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The E2O project has produced a larger set of commonly used Evaluation procedure concepts as new concepts modeled using the Observables model (n=800+). The set was choosen from the 1000 most commonly used British primary care lab tests, excluding pure orderables.

There is evidence that re-modelling the content can bring significant improvements. There is also evidence that current content is not consistently represented and is in need of work, particularly if some content will stay in the procedure hierarchy.

There is still some disagreement about the requirement to represent orderables and reportables as distinct concepts, and if so, how these may be coordinated.

Two outcomes of the discussins  

Social Determinants of Health Observables

In relation to the change in modeling of primary and secondary/metastatic neoplasms, there has been a comment from Ed Cheetham about its implication for Observables concepts.

I can see how this approach will model existing combined primary and metastatic disorders (as now, through role grouping but including the new pathological process role), but is it suitable for complex observables such as 2960001000004100 |Presence of direct invasion by metastatic carcinoma of lymph node in excised specimen to perilymphatic tissue (observable entity)|? This too makes reference to both metastasis and local invasion, but its definition is made up of multiple self-grouped attributes. If the current 'inheres in=carcinoma, metastatic' becomes 'inheres in=carcinoma' and 'characterizes=discontinuous metastatic spread", how will this 'work' with the existing 'characterizes=direct local invasion' pair and current cardinality rules?

 Maybe this is covered by the line in the EAG paper that states "...The proposal involves creating new more specific subtypes of 1204295007 |Malignant proliferation of neoplasm (qualifier value)| as required e.g. Direct local invasion of primary malignant neoplastic proliferation (qualifier value) to model content..."? If so, this further complicates the role of 'characterizes' - since it now has a bearing on the interpretation of the 'inheres in' attribute (which is not included in its text definition – “This attribute specifies the process which the property describes, and on which the property (of this observable) depends.”).