We would like to have feedback from other countries on how do they translate related Clinical finding and Observable entity to facilitate distinction?
In theory, a Clinical finding could be formulated as a declarative sentence, whereas an Observable entity could be formulated as a “question”. In practice, however, they usually look very similar, which could lead to the wrong concept being selected.
Examples:
413712001 |Breastfeeding (mother) (observable entity)| vs. 1260078007 |Maternal breastfeeding (finding)|
225489003 |Uses ‘I’ statements (finding)| vs. 225490007 |Use of ‘I’ statements (observable entity)|
This is a common question, especially when the Observable entity does not provide any definitional relationships that expresses the semantics. Your perception that Observables should represent the “question” is correct and formulating the implied semantics of something as vague as 413712001 |Breastfeeding (mother) (observable entity)| can sometimes be challenging. In this case, the meaning of the observable could be “Is the mother breastfeeding”, while the clinical finding 1260078007 |Maternal breastfeeding (finding)| implies that the mother is currently breastfeeding, based on the default context of “currently present in the subject”.
The best distinction is what you have suggested, i.e. the Observable entity in and of itself is not a complete clinical statement without an associated value, whereas a clinical finding is a complete declarative concept. With many of SNOMED’s legacy terms, this distinction can be difficult to ascertain.
One aspect of the quality improvement project that had been taken on by SNOMED was an attempt to reconcile this perceived “duplication of semantics”; however, not everything has been resolved. It would be useful when these types of issues arise to submit them as content changes.
This is not a problem that we have solved through translation, since it’s not possible to avoid duplicate descriptions across different hierarchies. Rather it’s a matter of specifying which hierarchies are to be displayed and which concepts are to be selectable in specific fields of a health record. For example, a form used within the surgery department will only allow for the selection of concepts of the procedure hierarchy.
Which concepts can be used in which fields is decided by hospitals’ CMIOs, who convey their technical needs to their software vendors.
Thank you for your feedback Pedro! Ideally, we would like it to be managed that way too. But that will take time, so we were looking for a way to make it more obvious to users through translation.
