Dear all,
this is a perfect example of the diagnosis evolvment process and Bayes’ theorem during clinical decision making. We almost always start off with a “working diagnosis”, aka suspected. Then Bayes’ theory coming into play. The more evidence I have about htat patinent, e.g. lab best, imaging film etc, I either increase the probabliy or decrease the probability of “my working diagnosis”. therefore “Diganosis” is contantly changing.
@robyn.rubin “Examinatoin for suspected COVID-19” is a working diagnosis. That diagnosis should have been updated after the test result comes up. this working diagnosis is going to be changed to either “COVID-19 confirmed by COVID-19 confirmed by laboratory test” or “COVID-19 confirmed using clinical diagnostic criteria”. This may not always be possible as clinicans may not always change it promptly. Or, patients might be transferred elsewhere.
If we merely want to create a research database, then to me, store the data as its native form is important. @Alexander Davydov Disease suspected hierarchy is not going to help you because SNOMED CT is not going to author “suspected” concept for every condition.
in addition, FHIR has clearly stipulates that Diagnosis verification status is a mandatory messaging standard.
e.g. Provisional (or Suspected) is one of them and the definition is: This is a tentative diagnosis - still a candidate that is under consideration. (https://www.hl7.org/fhir/valueset-condition-ver-status.html)
I would strongly suggest your organisation work towards being able to store diagnosis verification status (discreetly). the analytical tool shouldn’t be a problem if we use the SNOMED CT expressions.