Time:
0900 - 1230 BST
0800 - 1130 UTC
Zoom Meeting Details
Jim Case is inviting you to a scheduled SNOMED International Zoom meeting.
Topic: SNOMED EAG Face to face meeting London
Time: Apr 16, 2024 09:00 London
Join from PC, Mac, Linux, iOS or Android:
https://snomed.zoom.us/j/89827589410?pwd=nPOQj9SzZnrFpeA5lsIov90Lvt22Og.1
Password: 848732
Attendees
Chair:
AG Members:
Invitees:
Apologies:
Meeting Files:
View file | ||||
---|---|---|---|---|
|
View file | ||||
---|---|---|---|---|
|
View file | ||||
---|---|---|---|---|
|
View file | ||||
---|---|---|---|---|
|
View file | ||||
---|---|---|---|---|
|
Objectives
- Obtain consensus on agenda items
Discussion items
Item | Description | Owner | Notes | Action |
---|---|---|---|---|
1 | Call to order and role call | This meeting is being recorded to ensure that important discussion points are not missed in the minutes. The recording will be available to the SNOMED International community. Joining the meeting by accepting the Zoom prompt declares that you have no objection to your comments being recorded |
| |
2 | Conflicts of interest and agenda review | None recorded | ||
3 | EAG item status since October 2023 | Here is the status of items brought to the EAG since October 2023:
| ||
4 | Adverse reaction subtypes | On the January EAG call, it was agreed that all disorder concepts with a CAUSATIVE AGENT relationship value derived from the 373873005 |Pharmaceutical / biologic product (product)| hierarchy should be modeled as subtypes of 281647001 |Adverse reaction (disorder)|. Upon further review of the content, there are a number of substances that could also fit under this grouper term. A spreadsheet with a listing of disorders with a CAUSATIVE AGENT value derived from the substance hierarchy was sent out for review by the EAG. This had a column suggestions as to which concepts should or should not be subtypes of 281647001 |Adverse reaction (disorder)|. The spreadsheet is available at: https://docs.google.com/spreadsheets/d/1P1D5rEU-fBwkWak_ldhszerwMq8PKCOw/edit#gid=1482910902 Discussion: Decision: Based on the difficulty in determining what an adverse reaction is, we will leave the concepts where they are are. | ||
5 | Change Surgical approach to Procedure approach | At the March 2024 EAG call, the group asked for an impact analysis of the change from Surgical approach to a more general Procedure approach. The results of that analysis are presented in the attached document. Discussion: Why were there no classification changes when sufficiently defining a large number of currently primitive concepts? The group would like to see the results on this for the non-surgical procedures. Not sure that the benefits of this generalization are sufficient. There may be additional impacts when this attribute is applied to existing sufficiently defined concepts. There is always an implicit approach in procedures. There are questions about reproducibility. Are some approaches solely surgical? Decision: Distribute list of non-surgical procedures affected by this change | ||
6 | Bypass graft revision proposal | As part of the QI project, substantial changes to the representation of bypass grafts and shunts have been proposed. A briefing note (attached) and a detailed document for the proposed changes (referenced in the briefing note) are provided. Discussion: 2024-03-11 How are bypass concepts without definition of proximal and distal targets going to be modeled? A: Need review. How are proximal and distal defined? A: It is based on either anatomic position or flow of contents. Definitions for proximal and distal anastomosis will be provided. Concern about creating intermediate primitives as this complicates the assignment of parents. Also need to make sure the definitions are clear. Where do "-stomy" concepts fit into this proposed model. 2024-04-16: Added document with proposed definitions for bypass, shunt, bypass graft, shunt with graft, anastomosis, etc. Decision: 2024-03-11 Comments will be added to the document by the EAG members. 2024-04-16: Proposed definitions will be revised based on input and resubmitted to the EAG for review. |
| |
7 | Remodeling of 1263452006 |Anesthesia and/or sedation procedure (procedure)| hierarchy | The current concepts 1263452006 |Anesthesia and/or sedation procedure (procedure)| and 410011004 |Administration of anesthesia AND/OR sedation (procedure)| are disjunctive groupers. The attached document provides details on proposed changes to this hierarchy that improves the modeling and specificity of anesthetic and sedation procedures. The proposed changes have been reviewed and accepted by the Anesthesia CRG. Key elements include:
Discussion: Decision: | ||
8 | USING DEVICE vs. DIRECT DEVICE use in procedures | During QI review of procedures, inconsistencies were revealed in the use of USING DEVICE and DIRECT DEVICE in procedures. The current definitions for these attributes from the editorial guide: Direct deviceDirect device (attribute) represents the device on which the method directly acts. Using deviceUsing device (attribute) refers to the instrument or equipment utilized to execute an action. It is used when the device is actually used to carry out the action, that is the focus of the procedure. If the device is simply the means to access the site of the procedure, then Using access device is the appropriate attribute. Examples of inconsistencies: We would like to come up with more specific editorial guidelines related to what is meant by "the device on which the method directly acts". In general, parameters could include things such as "materially changed by the procedure", "remains in the body following the procedure", etc. The use of the word "using" in FSNs can bias a content author to use the attribute USING DEVICE when the more appropriate DIRECT DEVICE should be used. A broader application of DIRECT DEVICE in procedure modeling could have large impacts on the number of concept affected, but would resolve the current inconsistencies. An example of where this is an issue is described in the attached document related to the modeling of hernia repair. USING DEVICE and USING ACCESS DEVICE are also inconsistently used and sometimes incorrectly. In a review of procedure subhierarchies (e.g. arthroplasty), USING ACCESS DEVICE was modeled in the surgical action RG, when in many cases the device does not act as an access to the surgical area, but plays another role, (e.g. illumination). An evaluation of the current benefits of USING ACCESS DEVICE over USING DEVICE is underway. While it is not part of this topic, we expect the same issues to be present related to USING SUBSTANCE and DIRECT SUBSTANCE Discussion: Decision: | ||
9 | Nontraumatic vs spontaneous injury | Jim Case | There is an inconsistency in our review of nontraumatic vs. spontaneous injury. In some cases SNOMED makes a distinction between them: A discussion page has been set up to solicit comments from the EAG (Re: Nontraumatic vs. Spontaneous injury) The discussion brought out a number of meaningful points.
If it is thought that these should be distinct, then much more specific definitions need to be developed and published. If it is not thought that the distinction is clinically meaningful, then what should SNOMED select as the FSN and PT and should all existing differentiated concepts be merged? Should a nontraumatic and spontaneous description be a consistent feature of these concepts? Discussion: Decision: | |
10 | AOB | EAG | It is planned to increase the use of the Discussion section of the EAG Confluence site to allow for a more straightforward consolidation of comments solicited from the EAG regarding topics under consideration as well as publishing the outcome of the discussion and the planned implementation of decisions made, if applicable. This will require some modifications to the discussion section to allow for the assignment of statuses to discussion pages, which will be requested from the SI technical team. | |
11 | Next meeting | May 27, 2024 |
...