Documentation - Nutrition Care Process Terminology Clinical Project Group

A draft document describing the background and modeling solution has been added to this page (Revision of nutrition content in SNOMED CT).  I would appreciate a review of the document by the project group and any comments on the approach.  

On the topic of “inadequate intake of nutrient X”:

If an inadequate intake finding is due to inadequate intake and/or inadequate absorption and/or metabolism, does this necessitate separation these as term concepts when a disorder is not evident?

I would hesitate to use the word 'assimilation' because based on interpreting the OED (Oxford dictionary) definition, this means absorption and does not include metabolism. 

Also, I have added under documentation a proposed hierarchy. 

Input/request on the document you posted earlier:

It is difficult to understand the implications of the suggested reorganization based on the description provided here, specifically with regards to item 5 in the initial design section.  Is it possible to look at the change in a development version of SNOMED?  This would help us understand and provide feedback and consent for the proposed changes.

More simply put, would you be able to walk us through the process in a development environment (in the next mtg to discuss) so we are understand what is going on?

It is not clear what is happening when we study the document.

To respond to the topic of "Inadequate intake", it is defined in NCPT as follows:

X=a specific nutrient

Inadequate X intake

Definition

Lower X intake compared to established reference standards or recommendations based on physiological needs

Also, some additional input:

The point about the group discussing what is 'inadequate intake' is a concept that needs to be clarified. The phrasing and the layout do not clarify the previously posted question (If an inadequate intake finding is due to inadequate intake and/or inadequate absorption and/or metabolism, does this necessitate separation these as term concepts when a disorder is not evident?) , but a discussion by the group might. 

Right now, our 'inadequate intake' (also excessive) diagnoses do include those that have 'normal' requirements but do not get enough (through all routes) as well as those who may have 'higher' (or 'lower') requirements because of malabsorption/metabolism issues.

Related to the hierarchy, is there a reason that there are categories for composition of EN and PN, but not administration of EN and PN (perhaps these are somewhere else)? Also, where do NCPT behavior-environment diagnoses fall, these do not seem to fit in this proposed hierarchy.

As a nurse I would view intake as the introduction, whether by eating/drinking or feeding pump and absorption/malabsorption the process by which it is utilised or not from the gastrointestinal tract or parenteral circulation.  So it would seem necessary to consider both issues contributing to nutrition/malnutrition 

SNOMED definitions doc contains the definitions that have been requested.

Thank you.

I've just uploaded the "workplan" document with my comments, but I can see that Bill Swan also did the same. So now there are two new documents with comments.

Tina, can you work with that, or should we do something else right now?

All, I will merge the docs submitted by Bill and Luise and upload as a merged document in the next few days. Thank you. 

Hello, all.

The workplan has been cleaned up, and am posting here.

Based on our discussion/mtg on August 20th, this workplan will be submitted for approval by SNOMED. 

Many thanks go out to all who have taken much time to provide input and comments!

Thank you so much! Tina Papoutsakis