Excessive Sweating

How do we represent this? We have a relation ToSweat, but how do we connect "excessively". We could have a range – inadequate – normal – excessive

"normal" varies over a wide range, depending on whether the person is at rest, fearful, or engaged in heavy exercise.

We could have "rate" as an attribute of the relation, and have a spectrum

Zero - abnormally low - low - normal - high - extreme - excessive (abnormally high)

Abnormally low is not in low range – low might be 0.1 – 0.3, whereas abnormally low might be 0 – 0.1 – some overlap is probably permissible.

So excessive would be an attribute of rate, and excessive means to exceed normal (or be abnormal). This gives

diaphoresis.PNG (27048 bytes)

We have to get the time right on this – it is currently, was or has been – another attribute of the ToSweat relation. The time has to be after any previous treatment – we can’t look at records 5 years ago, except as a weak indicator of the current state.

An alternative structure would have diseases having symptoms as an attribute, and then symptoms would have discernible signs, so

diaphoresisAttribute.PNG (20465 bytes)

We can then have multiple attributes, or an object group, where the applicability of all, any or some of the discernible symptoms is controlled by the object group. If they are tied directly to the attribute operator, they are separate and independent.

We can handle tachycardia in a similar way – heart rate excessive, where we understand that normal can vary over a wide range depending on the state of the patient (resting, standing, walking, running). We can set up a distribution (or a table) based on level of activity.

How do we handle low white blood cell count? Just another use of the spectrum for low, or make it abnormally low? We have to know what the normal range is, or no, we are just told it is low. We probably have a spectrum for normal, so we have low normal and high normal.

The normal white cell count for adults is 4.0-10.0 x 109/L.

We are going to have to control the ranges for age and gender.

The normal red cell count for adult males is 4.5-5.5 x 1012/L, and 3.8-4.8 x 1012/L for adult females.

Medical Design Notes