4, text=Screening purpose, description=The context or reason for screening., comment=This data element is intended to provide collection context for the question/answer groups when queried at a later date. It is not expected that this data element will be exposed to the individual, but only stored in data. For example: pre-admission screening, the name of the actual questionnaire or screening for previous investigations., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0022]/events[at0023]/data[at0001]/items[at0027], code=at0027, itemType=ELEMENT, level=4, text=Any tests?, description=Is there a history of any investigations related to the screening purpose?, comment=In a template, the data element would usually be renamed to the specific question asked. The proposed value set can be adapted for local use by using the DV_TEXT or the DV_BOOLEAN datatypes choice to match each specific use case., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0022]/events[at0023]/data[at0001]/items[at0026]/items[at0025], code=at0025, itemType=ELEMENT, level=5, text=Comment, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0022]/events[at0023]/data[at0001]/items[at0042], code=at0042, itemType=SLOT, level=4, text=Additional details, description=Structured details or questions about investigation screening., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: All not explicitly excluded archetypes, extendedValues=null]], credentials=[]}, topLevelItems={protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0005], code=at0005, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items , dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0022]/events[at0023]/data[at0001], code=at0001, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items , dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0005]/items[at0019], code=at0019, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null] |