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Re: [Gnumed-devel] Family History tables


From: Jim Busser
Subject: Re: [Gnumed-devel] Family History tables
Date: Thu, 09 Jun 2011 09:08:59 -0700

On 2011-06-09, at 12:36 AM, Karsten Hilbert wrote:

> My question was: When you sister comes and tells me the very
> same thing: "mother diabetes at 52" it is technically
> possible to search for your record of "mother diabetes at
> 52" and also link your sister to that. That would only
> create one row. In that case, when your sister comes back
> and says: "Oh, no, it was at 62" and I change that it will
> automatically show up with *your* record as well.

Aaargh no!

Only in the situation where mother is a patient in GNUmed can we "know"" this.

If my mother is not in the praxis, then my position would be as follows:

- I told you my mother developed diabetes at 52
- I do have a sister
- my sister is crazy just like her friend
- so just because she tells you I am wrong and it was 62, you change one record 
in common to us which, as a result, changes it for me?

I would fire you. Then, I would sue you (for only $1, since I like you). <grin>

Under the design that suggested in my last posting, my own family history might 
works as follows:

- on creating me, my family history would be empty

- on adding entries based on what I tell my doctor, we get one record per 
instance of notable diseases in relatives of varying kinds X Y Z (mother father 
sister brother etc) at age AA

- where the info is based on verbal report instead of known-for-sure in-praxis 
data, then the kind of record we are talking about is not linked to any person… 
 "my" family history record of a mother who had diabetes onset at 52 is 
*distinct* from my sister's record of a mother with diabetes onset at 62

- now let us add each of my 13 and later 8 year old sons to the praxis

- do we agree that we may want to link them into me as being blood-related 
("clinically" related) to me, even though their heath contains no issues to 
show inside "my" family history?

- if yes, then we are talking about to show a minimum of one record per person, 
in my family history, for each person existing inside this praxis who have been 
linked to me

- we may now have 4 records in my family history:

        - my mother (not in-praxis) had diabetes onset at 52 (FHx record 
created 2010.11.28)
        - I have a sister (in praxis, age 30) with null disease data who was 
linked 2010.12.08
        - I have a son (in praxis, now 13) with null disease data who was 
linked 2011.01.27
        - I have a son (in praxis, now 8) with null disease data who was linked 
2011.06.09

If my mother *now* joins the praxis, and we create for her a health issue of 
diabetes (with onset at 62, telling you I often make such mistakes) we can now 
register against her that she has in-praxis a daughter, an in-praxis a son and 
two in-praxis grandsons.

From her record, we *could* programmatically select a health issue (with an 
age-at-onset inputted) and then invoke a function that can attach this health 
issue to the family history of all persons in GNUmed who appear as a blood 
relative. Or we could do it one at a time. Age-at-onset would be static but 
might later be corrected. If instead it had been inputted as a date-of-onset / 
diagnosis, then the age at onset is still calculable from

        date of onset or diagnosis  -  date of birth 

Some manual cleanup may exist inside each of my own family history and my 
sister's because inspection may show that I have

        - mother (not in-praxis) had diabetes onset at 52 (FHx record created 
2010.11.28)
        - sister (in praxis, age 30) with null disease data who was linked 
2010.12.08
        - son (in praxis, now 13) with null disease data who was linked 
2011.01.27
        - son (in praxis, now 8) with null disease data who was linked 
2011.06.08
        - mother (in-praxis) with diabetes onset at 62 who was linked 2011.06.09

and my sister has

        - mother (not in-praxis) had diabetes onset at 62 (FHx record created 
2010.12.08)
        - mother (in-praxis) with diabetes onset at 62 who was linked 2011.06.09

and we would delete the "not in praxis" records, which would of course transfer 
into the audit table

: - )

-- Jim


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