Date: 2018-01-26
1600 UTC
Zoom Meeting Details
SNOMED Int'l Editorial Advisory group
SNOMED International - Editorial advisory group conference call
UTC
Please join my meeting from your computer, tablet or smartphone.
Attendees
Chair:
AG Members
Observers:
Apologies
Meeting Files
Objectives
- Obtain consensus on agenda items
Discussion items
Item | Description | Owner | Notes | Discussion | Action | |||||
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1 | Call to order and role call | JCA |
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2 | Conflicts of interest Approval of minutes from Bratislava | JCA |
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3 | ECE Update | BGO | ||||||||
4 | Drug Model Update | TMO | ||||||||
5 | Observables Model Update | DKA | ||||||||
6 | Revision of editorial guidance for PATHOLOGICAL PROCES concerning "Inflammation (qualifier value) | JCA | Current editorial guidance on the use of the Pathological Process Value = 257552002 Inflammation (qualifier value) The current editorial guidance on the use of this process value eventually resulted in the need to distinguish between process and structure in the Morphologic abnormality hierarchy. E.g. 23583003 |Inflammation (morphologic abnormality)| vs. 409774005 |Inflammatory morphology (morphologic abnormality)|. There is a tracker item: IHTSDO-558 Initial draft Fast track document : https://drive.google.com/open?id=1eNWTLxES-4OGsqhj-q0PXTT2u_IAWLOe Questions:
This notion is critical to the continued improvement of content in SNOMED CT; however, it adds substantial complexity and will require clear and possibly extensive guidance to ensure consistent application. Templates may be the most efficient way to guarantee compliance. | |||||||
Disorder without disorder | JCA | Common pattern in classifications such as ICD. Currently all are primitive in SNOMED CT. One potential modeling pattern proposed is the use of the Situation model with one "known present" relationship group and one "known absent" relationship group. The problem with specific negation is that it is silent about other clinical aspects that may be of significance. What is the purpose of calling out one specific clinical manifestation? Comments solicited from, CMAG. | ||||||||
Lexical inconsistencies | JCA | We received a comment from a dutch lexographer: Dear fellow terminologist(s), | ||||||||
7 | Specimen from subjects other than the patient | JCA | Currently we have many concepts in the specimen hierarchy that include “from patient”as well as those that do not include it as an ancestor. Since the subject of record is the default for specimens, we would like to retire these apparent duplicates, but then we run into the problem of specimens derived from other sources such as donors or normal control patients. They cannot be subtypes if the intended meaning is “subject of record”..or can they, since the context is implied? How do we structure the specimen hierarchy to account for this? What are the analytical implications of having different sources for specimens as subtypes of one another? | The "soft" default of specimens originating from the patient is where the problem lies. Currently, the organization of the values for SPECIMEN SOURCE causes some specimens from patients to not classify under the grouper term "Specimen from patient". Suggestion to make a more general term "Patient from specimen or donor", but that would only address two of the SPECIMEN SOURCE types. KCA mentioned the many issues with the "soft default'. For the most part, these specimens are used as coming from the patient. However, does the FSN then need to be changed to reflect that these are from the patient? Does the PT need to reflect explicitly that it comes from the patient? Should every Specimen have the SPECIMEN SOURCE explicitly defined? Often this context comes from where the concept is used within the record. The history of these terms may provide some of the reasoning as to why these terms were created. For example, the restrictions in where codes could be used in earlier versions of HL7 v2 (i.e. prior to v2.5) meant there was not place to provide additional information around the specimen. KCA suggested that these then be segregated into a module so that they can eventually be segregated away from the core. Non-patient oriented specimens are the major issue now and many of the use cases still use the older transport structure, meaning they need pre-coordinated content. What are the requirements for the addition of these terms and what is the major function of the core to address these requirements? More modern transport mechanisms such as FHIR, do not need this level of pre-coordination. Comments from IMO indicated that most users of the terminology are not sufficiently sophisticated to use either terminology or model based post-coordination. The long-standing practice of using unspecified Specimens provides substantial challenges to revising this to make it explicit as it would result in a large number of changes that may impact implementers. | ||||||
8 | What is an "infected prosthesis" | JCA | Update: Proposed model (Infected Prosthesis) was tested and reviewed by the ECE. Construction has been performed and editorial guidance will be updated as necessary |
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11 | “Acquired” disorders testing | JCA |
Update: A grouper "period of life" term encompassing all stages of life (Postnatal (qualifier value)) after birth was created. Over 100 concepts with the string "Acquired" were reviewed and fully defined using the OCCURRENCE attribute. There were no adverse impacts from this initial test. One conditional issue relates to the ability to define terms with the string "juvenile". The definition of juvenile differs in age ranges from jurisdiction to jurisdiction. Likewise the definitions of age ranges for "childhood" and "adolescent". There is an inactive concept 282035009 - Juvenile (qualifier value) that was once a subtype of "Period of life", but was inactivated as duplicate to 59223006 - Juvenile (finding). The process to progress this needs to be determined. | 2017-11-03: A related tracker exists: PCP-71. The work related to this item will be linked to that tracker. |
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12 | Update of EAG Workplan | JCA | Review and revision of current workplan | Continued to next call due to lack of time. | KCA expressed support for the Oxford comma. The question being whether there should be a retroactive application to FSNs
| 13 | Use of the Oxford comma in FSNs | JCA | The Oxford comma is a comma added after the penultimate term in a list, e.g. For example "Disorder of head, neck, and shoulders". The purpose if its use is to make explicit the fact that the terms are part of a list. The editorial guide is silent about its use, but the example provided does not use the Oxford comma. There are currently 347 FSNs in SNOMED CT that use the Oxford comma. Most of these are terms obtained from other terminology, such as ICD and nursing. There are 2500 FSNs that contain comma delimited lists, but do not use the Oxford comma. Question: Should SNOMED CT be consistent in the use of this grammar mark or maintain fidelity to the original source of the terms that do use it? |
JRO was not in favor of using the Oxford comma where it does not add value. The challenge is to provide editorial guidance on what the conditions are that require its use or non-use. |
14 | AoB | Group | Placement of "conditions" and "predispositions" as clinical findings as opposed to disorders. - BGO Device disorder vs. device failure | Device complications | BGO | Bruce Goldberg presented issues from the ECE meeting that required additional input: Complications and sequelae update.pptx Device complications Problems with the device itself should be a finding and not a disorder. This would allow some rearrangement of the current device problem findings. The modleing structure would be to use the INTERPRETS/HAS INTERPRETATION pair to define the findings. Should also create a more specific "device failure" to segregate from general external equipment failure. desire to see more examples for each of the three patterns. Hypersensitivity condition remodeling to finding: Predispositions are not disorders per se as they do not have a pathologic process. Proposed to move a large number of concepts from under disease to findings. Because the proposal is to simply change the semantic tag within the same hierarchy would not require inactivation and recreation of these concepts. The distinction between findings and diseases was brought up. The problems associated with this distinction and the duplication of terms as both findings and disorders was discussed. KCA asked to see a list of these duplicates
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15 | Future meetings | JCANext conference call TBD |
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