1. OGMS Proposals Alexander P. Cox 2013 ICBO Meeting Montreal, Canada

2. Signs & Symptoms Sign is currently defined as: – A quality of a patient, a material entity that is part of a patient, or a processual entity that a patient participates in, any one of which is observed in a physical examination and is deemed by the clinician to be of clinical significance. Symptom is currently defined as: – A quality of a patient that is observed by the patient or a processual entity experienced by the patient, either of which is hypothesized by the patient to be a realization of a disease. These are defined classes

3. Signs & Symptoms ‘sign’ and ‘symptom’ fall outside of the continuant/occurrent distinction In the current forms, they are not particularly useful Other terms refer to signs and symptoms (whether explicitly or implicitly) and thereby have their utility reduced. These include: – syndrome = df “A pattern of signs and symptoms that typically co-occur.” – acute disease course = df “a disease course with a rapid onset but typical unfolding of signs and symptoms after this rapid onset.” – treatment = df “A processual entity whose completion is hypothesized (by a healthcare provider) to alleviate the signs and symptoms associated with a disorder” – clinical finding = df “A representation that is either the output of a clinical history taking or a physical examination or an image finding, or some combination thereof.” – clinical history = df “A representation of clinically significant bodily components, dispositions, and/or bodily processes of a human being that is inferred from relevant clinical findings.” – physical examination = df “A sequence of acts of observing and measuring qualities of a patient performed by a clinician; measurements may occur with and without elicitation.”

4. Signs & Symptoms Possible revisions: 1.Eliminate ‘sign’ and ‘symptom’ and just use ‘clinical finding’, redefine other terms accordingly 2.Make ‘sign’ and ‘symptom’ relations between clinical findings (or perhaps something more general), patients, and physicians X is sign of Y X is symptom of Y 3.Make ‘sign’ and ‘symptom’ roles that can be played by clinical findings (or perhaps something more general) X has role ‘sign of’ X has role ‘symptom of’ 4.Combination of #2 and #3 5.Other???

5. Syndrome syndrome = df “A pattern of signs and symptoms that typically co-occur.” ‘syndrome’ is a subclass of ‘quality’, which is a ‘specifically dependent continuant’ What is a pattern? If a pattern is a generically dependent continuant/occurrent, how does this affect syndrome?