Seeking input on high level ADL observables concepts

Clinical Reference Groups Nursing CRG
1

As mentioned in the July Nursing CRG meeting I am working on undertaking a review of << 129025006 |Activity of daily living (observable entity)| hierarchy. One of the aspects being examined is the intended meaning of some high level concepts within this hierarchy and how they are or may be used. Input from the Nursing CRG would be appreciated.

Concept list

413634008 Basic activity of daily living (observable entity)

301701000 Getting on and off furniture (observable entity)

300574001 Community living activity (observable entity)

285592006 Personal care activity (observable entity)

272387007 Domestic activity (observable entity)

258156005 Everyday tasks (observable entity)

129025006 Activity of daily living (observable entity)

129020001 Maintaining continence (observable entity)

129019007 Taking medication (observable entity)

129018004 Traveling (observable entity)

129016000 Climbing stairs (observable entity)

129014002 Doing housework (observable entity)

129013008 Using telephone (observable entity)

129012003 Preparing meals (observable entity)

129011005 Shopping (observable entity)

129010006 Managing money (observable entity)

129007004 Feeding (observable entity)

129006008 Walking (observable entity)

129005007 Transferring (observable entity)

129004006 Toileting (observable entity)

129003000 Dressing (observable entity)

129002005 Bathing (observable entity)

Some (but not all) of these concepts have been used as values for the interprets attribute on Finding concepts. For example: 129006008 |Walking (observable entity)| has been stated as the value for the Interprets relationship on two concepts and inferring as a value on eleven concepts. 129004006 |Toileting (observable entity)| has not be used as a value for an Interprets relationship. Please see the references tab in the browser for further information on use of these concepts as attribute values.

In addition please note, the modelling of these high level concepts will be explored further following the analysis of their meaning and the determination of their value.

<< 129025006 |Activity of daily living (observable entity)| also includes observables about specific abilities e.g. 165250009 |Ability to bathe self (observable entity)| and those concepts are currently used as Interprets values for Finding concepts representing:

The use of these concepts to represent these three types of Finding concepts is another aspect being examined but that will be investigated separately to the grouper issue.

2

Thanks Cathy!

3

This response was provided by the Australian NRC via email, with the request to add as a post.

In Australia all of the listed observables are used in the national Australian Clinical Data for Interoperability (AUCDI) specifications for the Functional Ability Data Group and in the Activity Name data element.

This data element is used to list the activity that a functional assessment is done against.

We find ourselves using higher level groupers for assessments where levels of function in individuals are higher so more specific assessments are not required.

For example |Everyday tasks| might be assessed as |no difficulty| in an adjacent data element. Just because this finding is normal, doesn’t mean its not valid for the patients records.

Some of these concepts are also fairly specific in our data element context, for example assessment of a persons Dressing, Bathing and Toileting are very common activities to assess function against.

I have noted that all of the examples listed are valid concepts in our Activity Name reference set and value set. If they were to be inactivated, we would likely request their re-activation as they are currently in use in our AUCDI National Specification.

4

Summary of 8th September 2026 Nursing CRG call discussion:

High level groupers such as those listed above are useful. Examples included search terms, grouping.

Outside of this call other feedback has also been provided on the use of these concepts in national refsets.