Embedding questionnaire scoring data into the FHIR Questionnaire/Response? - health-monitoring

We have a system where citizens download Questionnaire from a server, fill it in and submit a QuestionnaireResponse back into the server, storing it there. In our case, these are simple questions about how you're feeling and symptoms. A health worker can then access the QuestionnaireResponse. The health workers don't want the answers, but a score which has been calculated based on the answers.
Some vendors (non-FHIR) allow creating a form and a scoring system at the same time. If we wanted to support this within FHIR, I'm assuming we would have to embed the scoring information inside the Questionnaire (or potentially a separate resource, but that would give some redundance perhaps).
Is this best solved with extensions to the Questionnaire-resource, another resource or some other mechanism? And what'd be the best way (architectureally) to implement the actual scoring. Would it best be a separate application which subscribes to the QuestionnaireResponses, downloads the Questionnaire, extracts the scoring system, evaluates and then writes the score back into the QuestionnareResponse?
Are there other standards we should be looking to for help on this?
And for those especially interested, here's a really simplified Questionnaire resource. Typically it'd have more questions of course. Right now we've put the score into the 'code', which doesn't seem like a good idea.
{
"resourceType":"Questionnaire",
"id":"1140",
"meta":{
"versionId":"11",
"lastUpdated":"2016-06-14T13:01:47.000+00:00"
},
"text":{
"status":"generated",
"div":"<div><!-- Snipped for Brevity --></div>"
},
"status":"published",
"date":"2016",
"group":{
"linkId":"group1",
"title":"HelsaMi Hjertesvikt",
"concept":[
{
"system":"unknown",
"code":"unknown",
"display":"Hjertesvikt"
}
],
"group":[
{
"linkId":"group2",
"question":[
{
"linkId":"Feeling",
"text":"How do you feel today?",
"type":"choice",
"option":[
{
"system":"unknown",
"code":"3",
"display":"Good"
},
{
"system":"unknown",
"code":"2",
"display":"Medium"
},
{
"system":"unknown",
"code":"1",
"display":"Bad"
}
]
}
]
}
]
}
}
Would an extension for example look like this (embedded in to each option):
"extension": [{
"url": "http://example.com/scoring",
"valueInteger": 10
}
]

The score would simply be another answer to a "special" question. The question would have an extension that defines how the score is calculated. The question would likely be "read only" and could be hidden. You could even have multiple such questions, for example one per section to provide a sub-calculation and then one for the overall questionnare to total it up. As well, look at the coded ordinal extension for the Coding data type as it may be helpful for capturing scores for individual question answers.

Related

LUIS - understand any person name

we are building a product on LUIS / Microsoft Bot framework and one of the doubt we have is Person Name understanding. The product is set to use by anyone by just signing up to our website. Which means any company who is signing up can have any number of employees with any name obviously.
What we understood is the user entity is not able to recognize all names. We have created a phrase list but as per we know there is a limit to phrase list (10K or even if its 100K) and names in the world can never have a limit. The other way we are thinking is to not train the entity with utterances. However if we have 100s of customers with 1000s of users each, the utterances will not be a good idea in that case.
I do not see any other way of handling this situation. Probably I am missing something here? Anyone faced similar problem and how it is handled?
The worst case would be to create a separate LUIS instance for each customer but that's really a big task to do only because we cant handle names.
As you might already know, a person's name could literally be anything: e.g. an animal, car, month, or color. So, there isn't any definitive way to identify something as a name. The closest you can come is via text analysis parts of speech and either taking a guess or comparing to an existing list. LUIS or any other NLP tool is unlikely to help with this. Here's one approach that might work out better. Try something like Microsoft's Text Analytics cognitive service, with a POST to the Key Phrases endpoint, like this:
https://westus.api.cognitive.microsoft.com/text/analytics/v2.0/keyPhrases
and the body:
{
"documents": [
{
"language": "en-us",
"id": "myid",
"text": "Please book a flight for John Smith at 2:30pm on Wednesday."
}
]
}
That returns:
{
"languageDetection": {
"documents": [
{
"id": "e4263091-2d54-4ab7-b660-d2b393c4a889",
"detectedLanguages": [
{
"name": "English",
"iso6391Name": "en",
"score": 1.0
}
]
}
],
"errors": []
},
"keyPhrases": {
"documents": [
{
"id": "e4263091-2d54-4ab7-b660-d2b393c4a889",
"keyPhrases": [
"John Smith",
"flight"
]
}
],
"errors": []
},
"sentiment": {
"documents": [
{
"id": "e4263091-2d54-4ab7-b660-d2b393c4a889",
"score": 0.5
}
],
"errors": []
}
}
Notice that you get "John Smith" and "flight" back as key phrases. "flight" is definitely not a name, but "John Smith" might be, giving you a better idea of what the name is. Additionally, if you have a database of customer names, you can compare the value to a customer name, either exact or soundex, to increase your confidence in the name.
Sometimes, the services don't give you an 100% answer and you have to be creative with work-arounds. Please see the Text Analytics API docs for more info.
Have asked this question to few MS guys in my local region however it seems there is no way LUIS at moment can identify names.
Its not good as being NLP, it is not able to handle such things :(
I found wit.ai (best so far) in identifying names and IBM Watson is also good upto some level. Lets see how they turn out in future but for now I switched to https://wit.ai

CouchDB Read Configuration from design document

I would like to store a value in the config file and look it up in the design document for comparing against update values. I'm sure I have seen this but, for the life of me, I can't seem to remember how to do this.
UPDATE
I realize (after the first answer) that there was more than one way to interpret my question. Hopefully this example clears it up a little. Given a configuration:
curl -X PUT http://localhost:5984/_config/shared/token -d '"0123456789"'
I then want to be able to look it up in my design document
{
"_id": "_design/loadsecrets",
"validate_doc_update": {
"test": function (newDoc,oldDoc) {
if (newDoc.supersecret != magicobject.config.shared.token){
throw({unauthorized:"You don't know the super secret"});
}
}
}
}
It's the abilitly to do something like the magicobject.config.shared.token that I am looking for.
UPDATE 2
Another potentially useful (contrived) scenario
curl -X PUT http://trustedemployee:5984/_config/eventlogger/detaillevel -d '"0"'
curl -X PUT http://employee:5984/_config/eventlogger/detaillevel -d '"2"'
curl -X PUT http://vicepresident:5984/_config/eventlogger/detaillevel -d '"10"'
Then on devices tracking employee behaviour:
{
"_id": "_design/logger",
"updates": {
"logger": function (doc,req) {
if (!doc) {
doc = {_id:req.id};
}
if(req.level < magicobject.config.eventlogger.detaillevel ){
doc.details = req.details;
}
return [doc, req.details];
}
}
}
Here's a follow-up to my last answer with more general info:
There is no general way to use configuration, because CouchDB is designed with scalability, stability and predictability in mind. It has been designed using many principles of functional programming and pure functions, avoiding side effects as much as possible. This is a Good Thing™.
However, each type of function has additional parameters that you can use, depending on the context the function is called with:
show, list, update and filter functions are executed for each request, so they get the request object. Here you have the req.secObj and req.userCtx to (ab)use for common configuration. Also, AFAIK the this keyword is set to the current design document, so you can use the design doc to get common configuration (at least up to CouchDB 1.6 it worked).
view functions (map, reduce) don't have additional parameters, because the results of a view are written to disk and reused in subsequent calls. map functions must be pure (so don't use e.g. Math.random()). For shared configuration across view functions within a single design doc you can use CommonJS require(), but only within the views.lib key.
validate doc update functions are not necessarily executed within a user-triggered http request (they are called before each write, which might not be triggered only via http). So they have the userCtx and secObj added as separate parameters in their function signature.
So to sum up, you can use the following places for configuration:
userCtx for user-specific config. Use a special role (e.g. with a prefix) for storing small config bits. For example superLogin does this.
secObj for database-wide config. Use a special member name for small bits (as you should normally use roles instead of explicit user names, secObj.members.names or secObj.admins.names is a good place).
the design doc itself for design-doc-wide config. Best use the this.views.lib.config for this, as you can also read this key from within views. But keep in mind that all views are invalidated as soon as you change this key. So if the view results will stay the same no matter what the config values are, it might be better to use a this.config key.
Hope this helps! I can also add examples if you wish.
I think I know what you're talking about, and if I'm right then what you are asking for is no longer possible. (at least in v1.6 and v2.0, I'm not sure when this feature was removed)
There was a lesser-known trick that allowed a view/show/list/validation/etc function to access the parent design document as this in your function. For example:
{
"_id": "_design/hello-world",
"config": {
"PI": 3.14
},
"views": {
"test": {
"map": "function (doc) { emit(this.config.PI); })"
}
}
}
This was a really crazy idea, and I imagine it was removed because it created a circular dependency between the design document and the code of the view that made the process of invalidating/rebuilding a view index a very tricky affair.
I remember using this trick at some point in the distant past, but the feature is definitely gone now. (and likely to never return)
For your special use-case (validating a document with a secret token), there might be a workaround, but I'm not sure if the token might leak in some place. It all depends what your security requirements are.
You could abuse the 4th parameter to validate_doc_update, the securityObject (see the CouchDB docs) to store the secret token as the first admin name:
{
"test": "function (newDoc, oldDoc, userCtx, secObj) {
var token = secObj.admins.names[0];
if (newDoc.supersecret != token) {
throw({unauthorized:"You don't know the super secret"});
}
}"
}
So if you set the db's security object to {admins: {names: ["s3cr3t-t0k3n"], roles: ["_admin"]}}, you have to pass 's3cr3t-t0k3n' as the doc's supersecret property.
This is obviously a dirty hack, but as far as I remember, the security object may only be read or modified by admins, you wouldn't immediately leak your token to the public. But consider adding a separate layer between the CouchDB and your caller if you need "real" security.

How to find an object which is at nth nested level in mongoDB? (single collection, single document)

I am trying to find an nth object using '_id', which is in the same document.
Any suggestions or references or code samples would be appreciated.
(e.g)
Document will look as below:
{
"_id": "xxxxx",
"name": "One",
"pocket": [{
"_id": "xxx123",
"name": "NestedOne",
"pocket": []
}, {
"_id": "xxx1234",
"name": "NestedTwo",
"pocket": [{
"_id": "xxx123456",
"name": "NestedTwoNested",
"pocket": [{"_id": "xxx123666",
"name": "NestedNestedOne",
"pocket": []
}]
}]
}]
}
The pockets shall hold more pockets and it is dynamic.
Here, I would like to search "pocket" using "_id" , say "xxx123456", but without using static reference.
Thanks again.
I highly recommend you change your document structure to something easier to manage/search, as this will only become more of a pain to work with.
Why not use multiple collections, like explained in this answer?
So an easy way to think about this for your situation, which I hope is easier for you to reason about than dropping some schema code...
Store all of your things as children in the same document. Give them unique _ids.
Store all of the contents of their pockets as collections. The collections simply hold all the ids that would normally be inside the pocket (instead of referencing the pockets themselves).
That way, a lot of your work can happen outside of DB calls. You just batch pull out the items you need when you need them, instead of searching nested documents!
However, if you can work with the entire document:
Looks like you want to do a recursive search a certain of number of levels deep. I'll give you a general idea with some pseudocode, in hopes that you'll be able to figure the rest out.
Say your function will be:
function SearchNDeep(obj, n, id){
/**
You want to go down 1 level, to pocket
see if pocket has any things in it. If so:
Check all of the things...for further pockets...
Once you've checked one level of things, increment the counter.
When the counter reaches the right level, you'd want to then see if the object you're checking has a `'_id'` of `id`.
**/
}
That's the general idea. There is a cleaner, recursive way to do this where you call SearchNDeep while passing a number for how deep you are, base case being no more levels to go, or the object is found.
Remember to return false or undefined if you don't find it, and the right object if you do! Good luck!

Freebase batch search

I'm trying to use Freebase to search for multiple items at a time (using one API call). For example, if I have two items:
Robert Downey, Jr.
The Avengers
I want to query Freebase once and get back results for both items. Basically all I need is the mid for the top 3 or 4 results for both items. I would like to rely on Freebase's search API to provide disambiguation for topics. For example, I'd like to be able to search for "Robert Downey, Jr." with the abbreviation: "RDJ".
This is easy to do when searching one item at a time:
https://www.googleapis.com/freebase/v1/search?query=rdj
Making two calls like this would give me exactly what I'm looking for, but I would like to stay away from making these calls individually.
Reconciliation
I did run across the json-rpc call for reconciliation, and I have tried the following:
Endpoint: https://www.googleapis.com/rpc
POST body:
[
{
"method": "freebase.reconcile",
"apiVersion": "v1",
"params": {
"name": ["RDJ"],
"key": "api_key",
"limit":10
}
},
{
"method": "freebase.reconcile",
"apiVersion": "v1",
"params": {
"name": ["the avengers"],
"key": "api_key",
"limit":10
}
}
]
This works fairly well for Robert Downey, Jr in that I get a result of type /film/actor as I did using the search api. However, for The Avengers, I get a set of results with type /book/book rather than the 2012 film. These results don't seem to be prioritized the same way as the search results.
I tried something similar using json-rpc for a Freebase search method:
{
"method": "freebase.search",
"apiVersion": "v1",
"params": {
"name": ["RDJ"],
"key": "api_key",
"limit":10
}
}
But the "freebase.search" method didn't seem to exist.
One thing to note is that I will not know the expected type of the items I am looking for before hand.
Long story short: I want the exact results the search API provides, but with multiple queries wrapped up into one call.
Am I missing something terribly simple like an OR operator for the search API?? I've been searching for days, but can't seem to find a good solution. I would appreciate any help at all!
Why not just make two calls asynchronously? That would give you the results you need with almost no penalty in latency.
A few relevant facts:
The Reconcile API is still experimental. It's intended for use in reconciling against a type at a minimum and usually scoring using additional property values.
The Search API isn't included in the RPC mechanism because its freeform output doesn't work with the assumptions of the RPC framework. Ditto for the Topic API, although that's not really relevant here.
The Search API has a fairly expressive S-expression language. You don't say if you want the queries scored independently or together, but if you want them ranked jointly, you can use a filter expression like [(any name:rdj name:"The Avengers")]
https://www.googleapis.com/freebase/v1/search?query=&limit=10&filter=%28any%20name:rdj%20name:%22the%20avengers%22%29

CouchDB: Single document vs "joining" documents together

I'm tryting to decide the best approach for a CouchApp (no middleware). Since there are similarities to my idea, lets assume we have a stackoverflow page stored in a CouchDB. In essence it consists of the actual question on top, answers and commets. Those are basically three layers.
There are two ways of storing it. Either within a single document containing a suitable JSON representation of the data, or store each part of the entry within a separate document combining them later through a view (similar to this: http://www.cmlenz.net/archives/2007/10/couchdb-joins)
Now, both approaches may be fine, yet both have massive downsides from my current point of view. Storing a busy document (many changes through multiple users are expected) as a signle entity would cause conflicts to happen. If user A stores his/her changes to the document, user B would receive a conflict error once he/she is finished typing his/her update. I can imagine its possible to fix this without the users knowledge through re-downloading the document before retrying.
But what if the document is rather big? I'll except them to become rather blown up over time which would put quite some noticeable delay on a save process, especially if the retry process has to happen multiple times due to many users updating a document at the same time.
Another problem I'd see is editing. Every user should be allowed to edit his/her contributions. Now, if they're stored within one document it might be hard to write a solid auth handler.
Ok, now lets look at the multiple documents approach. Question, Answers and Comments would be stored within their own documents. Advantage: only the actual owner of the document can cause conflicts, something that won't happen too often. Being rather small elements of the whole, redownloading wouldn't take much time. Furthermore the auth routine should be quite easy to realize.
Now here's the downside. The single document is real easy to query and display. Having a lot of unsorted snippets laying around seems like a messy thing since I didn't really get the actual view to present me with a 100% ready to use JSON object containing the entire item in an ordered and structured format.
I hope I've been able to communicate the actual problem. I try to decide which solution would be more suitable for me, which problems easier to overcome. I imagine the first solution to be the prettier one in terms of storage and querying, yet the second one the more practical one solvable through better key management within the view (I'm not entirely into the principle of keys yet).
Thank you very much for your help in advance :)
Go with your second option. It's much easier than having to deal with the conflicts. Here are some example docs how I might structure the data:
{
_id: 12345,
type: 'question',
slug: 'couchdb-single-document-vs-joining-documents-together',
markdown: 'Im tryting to decide the best approach for a CouchApp (no middleware). Since there are similarities to...' ,
user: 'roman-geber',
date: 1322150148041,
'jquery.couch.attachPrevRev' : true
}
{
_id: 23456,
type: 'answer'
question: 12345,
markdown: 'Go with your second option...',
user : 'ryan-ramage',
votes: 100,
date: 1322151148041,
'jquery.couch.attachPrevRev' : true
}
{
_id: 45678,
type: 'comment'
question: 12345,
answer: 23456,
markdown : 'I really like what you have said, but...' ,
user: 'somedude',
date: 1322151158041,
'jquery.couch.attachPrevRev' : true
}
To store revisions of each one, I would store the old versions as attachments on the doc being edited. If you use the jquery client for couchdb, you get it for free by adding the jquery.couch.attachPrevRev = true. See Versioning docs in CouchDB by jchris
Create a view like this
fullQuestion : {
map : function(doc) {
if (doc.type == 'question') emit([doc._id, null, null], null);
if (doc.type == 'answer') emit([doc.question, doc._id, null], null);
if (doc.type == 'comment') emit([doc.question, doc.answer, doc._id], null) ;
}
}
And query the view like this
http://localhost:5984/so/_design/app/_view/fullQuestion?startkey=['12345']&endkey=['12345',{},{}]&include_docs=true
(Note: I have not url encoded this query, but it is more readable)
This will get you all of the related documents for the question that you will need to build the page. The only thing is that they will not be sorted by date. You can sort them on the client side (in javascript).
EDIT: Here is an alternative option for the view and query
Based on your domain, you know some facts. You know an answer cant exist before a question existed, and a comment on an answer cant exist before an answer existed. So lets make a view that might make it faster to create the display page, respecting the order of things:
fullQuestion : {
map : function(doc) {
if (doc.type == 'question') emit([doc._id, doc.date], null);
if (doc.type == 'answer') emit([doc.question, doc.date], null);
if (doc.type == 'comment') emit([doc.question, doc.date], null);
}
}
This will keep all the related docs together, and keep them ordered by date. Here is a sample query
http://localhost:5984/so/_design/app/_view/fullQuestion?startkey=['12345']&endkey=['12345',{}]&include_docs=true
This will get back all the docs you will need, ordered from oldest to newest. You can now zip through the results, knowing that the parent objects will be before the child ones, like this:
function addAnswer(doc) {
$('.answers').append(answerTemplate(doc));
}
function addCommentToAnswer(doc) {
$('#' + doc.answer).append(commentTemplate(doc));
}
$.each(results.rows, function(i, row) {
if (row.doc.type == 'question') displyQuestionInfo(row.doc);
if (row.doc.type == 'answer') addAnswer(row.doc);
if (row.doc.type == 'comment') addCommentToAnswer(row.doc)
})
So then you dont have to perform any client side sorting.
Hope this helps.

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