In working through many of the changes we discussed in Wellington, I was going to revise measurement properties to include histologic grading. recognizing that there are many scales applied in AP, would all simply reflect their thoughts whether it is appropriate to have the grading scales referenced within CAP checksheets included in the model; for example: Gleason grade, Fuhrman grade, Dukes grade etc
Would each one be a separate scale or easily referenced as such? Is our next meeting at 4pm Eastern on Nov 17? There is not a time listed on the IHTSDO calendar for this group.
With this question I am just asking if we should implement each of the many histologic grading scales as distinct Property types in the Observables we are modeling. In that case we would have a different 'question' concept for each type of grading. My presumption from there would be that we would also have distinct 'answer valuesets' configured into the pathologists AP system when they complete the synoptic report. That also creates intellectual property issues we will have to research as to the use of the grading codes but should not stymie our move forward
Jim, I think the question is important and the answer may lie with the users. Some of the grading value sets are organ system specific (Dukes, for example). The question answer values would be contextually understood in natural language, but not computationally.
Are there staging systems that serve multiple organ systems? I do know that there are some organ systems that have more than one staging system (e.g., Colon). In those scenarios, is it important to assert the organ system in the question? I suspect that it is for data reuse.
We have plenty of opportunity in the Observables model to constrain the organ system if necessary to assure proper use of the grading system. I asked the pathologists this question because I DO NOT think there is a universal substitute for these scales which have been validated clinically for utility.
5 Comments
James R. Campbell
In working through many of the changes we discussed in Wellington, I was going to revise measurement properties to include histologic grading. recognizing that there are many scales applied in AP, would all simply reflect their thoughts whether it is appropriate to have the grading scales referenced within CAP checksheets included in the model; for example: Gleason grade, Fuhrman grade, Dukes grade etc
Alexis Carter (Ihtsdo US)
Would each one be a separate scale or easily referenced as such? Is our next meeting at 4pm Eastern on Nov 17? There is not a time listed on the IHTSDO calendar for this group.
James R. Campbell
Alexis,
With this question I am just asking if we should implement each of the many histologic grading scales as distinct Property types in the Observables we are modeling. In that case we would have a different 'question' concept for each type of grading. My presumption from there would be that we would also have distinct 'answer valuesets' configured into the pathologists AP system when they complete the synoptic report. That also creates intellectual property issues we will have to research as to the use of the grading codes but should not stymie our move forward
Jim
Scott Campbell
Thanks, Alexis and Jim.
Jim, I think the question is important and the answer may lie with the users. Some of the grading value sets are organ system specific (Dukes, for example). The question answer values would be contextually understood in natural language, but not computationally.
Are there staging systems that serve multiple organ systems? I do know that there are some organ systems that have more than one staging system (e.g., Colon). In those scenarios, is it important to assert the organ system in the question? I suspect that it is for data reuse.
James R. Campbell
We have plenty of opportunity in the Observables model to constrain the organ system if necessary to assure proper use of the grading system. I asked the pathologists this question because I DO NOT think there is a universal substitute for these scales which have been validated clinically for utility.
Jim