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Re: [Health-dev] Best way to add data to a patiente - Oncology Module

From: Luis Falcon
Subject: Re: [Health-dev] Best way to add data to a patiente - Oncology Module
Date: Sat, 30 Aug 2014 11:30:03 +0100

Dear Roberto
On Fri, 29 Aug 2014 12:14:51 -0300
Roberto Novaes <address@hidden> wrote:

> Hello to all!
> We are discussing the development of a module concerning specific
> needs for the oncological sector.
> The two main necessities are:
> 1) Register the ICD code of the disease, its TNM data (both clinical
> and pathological) and its correct staging classification. We are
> already developing a python library that exposes a function that
> receives the ICD, T, N and M values and returns the cancer staging
> (it is almost a wrapper around AJCC tables -->
> soon to be released to public under GPL 3 license :). Where is the
> best place to store this TNM and staging data? Should I add fields
> through inheritance from the Pathology class or from the PatientData
> class? Another option would be to create another model (lets say,
> NeoplasicDisease) that would have a FK to a patient.
Thanks a lot for the library ! That would be a lot of work, but
definitely a great asset ! 

Let me try to answer, from a general practitioner perspective, how to
integrate it in GNU Health.

I would definitely take advantage and use the "Pathology Groups"
functionality of GNU Health ( Health -> Configuration -> Diseases ->
Pathology Groups ). You can link it to diseases from the current WHO
ICD10 module. There is already a "neoplasic" group on it.

So, for example, you could call your TNM / Staging library if the
patient disease list contains one of the Neoplasic . There are
non-solid / diffuse oncological conditions where TNM does not work
well or just would not apply. 

> 2) It would also have to register some key dates, such as the date of
> the first appointment or the date of the diagnosis, the date when a
> relapse has been detected, the date when a progression has been
> detected, the date when a metastasis has been found,  and the date of
> death, in order to create the survival analysis curve for the clinic.
> I know some of those dates are already registered by the system, such
> as date of first appointment or date of death. Should the remaining
> dates be registered on the same ways discussed above (on separate
> model or on the existing models through inheritance?)

You have all that information starting from the gnuhealth patient model.
Appointments, evaluation dates, procedures, tests, etcetera are
available from the main "patient control panel", which should be your
friend :) . 

Finally, a personal side-note. We, as individuals, and our health
conditions require an integrative approach. This concept stands up more
when dealing with oncological conditions. We need to look at the
bio/psycho/social/spiritual factors as a whole, both to promote health
and for healing. I always have it present when designing and
implementing GNU Health.


> Sincerely,
> Roberto Novaes
> Sílex Sistemas Ltda.

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