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jonathan@openhealth.org (Jonathan Borden) writes:
>I can assure you that I, for one, write certain prescriptions in a way
>that is meant to be dispensed _exactly_ as prescribed. In other,
>frequent, situations, there is intended to be a range of dispensions
>for a prescription. This is exactly why I say that an ontology is
>intended to convey a _set of meanings_.
Creators of information do tend to believe that their intentions are
paramount, yes.
>When a pharmacist sees a drug interaction that the doctor hasn't, the
>intention is to flag this, and contact the doctor for more
>instructions ... this is exactly what ontologies (and schemata in
>general) are great at: spotting inconsistencies.
Then perhaps we can get rid of what little remains of the pharmacist's
job, and simply switch to automated pill dispensers.
>"Dispense as written" seems to be a pretty clear directive, whether or
>not it is followed. Are you really arguing that such a prescription is
>intended to be open for interpretation? If so, we are so far off, that
>continuing this discussion would seem pointless.
Insurers seem to be the ones contesting DAW, primarily in cases where
(far cheaper) generic alternatives are available. The equivalence of
brand names and generics is something that probably isn't supposed to be
arguable, but certainly is in practice, as is choice of treatment
generally. The prescription represents a choice made by the doctor, and
that choice is not necessarily treated as god-given by certain other
agencies.
Insurers may know what you mean by DAW, but they would certainly like to
reinterpret the prescription.
>Err, sometimes it is important to categorize (i.e. classify)
>documents. This is a useful activity in and of itself -- for example:
>coding medical documents is essential to medical billing -- which is
>an entirely practical task for a hospital.
Categorization is a useful activity. Formalizing categorizations and
making them interchangeable comes with costs that are often
underestimated.
>> Common understandings are useful, but I regard most ontology work as
>> an effort to create global understandings where local understandings
>> are both more flexible and workable without being globalized.
>
>As I've frequently said: ontologies are often intended to be _local_,
>for example to be shared between two parties, much like a syntactic
>schema. What _you regard_ and what folks that use ontologies do may be
>different. An ontology may be represented and transmittent from point
>to point as a document -- where is this "global" requirement coming
>from? ....
Perhaps you should hang out at more knowledge tech sessions? Or listen
to the people who get excited about merging RDF graphs ad infinitum?
http://www.w3.org/2003/Talks/0521-www-keynote-tbl/slide20-0.html
Maybe "standard" is a less negatively-charged word than global, but I'll
argue that it's generally a synonym.
>> Markup alone solves no problems. Markup in particular contexts can
>> be very useful. You seem to find the creation of global contexts
>> useful, while I find them constraining and overwhelmingly tied to
>> information politics rather than technical need.
>
>Where does this "global" stuff come from? Where have I ever mentioned
>"global contexts"?
You've mentioned standardization enough times that I have no qualms
using the word global.
>>...Markup feels to me like an
>> opportunity to avoid such over-ambitious projects by letting people
>> label information using terms that are meaningful to them - and
>> subject to later interpretation.
>
>You may wish to avoid "over-ambitious projects", but those of us that
>are faced with them have a need to share intention on occasion -- how
>do you propose that we communicate?
The way that humans have communicated for centuries, though negotiation
in local contexts.
>Case in point: I've written a medical document (it mostly consists of
>lots of medical terms). You've been captured and held hostage (that's
>the only way we can force you to answer the following questions) and a
>gun is placed to your head. You are instructed to interpret my
>document on pain of getting your brains splattered against a wall if
>your captors disagree with your interpretation.
>
>You are lucky because my document is typed and the words are spelt
>correctly and all the sentences have proper structure.
>
>Would you like the dictionary that I provide? Yes or no. (BTW: you are
>allowed to show this dictionary to your captors to attempt to resolve
>a dispute you may come into with them).
I'm sorry, Jonathan, but this example is far too ridiculously contrived
for me to take seriously. Have you been watching Steven Seagall movies
or something?
>> "Don't encourage that as a general solution" seems quite completely
>> appropriate to me. I lack sympathy for the problem-solving approach
>> you've chosen.
>
>If you were actually in the above situation, you would rapidly gain
>sympathy for my approach.
No, I'm a very different person with quite thoroughly different
foundations than yours, and would find a different approach. Perhaps if
I'd lived your life precisely I'd have more sympathy.
--
Simon St.Laurent
Ring around the content, a pocket full of brackets
Errors, errors, all fall down!
http://simonstl.com -- http://monasticxml.org
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