New terms request: health procedure and health activity

[pfabry]

We would like to propose two classes related to health processes:

• Health procedure defined as: “A planned process that has the objective of contributing to a desired effect on the health status of an organism or several organisms achieved through the treatment, diagnosis, or prevention of disease or injury. It has some components that are planned processes, including at least one that is a health activity.”
• Health activity defined as: “A planned process that aims to produce a truthful statement about the health status of an organism or modify it.”

Both, as their Aristotelian definitions imply, are subclasses of Planned process. Health procedure is similar to OGMS:health care process, but has in our view a broader scope. As a matter of fact, the definition of health care process is currently: “A planned process with the objective to improve the health status of a patient that directly involves the treatment, diagnosis, or prevention of disease or injury of a patient”. This definition implies that the processes encompassed by this class:

• take place in a health care setting (because of the mention of the term “patient”);
• are performed with the objective to improve someone’s health.

However, we believe that there is also a need for representing processes performed outside a health care setting, such as taking an acetaminophen tablet for a headache at home; and non-interventional processes, like a smartwatch taking its bearer’s pulse. Hence the health procedure and health activity classes. The term “health procedure” has been chosen because on one hand “health process” is too generic and may encompass e.g. a heart-beating process in a living organism, and on the other hand, the term “health intervention” suggests processes that modify one’s health status. Concerning the definition of health procedure and its difference with that of health care process:

• We propose “the objective of having a desired effect on the health status” rather than “the objective of improving the health status” because in some cases (palliative care or human challenge trials for vaccine development for example) the objective of improvement is subject to discussion;
• We propose “the health status of an organism or several organisms” rather than “the health status of a patient” because “patient” refers to a health care setting while “organism” allow us to encompass all processes within and outside a health care setting, as well as veterinary procedures. In addition, a public health procedure aims to affect the health status of a population and not a single person.

The addition of the class health activity allows us to distinguish between two levels of processes concerning health procedures: at the higher level, the health procedures themselves, which are processes with an established objective of having a desirable impact on some health status, and at the lower level, the health activities which constitute the building blocks of health procedures but can be carried out independently of any health procedure. Health activities can capture a fact concerning a health status (like a height measurement for example) or aim at modifying (positively or even negatively, for example exposing an individual to SARS-Cov-2 during a human challenge trial) the health status. They can also be performed without any objective regarding the health status. Let’s take for example the process of measuring someone’s height. It could be done in a health care context to assess a patient’s Body Mass Index (BMI), or by a mother measuring her child at home for their birthday.
Both these measuring processes are health activities as they aim to produce a statement about someone’s health status (their height). However, the first one is a component of a health procedure (a BMI assessment), while the second one is not related to health care. These propositions have been detailed in a paper accepted for ICBO 2021. In accordance to OBO Foundry principles, we believe that those classes might belong naturally to OGMS. In order to do so, we propose the following taxonomy:

• Planned process
  • Health procedure
  • Health care process
  • Health activity
  • Ancillary health care process

We believe that ancillary health care process is not impacted as it is not a health procedure. We propose to add the following axiom:

health procedure subClassOf (has_component_process some health activity)

where has_component_process is an object property from RO. Since we suggest to reclassify “Health care process” as a subclass of “Health procedure”, we suggest to change its Aristotelian definition accordingly as follows: ”A health procedure with the objective to improve the health status of a patient.”

Regards,

Paul Fabry

[pfabry]

We are about to deploy our ontologies stack. These two terms would seem to belong naturally to OGMS, could you let us know your position towards them? Thanks :-)