This may be a topic for the CDM WG but I’d like to get a discussion rolling about “Annotation” in the CDM. To clarify what I mean by annotation (and how it differs from the metadata and fact_relationship tables) , I’ll provide a few example annotation scenarios:
- I am doing a manual chart review and want to annotate something about a particular patient that is 1) not precisely temporal 2) not easily represented by a concept (unresectable head and neck cancer that has failed 2 cycles of drug X and reviewer confidence is 8 on a scale of 1-10 that this is correct). This is not intended to be a cohort definition but rather an annotation about a particular patient.
- I want to highlight something about a time period that might affect multiple patients. For example, Hurricane Harvey likely affected medication compliance in a set of zip codes over a period of time. How can I annotate the CDM wth such things that are not exactly traditional metadata.
I’m sure others have examples and I would like to hear about them.
At Georgia Tech, we have have been dealing the both of the above. The most pressing need for us is annotation related to chart review. As a placeholder, we have developed an initial data model for defining annotation sets and answers in JSON. I think we should work as a community to achieve a consensus on how to approach this type of thing (if people are interested).
We can move this to GitHub or take up with the architecture WG etc, but just wanted to get the ball rolling.