过敏的讨论

[wanghaisheng]

you may know internet environment definitely List has its advantages what it can summarize info ,but

[wanghaisheng]

[15/2/11 下午12:58:55] Brett Esler: true - but I could generate a dynamic list of 'current', 'all' or empty (none known) based on status of the records for AllergyIntolerance + a record for 'none known allergy' - 'curated' is just me adding/removing records - all AU GP and specialist systems work this way; the List is not a first class concept just a view on the records [15/2/11 下午12:59:25] Brett Esler: if I am building a CRUD wrapper around these systems I need a way to record none known but don't want to support a CRUD List resource just read

[wanghaisheng]

Through all this discussion there is a problem with whether we all are using the same definition of the word "allergy". It means different things to different individuals. To an immunologist it means a specific type of immune reaction. To a patient it means "something bad happened the last time I was exposed to substance X". Most physicians and other clinicians have an understanding of mechanisms that is closer to a patient's definition. I say this having taught the subject of allergy and immunology to medical students and residents at a top tier medical school and seen thousands of allergy consults from other physicians over 20+ years.

Also, importantly, some patients have a different understanding of adverse reactions and aren't familiar with the word "allergy". I learned early in my career that this was the case after an occasional patient would say they had "NKDA" when asked about allergies, then 20 min later I would give them a prescription for something and they would say, "Oh, I can't take that, I almost died the last time I took it." So, "not sure about allergies" is not equivalent to No Known Adverse Reactions (or the IHTSDO term "adverse sensitivity").

My habit in practice was to ask patients, "Have you ever had a bad reaction to any medication, or is there anything you cannot take?"

Russ