ARCHETYPE Relative anatomical location (openEHR-EHR-CLUSTER.anatomical_location_relative.v2)

Name: Relative anatomical location
License: http://creativecommons.org/licenses/by-sa/4.0/

ARCHETYPE ID	openEHR-EHR-CLUSTER.anatomical_location_relative.v2
Concept	Relative anatomical location
Description	A physical site on or within the human body that is described in terms of its relationship to other body parts.
Use	Use to record structured and consistent details about a single identified physical site on, or within, the human body by describing its location in relation to identified macroscopic anatomical landmarks. It may be necessary to describe the single physical location using more than one relative location - for example, 2 cm inferior to 'landmark A' AND 3 cm medial to 'landmark B'. In practice, some archetypes carry a single data element for carrying a simple description of body site - for example, OBSERVATION.blood_pressure and CLUSTER.symptom when describing ear pain. In this situation, where the value set is predictable and simple to define, this single data element is a very accurate and pragmatic way to record the site in the body and to query at a later date. However in the situation where the anatomical location is not well defined or needs to be determined at run-time, it may be more flexible to use this structured archetype. This archetype is specifically designed to be used within the context of any appropriate ENTRY or CLUSTER archetypes which supply the context of the identified body site, including insertion within the CLUSTER.anatomical_location if 'Body site name' or other data elements are also required. Clinical use cases: - 5 cm inferior to the left tibial tuberosity; - 2 cm medial to the right nipple; and - 5 cm within the anal opening. In the situation where the CLUSTER.anatomical_location can only be used to name a large and/or non-specific body part, the use of this archetype within the 'Alternative Structure' SLOT will support recording of a more precise location - for example, 2 cm anterior to the cubital fossa of the left forearm or 4 cm below R costal margin on the chest wall in the mid-clavicular line.
Misuse	Not to be used to record 'unilateral' and 'bilateral', as these terms are qualifiers for conclusions rather than anatomical locations. Not to be used to specify a simple location of a named physical site in the body. Not to be used to specify a simple location of a named physical site in the body, such as left femur or medial aspect of nose. Use the CLUSTER.anatomical_location archetype for this purpose. Not to be used to represent location of anatomical features at the microscopic level, for example in reporting histopathology. Use a CLUSTER archetype for histopathology nested within the OBSERVATION.laboratory_test_result archetype for this purpose.
Purpose	To identify and record structured details about a single physical site on, or within, the human body in terms of its relationship to other macroscopic anatomical landmarks.
References	Avgrenet fra: Relative anatomical location, Published archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2023-07-11]. Available from: https://ckm.openehr.org/ckm/archetypes/1013.1.4863
Copyright	© openEHR Foundation
Authors	Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2008-11-10
Other Details Language	Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2008-11-10
OtherDetails Language Independent	{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, references=Avgrenet fra: Relative anatomical location, Published archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2023-07-11]. Available from: https://ckm.openehr.org/ckm/archetypes/1013.1.4863, current_contact=Heather Leslie, Atomica Informatics, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=95E62F4E6D9564FD0AF5151BBB3CC2A7, build_uid=3ead758e-ab77-4b0a-8979-23821aa53050, ip_acknowledgements=This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/snomed-ct/get-snomed or info@snomed.org., revision=2.2.0}
Keywords	location, site, anatomical, relative, approximate, anatomic region, topographic anatomy, macroscopic anatomy, macroscopic, anatomic, anatomy
Lifecycle	published
UID	f0ffebf8-c555-4927-a9f2-fd219d9335d8
Language used	en
Citeable Identifier	1013.1.4863
Revision Number	2.2.0
All	Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=A physical site on or within the human body that is described in terms of its relationship to other body parts., archetypeConceptComment=null, otherContributors=Hildegunn Siv Aase, Helse Bergen, Norway Tomas Alme, DIPS, Norway Anne Pauline Anderssen, Helse Nord RHF, Norway Vebjoern Arntzen, Oslo university hospital, Norway Vebjørn Arntzen, Oslo universitetssykehus HF, Norway (Nasjonal IKT redaktør) Koray Atalag, University of Auckland, New Zealand Gustavo Bacelar-Silva, Healthcare Designs, Brazil (openEHR Editor) Silje Ljosland Bakke, Helse Vest IKT AS, Norway (Nasjonal IKT redaktør) Lars Bitsch-Larsen, Haukeland University Hospital, Bergen, Norway Hanne Marte Bårholm, Helse Vest IKT, Norway (Nasjonal IKT redaktør) Bjørn Christensen, Helse Bergen HF, Norway Aitor Eguzkitza, UPNA (Public University of Navarre) - CHN (Complejo Hospitalario de Navarra), Spain Shahla Foozonkhah, Ocean Informatics, Australia Einar Fosse, National Centre for Integrated Care and Telemedicine, Norway Sebastian Garde, Ocean Informatics, Germany Heather Grain, Llewelyn Grain Informatics, Australia Mikkel Johan Gaup Grønmo, Helse Nord IKT, Norway (Nasjonal IKT redaktør) Kristian Heldal, Telemark Hospital Trust, Norway Anca Heyd, DIPS ASA, Norway Dunmail Hodkinson, Black Pear Software Ltd, UK Hilde Hollås, Norway Hanne Joensen, Helse Bergen HUS, Norway Karl Trygve Kalleberg, Oslo Universitetssykehus, Norway Lars Karlsen, DIPS ASA, Norway Lars Morgan Karlsen, Nordlandssykehuset Bodø, Norway Shinji Kobayashi, Kyoto University, Japan Nils Kolstrup, Skansen Legekontor og Nasjonalt Senter for samhandling og telemedisin, Norway Kanika Kuwelker, Helse Vest IKT, Norway (Nasjonal IKT redaktør) Siri Laronningen, Kreftregisteret, Norway Liv Laugen, Oslo universitetssykehus, Norway (Nasjonal IKT redaktør) Sabine Leh, Haukeland University Hospital, Department of Pathology, Norway Heather Leslie, Atomica Informatics, Australia (openEHR Editor) Vesna Levasic, Orthopaedic Hospital Valdoltra, Slovenia Hallvard Lærum, Direktoratet for e-helse, Norway Luis Marco Ruiz, Norwegian Center for Integrated Care and Telemedicine, Norway Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor) Bjoern Naess, DIPS ASA, Norway Maria Beate Nupen-Stieng, Oslo Universitetssykehus, Norway Andrej Orel, Marand d.o.o., Slovenia Tanja Riise, Nasjonal IKT HF, Norway Terje Sagmyr, Helse Vest IKT, Norway (Nasjonal IKT redaktør) Thomas Schopf, University Hospital of North-Norway, Norway Rowan Thomas, St. Vincent's Hospital Melbourne, Australia Richard Townley-O'Neill, NEHTA, Australia John Tore Valand, Helse Vest IKT, Norway (Nasjonal IKT redaktør) Marit Alice Venheim, Helse Vest IKT, Norway (Nasjonal IKT redaktør) Dmitri Wall, Irish Skin Foundation, Ireland, originalLanguage=en, translators= German: Darin Leonhardt, PLRI für medizinische Informatik/ Medizinische Hochschule Hannover, leonhardt.darin@mh-hannover.de Swedish: Linda Aulin, Region Stockholm, Karolinska University Hospital, linda.aulin@sll.se Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, lbla@helse-bergen.no, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Portuguese (Brazil): Beatriz de Faria Leao, BLEAO INFORMÁTICA EM SAÚDE, bfleao@terra.com.br, MD, PhD Arabic (Syria): Mona Saleh Slovenian: Biljana Princic , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={state=[], contacts=[], details=[], description=[], content=[], provider=[], data=[], identities=[], other_participations=[], activities=[], protocol=[], credentials=[], events=[], context=[], relationships=[], target=[], capabilities=[], items=[ResourceSimplifiedHierarchyItem [path=/items[at0020], code=at0020, itemType=CLUSTER, level=1, text=Relative location, description=Detail to identify a single physical site either on, or within, the human body in terms of its relationship to other macroscopic anatomical landmarks., comment=More than one relative location may be required to provide an accurate cross reference., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0021], code=at0021, itemType=ELEMENT, level=2, text=Landmark name, description=Identified body site used as a reference point for the actual body site., comment='Landmark name' can identify an anatomical structure (such as the umbilicus), an anatomical line (such as the mid-clavicular line), a well defined anatomical point (such as McBurney's point). This data element should be coded with a terminology capable of triggering decision support, where possible - an appropriate termset for use here could comprise individual concepts or a list of precoordinated terms. Free text should be used only if there is no appropriate terminology available. It is strongly recommended that 'Landmark name' be recorded as specifically as is anatomically possible. For example: record 'upper eyelid' rather than recording 'eyelid' with 'upper' as a qualifier; 'fifth rib' rather than 'rib' with a numeric qualifier., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0062], code=at0062, itemType=ELEMENT, level=2, text=Laterality, description=The side of the body on which the identified landmark is located., comment=If the identified landmark has no laterality, this data element should not have a value. If the 'Landmark name' data element uses pre-coordinated terms that include laterality, then this data element is redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=[SNOMED-CT::272741003 \| Laterality], values= at0068::Left [Left side of the body.] [SNOMED-CT::7771000 \| Left] at0069::Right [Right side of the body.] [SNOMED-CT::24028007 \| Right] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Distance from landmark, description=Distance of location from the identified landmark., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length Units: >=0.0 cm Limit decimal places: 1 >=0.0 in Limit decimal places: 1 >=0.0 mm Limit decimal places: 1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0006], code=at0006, itemType=ELEMENT, level=2, text=Direction, description=Detail about the relative direction of the body site to the landmark., comment=Common aspects have been included as a value set, which can be extended over time, plus a free text option. Assumes that the body is being described while in the anatomical position. Occurrences are set to allow for a maximum of six directions to be recorded. Within this value set, clinicians will recognise that there are eight mutually exclusive directional pairs - for example, a body site cannot be simultaneously 'medial to' and 'lateral to' an identical landmark. Other mutually exclusive pairs are 'Superior to' and 'Inferior to'; 'Anterior to' and 'Posterior to'; 'Proximal to' and 'Distal to'; 'Superficial to' and 'Deep to'; 'Cranial to' and 'Caudal to'; 'Rostral to' and Caudal to'; and 'Within' and 'External to'. Combinations made from one selection from within each of the eight pair sets is potentially valid, although in clinical practice it will be very unlikely to need to simultaneously record more than two directions to describe a specified body site., uncommonOntologyItems=null, occurencesFormal=0..6, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:* Coded Text at0007::Medial to [Towards the middle, from the landmark.] at0008::Lateral to [Towards the side, from the landmark.] at0009::Superior to [Above the landmark.] at0010::Inferior to [Below the landmark.] at0012::Anterior to [Towards the front, or ventral aspect, from the landmark.] at0013::Posterior to [Towards the back, or dorsal aspect, from the landmark.] at0055::Proximal to [Closer to the body, relative to the landmark.] at0056::Distal to [Further from the body, relative to the landmark.] at0057::Superficial to [Nearer the outer surface, relative to the landmark.] at0058::Deep to [Further away from the outer surface, relative to the landmark.] at0059::Within [Inwards from the outer opening of a body cavity, for example outer ear canal, fistula or wound, relative to the landmark.] at0060::External to [Outwards from the inner opening of a body cavity, for example anal fistula or nasal cavity, relative to the landmark.] at0063::Oral to [Towards the mouth, relative to the landmark. Usually used to describe locations within the digestive system.] at0064::Anal to [Towards the anus, relative to the landmark. Usually used to describe locations within the digestive system.] at0065::Caudal to [Towards the tail, relative to the landmark.] at0066::Cranial to [Towards the head, relative to the landmark.] at0067::Rostral to [Towards the front of the head, relative to the landmark.] Text , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0023], code=at0023, itemType=ELEMENT, level=1, text=Description, description=Narrative description that can be used to further refine and support the relative location structured data., comment=For example: a tattoo covers the bottom half of this area., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0054], code=at0054, itemType=SLOT, level=1, text=Multimedia representation, description=Image or other media used to support identification of the location on the body., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.media_file.v1 and specialisations, extendedValues=null]], source=[], ism_transition=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0020], code=at0020, itemType=CLUSTER, level=1, text=Relative location, description=Detail to identify a single physical site either on, or within, the human body in terms of its relationship to other macroscopic anatomical landmarks., comment=More than one relative location may be required to provide an accurate cross reference., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0021], code=at0021, itemType=ELEMENT, level=2, text=Landmark name, description=Identified body site used as a reference point for the actual body site., comment='Landmark name' can identify an anatomical structure (such as the umbilicus), an anatomical line (such as the mid-clavicular line), a well defined anatomical point (such as McBurney's point). This data element should be coded with a terminology capable of triggering decision support, where possible - an appropriate termset for use here could comprise individual concepts or a list of precoordinated terms. Free text should be used only if there is no appropriate terminology available. It is strongly recommended that 'Landmark name' be recorded as specifically as is anatomically possible. For example: record 'upper eyelid' rather than recording 'eyelid' with 'upper' as a qualifier; 'fifth rib' rather than 'rib' with a numeric qualifier., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0062], code=at0062, itemType=ELEMENT, level=2, text=Laterality, description=The side of the body on which the identified landmark is located., comment=If the identified landmark has no laterality, this data element should not have a value. If the 'Landmark name' data element uses pre-coordinated terms that include laterality, then this data element is redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=[SNOMED-CT::272741003 \| Laterality], values= at0068::Left [Left side of the body.] [SNOMED-CT::7771000 \| Left] at0069::Right [Right side of the body.] [SNOMED-CT::24028007 \| Right] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Distance from landmark, description=Distance of location from the identified landmark., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length Units: >=0.0 cm Limit decimal places: 1 >=0.0 in Limit decimal places: 1 >=0.0 mm Limit decimal places: 1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0006], code=at0006, itemType=ELEMENT, level=2, text=Direction, description=Detail about the relative direction of the body site to the landmark., comment=Common aspects have been included as a value set, which can be extended over time, plus a free text option. Assumes that the body is being described while in the anatomical position. Occurrences are set to allow for a maximum of six directions to be recorded. Within this value set, clinicians will recognise that there are eight mutually exclusive directional pairs - for example, a body site cannot be simultaneously 'medial to' and 'lateral to' an identical landmark. Other mutually exclusive pairs are 'Superior to' and 'Inferior to'; 'Anterior to' and 'Posterior to'; 'Proximal to' and 'Distal to'; 'Superficial to' and 'Deep to'; 'Cranial to' and 'Caudal to'; 'Rostral to' and Caudal to'; and 'Within' and 'External to'. Combinations made from one selection from within each of the eight pair sets is potentially valid, although in clinical practice it will be very unlikely to need to simultaneously record more than two directions to describe a specified body site., uncommonOntologyItems=null, occurencesFormal=0..6, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:* Coded Text at0007::Medial to [Towards the middle, from the landmark.] at0008::Lateral to [Towards the side, from the landmark.] at0009::Superior to [Above the landmark.] at0010::Inferior to [Below the landmark.] at0012::Anterior to [Towards the front, or ventral aspect, from the landmark.] at0013::Posterior to [Towards the back, or dorsal aspect, from the landmark.] at0055::Proximal to [Closer to the body, relative to the landmark.] at0056::Distal to [Further from the body, relative to the landmark.] at0057::Superficial to [Nearer the outer surface, relative to the landmark.] at0058::Deep to [Further away from the outer surface, relative to the landmark.] at0059::Within [Inwards from the outer opening of a body cavity, for example outer ear canal, fistula or wound, relative to the landmark.] at0060::External to [Outwards from the inner opening of a body cavity, for example anal fistula or nasal cavity, relative to the landmark.] at0063::Oral to [Towards the mouth, relative to the landmark. Usually used to describe locations within the digestive system.] at0064::Anal to [Towards the anus, relative to the landmark. Usually used to describe locations within the digestive system.] at0065::Caudal to [Towards the tail, relative to the landmark.] at0066::Cranial to [Towards the head, relative to the landmark.] at0067::Rostral to [Towards the front of the head, relative to the landmark.] Text , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0023], code=at0023, itemType=ELEMENT, level=1, text=Description, description=Narrative description that can be used to further refine and support the relative location structured data., comment=For example: a tattoo covers the bottom half of this area., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0054], code=at0054, itemType=SLOT, level=1, text=Multimedia representation, description=Image or other media used to support identification of the location on the body., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.media_file.v1 and specialisations, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]