From: owner-mnm@lists.hl7.org on behalf of Gunther Schadow
[gunther@aurora.regenstrief.org]
Sent: Wednesday, July 09, 2003 11:10 AM
To: Russler, Dan
Cc: 'QUADE_LINDA@LILLY.COM'; mnm@lists.hl7.org; Bob Dolin; Sandy Boyer
Subject: Re: RIM PROPOSAL: Add attribute Act.title

I think we gave enough examples for why Act.title and Act.code can be different and why Act.title makes sense. Again, examples are:

title                                  code
-------------------------------------- -----------------------------
3rd Lilly Prozac Study                 medication clinical trial
Scandiavian Simvastatin Study          medication clinical trial
Indianapolis Network for Patient Care  NIH funded research project
Shared Pathology Information Network   NCI funded research project
Brown vs. Board of Education           Court case
Health for all by the year 2000        WHO program
Guidelines for Risk Stratification     Clinical Guideline
    after Myocardial Infarction

in all these cases the code doesn't necessarily derive from the title, nor is the title derived from the code. Also in these cases the title isn't obviously something that specifies the "kind of Act".

So, I don't hear an argument against the title. Notice that we have considered something like Act.name on and off over the years. The only reason I think we never really pursued it until now is that we considered Act mostly as a healthcare service event, and there it is exceedingly rare that someone gives an individual title to a healthcare service event (like "Ole Ollies Odd Omentum Operation" doesn't happen so often.)

As far as its relation to mood goes, we just have to consider what makes most sense: clearly we use Act.code in definition mood and event mood as a classifier for a kind; but because definition mood Acts are descriptions of kinds of acts by themselves, an ActDefinition.code may feel like the name or title. However, ActEvent.code is for most people understandible as only a code for the kind of event, not for the individual occurrence. Conversely, with Act.title, people will understand that Act.title is free to choose differently for each individual event, although there is no requirement that title be unique between two act events. Conversely, Act.title may feel overlapping with Act.code in the case of definition mood, but as we can see above, that is not necessarily the case.

So, let us have Act.title for anyting that humans consider the name or title of an act and that they don't want to consider a code. Make sure that we never turn the Act.title into a "string with code" and that we understand that the only true handle on an Act instance for a computer is its Act.id, and not its title. If we just use these common sense considerations, we'll be safe; in fact safer than we used to be when we told people to use Act.code for everything.

regards,
-Gunther

Russler, Dan wrote:
> I don't think there is any reason that the information within the cd
> datatype can't evolve over the lifecycle of an instance...For example, a 
> text string placed in original text may be coded by one coder to SNOMED 
> as an update to the instance; later, another coder may add the ICD code 
> to the instance; later, another person may add a Spanish text string to 
> the instance so that the meaning can be printed in Spanish; none of 
> these activities are necessarily perfect one to one mappings, but 
> reflect the kinds of activities done every day to instances of information.
> 
> So I think we need to be specific on how act.title differs from 
> act.code
> on how it modifies the meaning of the instance. The idea that both 
> act.code and act.title could both be in definition mood is 
> troublesome...it would mean that two instances in event mood could have 
> both the same act.title and act.code...If that is so, then there is much 
> overlap between the text strings in act.code and the text string in 
> act.title....Dan
> 
> -----Original Message-----
> From: QUADE_LINDA@LILLY.COM [mailto:QUADE_LINDA@LILLY.COM]
> Sent: Tuesday, July 08, 2003 5:24 PM
> To: Gunther Schadow
> Cc: Russler, Dan; mnm@lists.hl7.org; Bob Dolin; Sandy Boyer
> Subject: Re: RIM PROPOSAL: Add attribute Act.title
> 
> 
> using act.code original text for the title also made it impossible to 
> use act.code for any legitimate classification purposes. Linda
> _________________________
> Linda M. Quade
> Associate Information Consultant
> Eli Lilly & Company
> Lilly Corporate Center, DC 3047
> Indianapolis  IN  46285
> 
> LindaQ@Lilly.com
> phone: 317.276.9874
> fax: 317.277.8768
> 
> 
> 
> 
> Gunther Schadow <gunther@aurora.regenstrief.org>
> 07/08/2003 03:59 PM
> 
>  
>         To:     "Russler, Dan" <Dan.Russler@McKesson.com>
>         cc:     mnm@lists.hl7.org, Linda Quade <QUADE_LINDA@LILLY.COM>, 
> Bob Dolin
> <Robert.H.Dolin@kp.org>, Sandy Boyer <slboyer@attglobal.net>
>         Subject:        Re: RIM PROPOSAL: Add attribute Act.title
> 
> 
> The two fields do not do the same thing. There is always ambiguity 
> left
> with Act.code.orginalText and it isn't always appropriate to use it at all.
> 
> Original text is used when something is encoded after it had been
> written down. If you author an Act directly and pull a code from a list, 
> then you don't have original text, but you still might have a title.
> 
> Act.code is believed to represent the kind of act whereas an Act title
> is supposed to name an instance. The difference is blurry, but if you 
> need a title such as "Brown v. Board of Education" then this is not the 
> original text for a code "SupremeCourtDecisionAct".
> 
> Act title is in many cases more akin to something in the Act.id than 
> in
> the Act.code.
> 
> The practice to use Act.code.orginalText was a crutch at best and has
> been very confusing and hard to justify upon closer look.
> 
> regards
> -Gunther
> 
> 
> Russler, Dan wrote:
>  > So do we need better education or a new attribute?...Do you want to  
> > make
> 
>  > the original text an optional field?...My main point was that we 
> would  > now have two fields for the same thing...The proposal adds an 
> attribute,
> 
>  > but didn't take anything away from act.code...Dan
>  >
>  > -----Original Message-----
>  > From: Gunther Schadow [mailto:gunther@aurora.regenstrief.org]
>  > Sent: Tuesday, July 08, 2003 4:40 PM
>  > To: Russler, Dan
>  > Cc: mnm@lists.hl7.org; Linda Quade; Bob Dolin; Sandy Boyer  > 
> Subject: Re: RIM PROPOSAL: Add attribute Act.title  >
>  >
>  > As I said in the rationale: yes, it was in Act.code.originalText, but
>  > it
> 
>  > was never quite clear there
>  >
>  > Russler, Dan wrote:
>  >  > Up to now, I believe this act title would be found in the 
> act.code
>  > > within the cd datatype as the text description field...or am I
> missing
>  >  > the point?...Dan
>  >  >
>  >  > -----Original Message-----
>  >  > From: Gunther Schadow [mailto:gunther@aurora.regenstrief.org]
>  >  > Sent: Tuesday, July 08, 2003 4:33 PM
>  >  > To: mnm@lists.hl7.org
>  >  > Cc: Linda Quade; Bob Dolin; Sandy Boyer
>  >  > Subject: RIM PROPOSAL: Add attribute Act.title
>  >  >
>  >  >
>  >  > Hi, Abdul-Malik said that we could issue this proposal through the 
>  > > email  > list without a cover sheet and spread sheet.
>  >  >
>  >  > ADD ATTRIBUTE Act.title : ST
>  >  >
>  >  > <definition>
>  >  > A word or phrase by which an Act may be known among people.
>  >  >
>  >  > Example: name of a research study (e.g. "Scandinavian Simvastatin
>  >  > Study"), name of a court case (e.g. "Brown v. Board of Education"),
> name
>  >  > of another kind of work project or operation. For acts representing 
>  > > documents, this is the title of the document.  >
>  >  > Discussion: This is not a formal identifier but rather a
>  >  > human-recognizable common name. </definition>
>  >  >
>  >  > This proposal is being put forth jointly by the Technical Committees
>  >  > RCRIM and ORD and SDTC.
>  >  >
>  >  > Rationale: in the past one had to use Act.code.originalText to place
> a
>  >  > document title and it wasn't clear whether a given
> Act.code.orginalText
>  >  > really is supposed to be a title. Use case for titles is
>  > (obviously)  > document titles but also project names such as required
>  > for research  > studies.  >
>  >  > thanks for the consideration,
>  >  > -Gunther
>  >  >
>  >  > --
>  >  > Gunther Schadow, M.D., Ph.D. gschadow@regenstrief.org
>  >  > Medical Information Scientist      Regenstrief Institute for Health
> Care
>  >  > Adjunct Assistant Professor        Indiana University School of
> Medicine
>  >  > tel:1(317)630-7960                         
> http://aurora.regenstrief.org
>  >  >
>  >  >
>  >  >
>  >  > ---
>  >  > To access the Mailing List archives, go to:
>  >  > http://lists.hl7.org/lyris.pl?enter=mnm
>  >  >
>  >
>  >
>  > --
>  > Gunther Schadow, M.D., Ph.D.                    gschadow@regenstrief.org
>  > Medical Information Scientist      Regenstrief Institute for Health Care
>  > Adjunct Assistant Professor        Indiana University School of Medicine
>  > tel:1(317)630-7960                         http://aurora.regenstrief.org
>  >
> 
> 
> -- 
> Gunther Schadow, M.D., Ph.D.                    gschadow@regenstrief.org
> Medical Information Scientist      Regenstrief Institute for Health Care
> Adjunct Assistant Professor        Indiana University School of Medicine
> tel:1(317)630-7960                         http://aurora.regenstrief.org
> 
> 
> 
> 
> 
> 
> ---
> To access the Mailing List archives, go to: 
> http://lists.hl7.org/lyris.pl?enter=mnm
> 


-- 
Gunther Schadow, M.D., Ph.D.                    gschadow@regenstrief.org
Medical Information Scientist      Regenstrief Institute for Health Care
Adjunct Assistant Professor        Indiana University School of Medicine
tel:1(317)630-7960                         http://aurora.regenstrief.org



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