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Re: [Gnumed-devel] Free your mind with mindmapping

From: Karsten Hilbert
Subject: Re: [Gnumed-devel] Free your mind with mindmapping
Date: Sun, 10 May 2009 17:42:05 +0200
User-agent: Mutt/1.5.18 (2008-05-17)

On Sat, May 09, 2009 at 09:14:08AM +0200, Hilbert, Sebastian wrote:

> > It often helps to ask oneself a few questions a la:
> >
> >     What do I need to *compute* ?
> It is about the level of detail. If you don't store the fact

Note that I wasn't saying that you don't *store* the detail.
Only whether one needs to store it in an actually computable

There's three levels of storage:

- "just so":
        leads detail is buried somewhere in the narrative

- "as a leads field":
        there is a dedicated database column intended for
        holding narrative related to leads only

- "as a leads *definition*":
        there are several fields allowing one the store lead
        type, lead connector, implant time, etc which then
        fully defines the (virtual concept) of a lead
        only this is fully computable

> If someone has chosen to use a left ventricular lead in the RA channel 
> because 
> a two chamber generator is cheaper than a three chamber generator than you 
> better know that so you don't program a mode where it wrongly assumes you are 
> pacing in the right atrium and later in the right ventricle because that 
> could 
> do some bad things.

Sure, but that can easily be found in the narrative. No need
for computabiltity.

> >     What do I need to *store* ?
> In the software we currently use the physical leads are ignored.
Now, that's no good.

> It simply 
> assumes there is a lead for each chamber and it will not change over time.
And that's quite obviously bull.

> > > that has just been recalled
> >
> > That is outside knowledge being factored into the qestion.
> > It won't influence our model.
> Well if you do not record the device but only device class
Of course do you record the specific device. But the recall
comes from the outside. It comes down to this:

Do you really want to be able to sit down and tell GNUmed:

Find all patients with device X with 2 leads of type Y
implanted between NOW and THEN and write them a serial
letter to come to the office ?

Or would it suffice to say:

Find all patient with device X so I can check your findings.

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