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Re: [Gnumed-devel] Re: GNUmed and FreeDiams


From: Jim Busser
Subject: Re: [Gnumed-devel] Re: GNUmed and FreeDiams
Date: Sat, 01 Jan 2011 20:34:02 -0800

On 2011-01-01, at 2:16 PM, Karsten Hilbert wrote:

> Strengths of ingredients are available in
> ref.consumable_substance.amount and .unit.

I have the feeling that the current table structure grew around

1) absence of importable external lists of medications, and therefore a desire 
to "build up lists" from user entries, and
2) a desire to escape being "dominated" by corporate brands and dependence on 
"purchased" information

Despite that I now possess a free, importable list (for Canada), I'd still like 
to better understand the concepts…

For those praxes that lack access to importable lists, we can now have covered 
(at minimum)

        International nonproprietary names (INN) in EN, FR, DE
        ATC (where available) for the above

The problem with populating the table

        ref.consumable_substance

from user input is because such a table, taken in isolation, provides no 
intrinsic meaning to the amounts and units. Consumable substance amounts and 
units, in theory, cover all possible dosage increments between {minimum… 
maximum} by taking fractions or multiples of something. But

1) you intend 

        ref.consumable_substance

to hold only discrete strengths of what is *actually* (commercially) available?

2) maybe the Brand is intended to be related (only indirectly by link table) to 
Consumable_Substance ONLY AND EXACTLY where the strength of that 
Consumable_Substance is a match to the brand?

3) is the intent to be able to display, in a plugin or widget
                based on any substance and strength
                        --> one-to-multiple Brands known available for that 
strength?

     … if this is true, then

        in the link table, a single Substance / strength would be replicated 
once-per-brand

        AND

        in the link table, a single Brand would be replicated
                once per strength (some Brands being available in multiple 
strengths) AND
                once per substance-in-drug (for combo drugs)
        
        AND

        the widget sequence should be

                user inputs part of a substance
                user is offered values among {substance, strength}
                on selecting a {substance, strength}
                --> eligible (valid for {substance, strength} Brands are offered
        
4) I had been worried that the informational value of Brand's multiple 
external_codes (across strengths) would be inaccessible to write into the 
XML3FreeDiams file, however is there some way that the addition of a substance 
to a patient drug list would keep resolvable the specific-to-strength 
external_code? 

Once I am clearer on how combo drugs are handled, I might have more questions 
:-)

-- Jim


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