2020-05-18 - OBSERVABLE Meeting

• The deadline to submit a proposal for the 2020 SNOMED CT Expo has been extended to 29 May. For more information see: https://www.snomed.org/news-and-events/events/snomedct-expo

SNOMED International continues to closely monitor the status of the COVID-19 pandemic and we are making contingency plans for the Expo.
If we feel that the COVID-19 risk to our Community of Practice is still too great to gather in person, we will move to a virtual event to allow Business Meetings to convene and for Expo presenters to share their great SNOMED CT work. Should we cancel the in-person event, we will do so with sufficient notice to respect the impact to your travel plans. Please do not hesitate to reach out to the Events team via events@snomed.org if you have any immediate questions.

Observables and Evaluation procedures

Since Observables were introduced into SNOMED CT the demarcation between Observables and Evaluation procedures has been a potential source of variability of SNOMED CT use. In order to progress this issue the group need to agree on what knowledge is needed to inform any future decision.

2019-11-18:

<<404684003 |Clinical finding (finding)| : 363714003 |Interprets (attribute)| = << 386053000 |Evaluation procedure| ==> 7148 concepts

...but also

1350 hits for <<386053000 | Evaluation procedure (procedure) |: [2..*] { 260686004 |Method (attribute)| = <<129265001 |Evaluation - action (qualifier value)| }

3 hits for <<386053000 | Evaluation procedure (procedure) |: [2..*] { 260686004 |Method (attribute)| = <<129266000 |Measurement - action (qualifier value)| }

611 hits for <<386053000 | Evaluation procedure (procedure) |: [2..*] { 246093002 |Component (attribute)| = * }

2019-12-16:

Some more exploration of existing Evaluation procedure content:

(<<386053000 |Evaluation procedure (procedure)| : [2..*] { * = * }) MINUS <<363679005 |Imaging (procedure)|

10 000-ish Evaluation procedures have 2 or more role groups...

<<386053000 |Evaluation procedure (procedure)| : [2..*] { 246093002 |Component| = * }

611 have 2 or more Components, indicating that it could be a panel. However, many examples are just strangely modeled and likely not intended to be panels. Thus, it's not straight forward to identify panel-like procedures among the Evaluation procedure. Sometimes, e.g. 442553005 | Measurement of chloride in peritoneal fluid specimen (procedure) |, additional Components are inherited from ancestors.

(<<386053000 |Evaluation procedure (procedure)| : [2..*] { 246093002 |Component| = * }) MINUS <<122869004 |Measurement procedure|

Even non Measurement procedures have multiple Components...

<<386053000 |Evaluation procedure (procedure)| : [3..*] { 246093002 |Component| = * }

A few have 3 or more components, many of which are in fact panels, but again likely not all of them. E.g. see <67899004 | Complement component, classic pathway (substance) |.

Briefing note should include:

• Current status in regard to overlap
  • Actual concepts
  • Concept models
• Current status in regard to modeling of Evaluation procedures
• Orders and results use of SNOMED CT
  • Actual use of Evaluation procedure concepts for reporting results
  • Actual use of Evaluation procedure concepts for ordering
• Panels vs. single-measurement observables/procedures

2020-01-28:

The issue of panel concepts (sets of distinct Observable entities) was discussed. The current Observables model, by design, does not allow representation of panels.

Many examples of panels are not well-defined, e.g. a Complete Blood Count may contain different observables in different laboratories. The benefit of adding content on the international level is likely limited. However, SNOMED CT should provide the means to represent such panels when there is agreement on meaning on a national, regional or local level.

Several Evaluation procedure concepts contain multiple groups, but all are not correctly modelled.

2020-02-24:

Aim to get feedback from members about usage of Evaluation procedures.

Further aim to identify candidates for Procedure-to-Observables transfer, i.e. Procedure concepts which represent observations which has a single, distinct result/value.

Some gaps exist in creating observables corresponding to those procedures, most notably techniques are missing.

2020-03-16:

The topic has been lifted in the Modeling Advisory Group.

Panels (aka observables without values): Examples of types of panels are groupers for lists, screening and function tests. Naming today is insufficient to distinguish from e.g. totals (e.g. amino acid panel vs. total amino acid etc.).

Definition and naming of panels (observables OR evaluation procedures).

2020-04-20:

EAG + MAG meeting to be planned. Preparation meeting held (slides).

Range of motion exist in SNOMED CT in the <<364564000 |Range of joint movement (observable entity)| hierachy as primitive concepts.

A template for such observables could be like this:

363787002 | Observable entity (observable entity) | |:
[[~1..1]] 704318007 | Property type (attribute) | = 65161000052106 | Angular range (property) (qualifier value) |,
[[~1..1]] 704319004 | Inheres in (attribute) | = [[+id(<<39352004 | Joint structure (body structure) |) @joint]],
[[~1..1]] 704321009 | Characterizes (attribute) | = [[+id(<<255324009 | Movement (observable entity) |) @movement]],
[[~1..1]] 370134009 | Time aspect (attribute) | = 123029007 | Single point in time (qualifier value) |

The scale type was tentatively left out, as questions about the use of the observables both for recording actual angles in the record and to model clinical finding is under discussion.

Next meeting is 2020-06-15 20.00UTC

• MBHCRG