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Descriptions:

Termdescription typeLanguage/acceptabilityLangauge/acceptabilityCase significance

Adverse [finding site] reaction caused by to [agent] (disorder)

Existing content has two different terming patterns - need agreement on which is preferred:

  • 292350008 |Alprazolam adverse reaction (disorder)|
    • 218620007 |Adverse reaction caused by naproxen

    (disorder)

    |

    Adverse reaction to X

    		FSNus:Pgb:Pci

    Adverse [finding site] reaction caused by to [agent]

    Adverse reaction to X

    Synonym X adverse reaction

    		SYNus:Pgb:Pci

    Concept model:

    Attribute CardinalityAttributeValuerole group numberRole group cardinality
    1..1


    Scg expression
    116680003|Is a (attribute)|



    Scg expression
    281647001 |Adverse reaction (disorder)|


    		0N/A
    1..1


    Scg expression
    246075003|Causative agent (attribute)|



    Scg expression
    [agent] << 105590001|Substance (substance)| OR << 373873005|Pharmaceutical / biologic product (product)| OR << 260787004|Physical object (physical object)| OR << 78621006|Physical force (physical force)|





    1




    1..1

    0..1


    Scg expression
    363698007 |Finding site (attribute)|



    Scg expression
    [finding site] <123037004 |Body structure (body structure)|


    Definition status:

    ...

      

    Scg expression
    900000000000073002|Defined (core metadata concept)|

    Template Language

    281647001 |Adverse reaction (disorder)|: [[~1..1]] { [[~0..1]] 363698007 |Finding site (attribute)| = [[+id(< 123037004 |Body structure (body structure)|) @site]], [[~1..1]] 246075003 |Causative agent (attribute)| = [[+id( << 105590001 |Substance (substance)| OR << 373873005 |Pharmaceutical / biologic product (product)|) @agent]] }

    Applies to:

    Scg expression
    << 282100009 |Adverse reaction caused by substance (disorder)|

    Editorial guidelines for selection of Causative agent attribute value:

    HierarchyConcept typeAllowedExceptionExamples and Notes - update examples to reflect final decision re: terming pattern(Note: Examples are existing concepts and may not reflect the terming patterns described in the template.)
    SubstanceBaseyesnone

    Example:

    • 292350008 |Alprazolam adverse reaction (disorder)|

    Expected classification: NEEDS INTERNAL AGREEMENT - agreed

    • Classification results are expected to be consistent with the modeling in the Substance hierarchy.
    SubstanceModificationnoTBD

    Example:

    292392003 |Fluphenazine adverse reaction (disorder)|

    292389002 |Fluphenazine decanoate adverse reaction (disorder)|

    292390006 |Fluphenazine enanthate adverse reaction (disorder)|

    Expected classification: NEEDS INTERNAL AGREEMENT - agreed

    • Classification results are expected to be consistent with the modeling in the Substance hierarchy based on the Is modification attribute and with other existing concepts in the subhierarchy. Concepts modeled using a modification should have the concept modeled using the base as an inferred parent if such a concept exists.
    • 292392003 |Fluphenazine adverse reaction (disorder)| will be modeled with Causative agent = 372730004 |Fluphenazine (substance)| and will have the following inferred descendants:
      • 292389002 |Fluphenazine decanoate adverse reaction (disorder)| with Causative agent = 396063006 |Fluphenazine decanoate (substance)|
      • 292390006 |Fluphenazine enanthate adverse reaction (disorder)| with Causative agent = 111125005 |Fluphenazine enanthate (substance)|
    SubstanceDisposition grouperyesnone

    Example:

    • 292736001 |Opioid antagonist adverse reaction (disorder)|

    Expected classification results: NEEDS INTERNAL AGREEMENT - agreed

    • Classification results are expected to be consistent with the modeling in the Substance hierarchy for concepts modeled with an attribute value from the Substance hierarchy.Classification results for products? - watch for examples
    ProductDisposition groupernononeNo use case has been identified for use of this concept type for modeling in this subhierarchy. Disposition groupers in the Product hierarchy should only exist as SD concepts with a corresponding concept in the Substance hierarchy; the corresponding concept in the Substance hierarchy should be used for modeling in this subhierarchy.NEEDS INTERNAL AGREEMENT - agreed until use case appears
    SubstanceRole groupernonone

    Role groupers in the Substance hierarchy will be inactivated in a future release and should not be used for modeling in this subhierarchy. NEEDS INTERNAL AGREEMENT

    Insert examples of role grouper.

    ProductRole grouperyesnone

    Example:

    Expected classification results:

    TBD if there are any restrictions on which product roles can be used in modeling in this subhierarchy

    SubstanceStructure grouperyesnone

    Example:

    • 218638005 |Adverse reaction caused by hydantoin derivative (disorder)|

    Expected classification: NEEDS INTERNAL AGREEMENT - agreed

    • Classification results are expected to be consistent with the modeling in the Substance hierarchy and with other existing concepts in the subhierarchy.
    ProductStructure groupernononeNo use case has been identified for use of this concept type for modeling in this subhierarchy. Structure groupers in the Product hierarchy should only exist as SD concepts with a corresponding concept in the Substance hierarchy; the corresponding concept in the Substance hierarchy should be used for modeling in this subhierarchy. NEEDS INTERNAL AGREEMENT - agreed
    Product or SubstanceBody system groupernonone

    Body system groupers in both the Substance and Product hierarchies will be inactivated in a future release and should no longer be used for modeling in this hierarchy. NEEDS INTERNAL AGREEMENT - agreed to inactivate these concepts.

    Example:

    • 293416008 |Drug groups primarily affecting cardiovascular system adverse reaction (disorder)|
    • 292670005 |Drug groups primarily affecting musculoskeletal system adverse reaction (disorder)|
    ProductMedicinal product-containingyesnone

    Example:

    • 292984002 |Ampicillin and cloxacillin adverse reaction (disorder)
    • 292267003 |Benserazide + levodopa adverse reaction (disorder)

    Expected classification results: NEEDS INTERNAL AGREEMENT - further discussion needed with Drug Project Group re: expectations for classification

    • 292984002 |Ampicillin and cloxacillin adverse reaction (disorder) will be modeled with Causative agent = 346320003 |Product containing ampicillin and cloxacillin (medicinal product)| and will have the the following inferred parents:
      • 292968003 |Ampicillin adverse reaction (disorder)| with Causative agent = 387170002 |Ampicillin (substance)|
      • 292963007 |Cloxacillin adverse reaction (disorder)| with Causative agent = 373276005 |Cloxacillin (substance)|
    • 292267003 |Benserazide + levodopa adverse reaction (disorder) will be modeled with Causative agent = 418467003 |Product containing benserazide and levodopa (medicinal product)| and will have the following inferred parents:
      • 292266007 |Levodopa adverse reaction (disorder)| with Causative agent = 387086006 |Levodopa (substance)|
      • Note: There is not an existing concept for Adverse reaction to benserazide.
    ProductMedicinal product-onlynononeNo use case has been identified for use of this concept type for modeling in this subhierarchy. Medicinal product-containing concepts can be used for modeling in this subhierarchy. NEEDS INTERNAL AGREEMENT - agreed till use case appears
    ProductMedicinal product form-containingyesnone

    Example:

    • 293543001 |Oral glyceryl trinitrate adverse reaction (disorder)
    • 293545008 |Parenteral glyceryl trinitrate adverse reaction (disorder)
    • 293546009 |Transdermal glyceryl trinitrate adverse reaction (disorder)

    Expected classification results: NEEDS INTERNAL AGREEMENT - further discussion needed with Drug Project Group re: expectations for classification

    • 293543001 |Oral glyceryl trinitrate adverse reaction (disorder) will be modeled with Causative agent = 346460001 |Product containing glyceryl trinitrate in oral dose form (medicinal product form)| and will have the following inferred parents:
      • 293542006 |Glyceryl trinitrate adverse reaction (disorder)| with Causative agent = 387404004 |Glyceryl trinitrate (substance)|
    • 293545008 |Parenteral glyceryl trinitrate adverse reaction (disorder) will be modeled with Causative agent = 346461002 |Product containing glyceryl trinitrate in parenteral dose form (medicinal product form)| and will have the following inferred parents:
      • 293542006 |Glyceryl trinitrate adverse reaction (disorder)| with Causative agent = 387404004 |Glyceryl trinitrate (substance)|
    • 293546009 |Transdermal glyceryl trinitrate adverse reaction (disorder)
      • 293542006 |Glyceryl trinitrate adverse reaction (disorder)| with Causative agent = 387404004 |Glyceryl trinitrate (substance)|
    ProductMedicinal product form-onlynononeNo use case has been identified for use of this concept type for modeling in this subhierarchy. Medicinal product form-containing concepts can be used for modeling in this subhierarchy. NEEDS INTERNAL AGREEMENT - agreed till use case appears
    ProductClinical drugnonone

    No use case has been identified for use of this concept type for modeling in this subhierarchy. NEEDS INTERNAL AGREEMENT - agreed till use case appears

    Extension model may provide sufficient use case for this.


    Rules for description generation:

    1. For the FSN, align terming and case sensitivity with the FSN for the concept that is selected as the attribute value, excluding the semantic tag. 
    2. For the PT, align terming and case sensitivity with the US and GB PT for the concept that is selected as the attribute value.
    3. In cases where neither the US or GB PT matches the FSN, excluding the semantic tag, a synonym corresponding to the FSN is required unless explicitly identified as an exception.
    4. Additional synonyms "[agent] adverse reaction" should be added. Other synonyms are not allowed unless explicitly identified as an exception.

    JIRA ticket for implementation: