Jim Case

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Jim Case

None stated.

Monica Harry

Source: Freshdesk ticket  NHSSME-20 - Getting issue details... STATUS

Lateralization of procedures EAG 20210901_MHA .pptx

EAG - Lateralizable procedures Briefing note September 1st 2021.docx

Discussion:

Question is whether the laterality should be the first part of the concept term or whether the procedure should begin the term. Action - body site vs. Body site - Action

Laterality must be attached to the body structure which may lead to confusing descriptions, especially for translations.

There are some instances where the structure may not be symmetrical independent structures (e.g. left and right lip).  There may be issues in translations in some cases.  For bilateral procedures they should be modeled with two role groups representing each side.

The use of "both" as opposed to "bilateral" may be preferred in some cases, especially for translation. There will be a description using "both" for all of these terms. 

Decision:

The consensus of the group was that the Action - body structure format.  Alternative representations can be added as descriptions.  

• Monica Harry and Krista Lilly to update ed. guide to reflect naming convention

Source: Freshdesk ticket 

EAG -Angiography_arteriography Briefing note September 1st 2021.docx

Angiography_Arteriography EAG 20210901_MHA .pptx

Discussion:

Over 500 procedures with a direct site of "Artery", but are named "Angiography".  Propose to rename these as FSN using "Arteriography" with a PT of "Angiography".  This will result in a sizeable number of changes to FSNs and descriptions.

Question: Is there a pattern in where we have used Angiography, when we are focused on an artery?  Is venography just a convenient by-product? 

Are we just using "angiography" as a convenient mechanism due to the general perceived synonymy in common use?  Will it cause problems down the road if we need to make the distinction?  

Because of the use of both "angiography" and "arteriography" synonymously, should we have both represented as descriptions but not to make "angiography" the preferred term when the focus is an artery.

Proposed that in the description that the artery be specified if the description contains "Angiography".

Alternative proposal is that we do not use "Arteriography" in the FSN.  Angiography would be used as long as the specific artery is specified.  This would be the same for the PT. Arteriography would be added as a synonym where appropriate.

Decision:

Concepts with "arteriography" in the FSN will be renamed "Angiography of X artery", with "Angiography of X artery" as the PT.  Arteriography of X artery will be added as a synonym.

The presence of "angiogram" description has previously been approved for the ones that are present, but we will go out for comment prior to inactivation of these "-gram" terms.

• Monica Harry to make changes to the FSNs as approved.

Toni Morrison

Introduction of new topic to reorganize product hierarchy to support modeling of non-therapeutic roles and non-medicinal products for future discussion.

EAG - Product roles introduction.pptx

Discussion:

The topic was introduced to the group. 

Question: What is the scope? A: Limited to those required for modeling.  We will not be proactively creating these types of products.

Understanding of the need, but must be very careful in creating new top level hierarchies. 

What are we doing with complex things such as food products (pizza, cheese sandwich, potato salad)?  Still to be determined as part of this discussion. 

Decision:

None at this time.

Paul Amos

Jeremy Rogers

Jim Case

Inactivation of Ambiguous Concepts - review of comments and problematic examples

From Jim Case  Ambiguous concepts identified by member

208493001 |Open fracture finger distal phalanx, multiple (disorder)|

208488004 |Open fracture finger middle phalanx, multiple (disorder)|

208482003 |Open fracture finger proximal phalanx, multiple (disorder)|

These are confusing concepts and it is unclear from the current wording what is intended.  As one would expect, these are most likely derived from ICD-9 (e.g. 816.13 Open fracture of multiple sites of phalanx or phalanges of hand), which is also open to interpretation.  In the recent remodeling of these concepts, the representation in some cases is that multiple phalanges or digits are involved, in other cases such as abrasions and open wounds, they are modeled as multiple morphologies on a single digit.

Given that the original source of these concepts was ambiguous as to whether one or more digits were involved, these concepts should be inactivated as ambiguous and replaced with concepts with more specific FSNs, i.e.

"Open fracture of distal phalanx of multiple fingers" and "Multiple open fractures of distal phalanx of finger".  The latter is an example of a concept that most likely would never occur, (multi-fragmentary fractures occur) but would need to be created in order to conform to the requirements associated with AMBIGUOUS inactivation reason from the concept inactivation workgroup.  Thus it too would be inactive (Paul Amos, what would be the inactivation reason?)

Useful references: Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know and Distal phalanx, distal and shaft, multifragmentary

Discussion:

Three options:

1. Inactivate as a classification concept
2. Create a non-useful concept and inactivate as "Non-conformant"
3. Create a new concept that represents comminuted or multi-fragmentary to support the alternative interpretation.

Issues with tooling prevents option 2. from being implemented at this time.  Interim solution would be to inactivate with one replacement and then return to these after the tooling solution is implemented. 

Decision:

Philip Brown

Jim Case