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commented
8 years ago See the first email in this thread, where the motivation for this was first
mentioned:
http://groups.google.com/group/cpr-ontology/browse_thread/thread/a62e527b18819d2
b
"[...] It is generally a bad idea to mix the ontology-epistemology divide. The
former is about collections
of things in reality and the latter is a study of how cognitive subjects come
to know the truth about phenomena in reality. Some bodily features, can exist
before they are perceived by a patient (who
then hypothesizes they indicate a disease) but they aren't considered symptoms
at that time. So, there is nothing about a cough (for example) that makes it a
symptom besides the way it is reported; this
is an epistemic distinction alone. This is mostly the case with signs as well
although what makes things a sign is a little more objective or empirical.
Still the distinction between signs and other bodily features is mostly
epistemic [...] So, now CPR only has symptom-recording and sign-recording. A
new processual entity called self-examination has been added that is an
agentive action performed by a patient on his or herself to determine the
existence of a medical problem. a symptom-recording is then a primitive
clinical-artifact that is the output of a medical-history-screening-act or
self-examination and is the presentation of a bodily
feature. So, here the logical distinction between a symptom and other bodily
features is that they are cpr:representedBy a symptom-recording rather than
some yet to be determined ontologic distinction. As a
result, a symptom-recording is no longer a clinical-finding since it could be
the output of a self-examination and thus not composed by a clinician. "
The concept or a sign / symptom is problematic for several reasons: 1) the
distinction is epistemic (and not in the realm of ontology), 2) there is rarely
consensus when you try to elicit definitions from clinicians, 3) they are
typically used as primitives (i.e., things are often designated explicitly as
signs or symptoms in a record and not classified or deduced as such and so an
axiomatic definition of them seems only to serve a philosophical and not an
informatics purpose ). If this is not the case, it would be useful to have
examples of realistic clinical questions whose answers depend on a definition
of what a symptom or sign *is*.
So, in this framework, you would say that a patient history (a recording of
anamnesis) is composed of symptom-recordings (or representational artifacts
that 'represent' symptoms).Original comment by chime...@gmail.com on 3 Sep 2010 at 1:59
Original issue reported on code.google.com by
sivaram....@gmail.comon 27 Aug 2010 at 8:26