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Scenarios
Each of the five scenarios starts from one reference that someone adds to a dictionary whose ranked list is: 1. PIH, 2. CIEL. Each scenario shows the CIEL concepts involved, their PIH equivalents, and what the expansion contains.
In scenarios 3, 4 and 4b there are two possible results. They depend on whose answers and set members a replaced concept brings (Rule 3 on the Rules page):
- Follows PIH: a replaced concept brings its replacement's own answers and set members. This is the draft default.
- Follows CIEL: it brings the referenced CIEL concept's answers and members, each replaced where PIH has an equivalent.
The earlier working document labelled these two results by step order: "apply equivalency, cascade" and "cascade, apply equivalency". That reading is ambiguous, and in two of its tables (scenarios 4 and 4b) the results sat under each other's headings. So here they're labelled by result.
| # | Scenario | Example |
|---|---|---|
| 1 | CIEL question, Yes/No/Unknown answers | CIEL:161557 Partner HIV tested |
| 2 | CIEL question, some answers in PIH | CIEL:162820 Problem severity |
| 3 | Equivalent question, overlapping answers | CIEL:163731 ≡ PIH:2545 |
| 4 | Equivalent set, different members and answers | CIEL:159947 Visit diagnoses ≡ PIH:7539 |
| 4b | Set not in PIH, equivalent member with different answers | CIEL:161451 Stool test |
| 5 | Adding a CIEL concept that has a PIH equivalent | CIEL:1065 Yes |
↳ marks an answer or set member of the row above it. A dash means there's no equivalent.
A CIEL question with equivalent Yes/No/Unknown answers. The question isn't in PIH, but all three of its answers are.
Reference: CIEL:161557, with cascade.
| CIEL | PIH equivalent |
|---|---|
| CIEL:161557 Partner HIV tested | — |
| ↳ CIEL:1066 No | ↳ PIH:1066 No |
| ↳ CIEL:1065 Yes | ↳ PIH:1065 Yes |
| ↳ CIEL:1067 Unknown | ↳ PIH:1067 Unknown |
Result (the same both ways): CIEL:161557 Partner HIV tested, with the answers PIH:1065 Yes, PIH:1066 No and PIH:1067 Unknown.
The question has no PIH equivalent, so the cascade starts from the CIEL question either way. Each CIEL answer is then replaced by its PIH equivalent. CIEL's Q-AND-A mappings point to the CIEL answers, so the dictionary needs them re-pointed to the PIH answers (Rule 4).
A CIEL question with some equivalent answers. The question isn't in PIH. Four of its six answers are, under different IDs: CIEL:1498 Mild is PIH:1901.
Reference: CIEL:162820, with cascade.
| CIEL | PIH equivalent |
|---|---|
| CIEL:162820 Problem severity | — |
| ↳ CIEL:162821 Mild to moderate | — |
| ↳ CIEL:1498 Mild | ↳ PIH:1901 Mild |
| ↳ CIEL:1499 Moderate | ↳ PIH:1900 Moderate |
| ↳ CIEL:162822 Moderate to severe | — |
| ↳ CIEL:1500 Severe | ↳ PIH:1903 Severe |
| ↳ CIEL:162819 Fatal | ↳ PIH:7059 Fatal |
Result (the same both ways): CIEL:162820 Problem severity, with PIH:1901 Mild, CIEL:162821 Mild to moderate, PIH:1900 Moderate, CIEL:162822 Moderate to severe, PIH:1903 Severe and PIH:7059 Fatal.
The two answers PIH doesn't have stay CIEL concepts. Because the IDs differ, the expansion has to follow the SAME-AS mappings, not matching IDs. CIEL:162820 has both Q-AND-A and CONCEPT-SET mappings to these six concepts, so each is both an answer and a set member.
An equivalent question with some overlapping answers. PIH:2545 History of tobacco use is SAME-AS CIEL:163731 Tobacco use status. Three answers match, and each source has one answer the other lacks.
Reference: CIEL:163731, with cascade. Under Rule 5's alternative, OCL would rewrite it to PIH:2545, with cascade.
| CIEL | PIH equivalent |
|---|---|
| CIEL:163731 Tobacco use status | PIH:2545 History of tobacco use |
| ↳ CIEL:1090 Never | ↳ PIH:1090 Never |
| ↳ CIEL:159452 In the past | ↳ PIH:1548 In the past |
| ↳ CIEL:159450 Currently | ↳ PIH:1550 Currently |
| ↳ CIEL:165267 Recently quit using tobacco | — |
| — | ↳ PIH:1067 Unknown (PIH only) |
| Follows PIH (draft) | Follows CIEL | |
|---|---|---|
| Question | PIH:2545 History of tobacco use | PIH:2545 History of tobacco use |
| Answers | PIH:1090 Never, PIH:1548 In the past, PIH:1550 Currently, PIH:1067 Unknown | PIH:1090 Never, PIH:1548 In the past, PIH:1550 Currently, CIEL:165267 Recently quit using tobacco |
| Not included | CIEL:165267 Recently quit using tobacco | PIH:1067 Unknown |
Compare the two in the prototype
An equivalent concept set with different members and answers (a cascade over several levels). PIH:7539 Visit Diagnoses is SAME-AS CIEL:159947 Visit diagnoses.
Reference: CIEL:159947, with cascade.
| CIEL | PIH equivalent |
|---|---|
| CIEL:159947 Visit diagnoses | PIH:7539 Visit Diagnoses |
| ↳ CIEL:1284 Problem list | ↳ PIH:3064 Diagnosis |
| ↳ CIEL:161602 Diagnosis or problem, non-coded | ↳ PIH:7416 Diagnosis or problem, non-coded |
| ↳ CIEL:159394 Diagnosis certainty | ↳ PIH:1379 Diagnosis certainty |
| ↳ CIEL:159393 Presumed diagnosis | ↳ PIH:1346 Presumed |
| ↳ CIEL:159392 Confirmed diagnosis | ↳ PIH:1345 Confirmed |
| ↳ CIEL:160249 Provisional diagnosis | — |
| ↳ CIEL:160250 Final diagnosis | — |
| ↳ CIEL:161908 Patient-reported | — |
| ↳ CIEL:159946 Diagnosis order | ↳ PIH:7537 Diagnosis order |
| ↳ CIEL:159944 Secondary | ↳ PIH:7535 Secondary |
| ↳ CIEL:159943 Primary | ↳ PIH:7534 Primary |
| ↳ CIEL:159945 Tertiary | ↳ PIH:7536 Tertiary |
| ↳ CIEL:163139 Quartenary | — |
| ↳ CIEL:159948 Diagnosis date | ↳ PIH:7538 Diagnosis date |
| ↳ CIEL:162820 Problem severity | — |
| ↳ CIEL:162821 Mild to moderate | — |
| ↳ CIEL:1498 Mild | ↳ PIH:1901 Mild |
| ↳ CIEL:1499 Moderate | ↳ PIH:1900 Moderate |
| ↳ CIEL:162822 Moderate to severe | — |
| ↳ CIEL:1500 Severe | ↳ PIH:1903 Severe |
| ↳ CIEL:162819 Fatal | ↳ PIH:7059 Fatal |
| — | ↳ PIH:13725 Condition clinical status (PIH only) |
| — | ↳ PIH:12358 Inactive status, PIH:13221 Active status, PIH:12957 Patient condition resolved, PIH:13724 Recurrence of disease, PIH:6349 Relapse, PIH:10513 In remission (PIH only) |
The cascade follows CONCEPT-SET and Q-AND-A mappings at every level, and the two results differ at both levels:
- Follows CIEL brings in Problem severity and its answers. It also brings four CIEL answers PIH doesn't have: Provisional diagnosis, Final diagnosis, Patient-reported and Quartenary. It leaves out PIH's Condition clinical status and its six answers.
- Follows PIH does the reverse.
Full results
Follows PIH (draft), 18 concepts: PIH:7539 Visit Diagnoses, PIH:3064 Diagnosis, PIH:7416 Diagnosis or problem, non-coded, PIH:1379 Diagnosis certainty, PIH:1345 Confirmed, PIH:1346 Presumed, PIH:7537 Diagnosis order, PIH:7534 Primary, PIH:7535 Secondary, PIH:7536 Tertiary, PIH:7538 Diagnosis date, PIH:13725 Condition clinical status, PIH:12358 Inactive status, PIH:13221 Active status, PIH:12957 Patient condition resolved, PIH:13724 Recurrence of disease, PIH:6349 Relapse, PIH:10513 In remission
Follows CIEL, 22 concepts: PIH:7539 Visit Diagnoses, PIH:3064 Diagnosis, PIH:7416 Diagnosis or problem, non-coded, PIH:1379 Diagnosis certainty, PIH:1346 Presumed, PIH:1345 Confirmed, CIEL:160249 Provisional diagnosis, CIEL:160250 Final diagnosis, CIEL:161908 Patient-reported, PIH:7537 Diagnosis order, PIH:7535 Secondary, PIH:7534 Primary, PIH:7536 Tertiary, CIEL:163139 Quartenary, PIH:7538 Diagnosis date, CIEL:162820 Problem severity, CIEL:162821 Mild to moderate, PIH:1901 Mild, PIH:1900 Moderate, CIEL:162822 Moderate to severe, PIH:1903 Severe, PIH:7059 Fatal
Compare the two in the prototype
A concept set with no PIH equivalent, containing an equivalent question with different answers (a cascade over several levels). CIEL:161451 Stool test has no PIH equivalent. Its member CIEL:304 Stool exam is equivalent to PIH:304 Stool microscopy, which has a different answer list.
Reference: CIEL:161451, with cascade.
| CIEL | PIH equivalent |
|---|---|
| CIEL:161451 Stool test | — |
| ↳ CIEL:304 Stool exam | ↳ PIH:304 Stool microscopy |
| ↳ CIEL:120759 Cestode infection | ↳ PIH:12266 Cestode Infection |
| ↳ CIEL:137504 Infection by Ascaris lumbricoides | ↳ PIH:12264 Infection by Ascaris Lumbricoides |
| ↳ CIEL:148882 Ancylostomiasis due to Ancylostoma duodenale | ↳ PIH:12269 Ancylostomiasis due to Ancylostoma Duodenale |
| ↳ CIEL:127133 Schistosoma mansonii infection | ↳ PIH:12261 Schistosoma Mansoni Infection |
| ↳ CIEL:5622 Other | ↳ PIH:5622 Other |
| ↳ CIEL:137329 Infection due to Entamoeba histolytica | — |
| — | ↳ PIH:13352 E histolytica (PIH only) |
| — | ↳ PIH:13353 Giardia lamblia (PIH only) |
| — | ↳ PIH:13384 Cyst of entamoeba (PIH only) |
| — | ↳ PIH:13363 No ova, cysts, and parasites (PIH only) |
| ↳ CIEL:161447 Stool microscopy with concentration | — |
| ↳ CIEL:161448 Kinyoun's stain for coccidians | — |
| ↳ CIEL:159362 Fecal occult blood test | ↳ PIH:12268 Fecal occult blood test |
| ↳ CIEL:1138 Indeterminate | ↳ PIH:1138 Indeterminate |
| ↳ CIEL:664 Negative | ↳ PIH:664 Negative |
| ↳ CIEL:703 Positive | ↳ PIH:703 Positive |
| ↳ CIEL:161449 Stool test for reducing substance | — |
| ↳ CIEL:664 Negative | ↳ PIH:664 Negative |
| ↳ CIEL:703 Positive | ↳ PIH:703 Positive |
| ↳ CIEL:161450 Stool fat test, semi-quantitative | — |
| ↳ CIEL:664 Negative | ↳ PIH:664 Negative |
| ↳ CIEL:1874 Trace | ↳ PIH:12271 Trace |
| ↳ CIEL:1362 One plus | ↳ PIH:12270 1+ |
| ↳ CIEL:1363 Two plus | ↳ PIH:1408 ++ |
| ↳ CIEL:1364 Three plus | ↳ PIH:1409 +++ |
| ↳ CIEL:1365 Four plus | ↳ PIH:11432 ++++ |
The set has no PIH equivalent, so both results start from CIEL's set. They differ only under Stool exam, which PIH has with its own answers:
- Follows PIH brings in four PIH answers that CIEL's Stool exam doesn't have: E histolytica, Giardia lamblia, Cyst of entamoeba, and No ova, cysts, and parasites. It leaves out CIEL:137329 Infection due to Entamoeba histolytica.
- Follows CIEL does the reverse.
The other members come out the same either way. An expansion contains each concept once, so Negative and Positive are one concept each, even though three tests use them.
Full results
Follows PIH (draft), 24 concepts: CIEL:161451 Stool test, PIH:304 Stool microscopy, PIH:12266 Cestode Infection, PIH:13352 E histolytica, PIH:13353 Giardia lamblia, PIH:12264 Infection by Ascaris Lumbricoides, PIH:12269 Ancylostomiasis due to Ancylostoma Duodenale, PIH:12261 Schistosoma Mansoni Infection, PIH:13384 Cyst of entamoeba, PIH:13363 No ova, cysts, and parasites, PIH:5622 Other, CIEL:161447 Stool microscopy with concentration, CIEL:161448 Kinyoun's stain for coccidians, PIH:12268 Fecal occult blood test, PIH:1138 Indeterminate, PIH:664 Negative, PIH:703 Positive, CIEL:161449 Stool test for reducing substance, CIEL:161450 Stool fat test, semi-quantitative, PIH:11432 ++++, PIH:1408 ++, PIH:12271 Trace, PIH:1409 +++, PIH:12270 1+
Follows CIEL, 21 concepts: CIEL:161451 Stool test, PIH:304 Stool microscopy, PIH:12266 Cestode Infection, PIH:12264 Infection by Ascaris Lumbricoides, PIH:12269 Ancylostomiasis due to Ancylostoma Duodenale, PIH:12261 Schistosoma Mansoni Infection, PIH:5622 Other, CIEL:137329 Infection due to Entamoeba histolytica, CIEL:161447 Stool microscopy with concentration, CIEL:161448 Kinyoun's stain for coccidians, PIH:12268 Fecal occult blood test, PIH:1138 Indeterminate, PIH:664 Negative, PIH:703 Positive, CIEL:161449 Stool test for reducing substance, CIEL:161450 Stool fat test, semi-quantitative, PIH:11432 ++++, PIH:1408 ++, PIH:12271 Trace, PIH:1409 +++, PIH:12270 1+
Compare the two in the prototype
Adding a CIEL concept that has a PIH equivalent. This is like scenario 4b, but simpler. Someone adds a simple concept from CIEL, such as CIEL:1065 Yes, a diagnosis or an anatomical term, and PIH has an equivalent. Is that allowed? Does OCL silently convert it? Does it warn the user? Or does it block it, the way we'd want to stop someone adding a second Yes concept to their source?
Draft answer (Rules 5 and 6): it's allowed. The reference stays CIEL:1065, the expansion contains PIH:1065 Yes, and OCL tells the user so when they add it.
PIH:1100 and CIEL:1100 are both "Daily or almost daily", but no SAME-AS mapping links them. Under the rules they aren't equivalent, so a dictionary could contain both. See Open questions.