Date: 2018-03
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
https://snomed.zoom.us/j/807454545
Attendees
Chair:
AG Members
Observers:
Apologies
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 Jan 2018 conference call | JCA | No conflicts reported | No conflict of interest reported. |
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| 3 | ECE Update | BGO |
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See Events, Conditions, Episodes Project Group meeting agenda 2-12-2018 | ||||||||||||
| 4 | Drug Model Update | TMO | Toni Morrison to provide an update on the status of the drug project | |||||||||||||
| 5 | Observables Model Update | DKA | ||||||||||||||
6 | Revision of Amyloidosis | JCA | On the ICD-11 MSAC call recently, a discussion ensured about the recent changes to nomenclature for Amyloidosis, with an emphasis on etiology (i.e. the type of amyloid) with secondary interest in the anatomical location of the amyloid deposition. This is contrary to the current way SNOMED classifies amyloidosis, which focuses on the site of deposition as opposed to detailed information about the type of amyloid. WHO description: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clinical signs and biochemical type of amyloid protein involved. Most amyloidoses are multisystemic, 'generalized' or 'diffuse'. There are a few forms of localized amylosis. The most frequent forms are AL amyloidosis (immunoglobulins), AA (inflammatory), and ATTR (transthyretin accumulation). | Reference for amyloidosis nomenclature is here. Discussion points: 1) The current subhierarchy <<17602002 |Amyloidosis (disorder)| is mostly primitive and does not go into much detail about the biochemical characteristics of the amyloid protein. Do we want to add the specific subtypes of amyloid? 2) Do we want to align the SNOMED CT amyloidosis content to the ICD-11 approach? What is the clinical importance? Most general clinical references emphasize the underlying origin of the amyloid (i.e. genetic, inflammation, dialysis). | ||||||||||||
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| 9 | Specimen from subjects other than the patient | JCA | Update since Bratislava: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? Tracker:
| No testing of options for this item has been performed since the last meeting. Issues still remaining:
| Current editorial guidance simply states "The | Specimen | hierarchy contains concepts representing entities that are obtained (usually from a patient) for examination or analysis." Thus, the editorial guidance does not specify the implied context of "from patient". In the current Specimen concept model, there is only a single attribute that allows for identification of the "source" of the specimen, i.e SPECIMEN SOURCE IDENTITY. The allowable range for this attribute is extremely broad encompassing: Person 125676002 (<<) Family 35359004 (<<) Community 133928008 (<<) Device 49062001 (<<) Environment 276339004 (<<) | Further review of the issue suggests that this is not a significant problem and that while exceptional conditions exist in the terminology, the number of affected concepts is very small. Number of concepts with SPECIMEN SOURCE IDENTITY as a stated relationship: Number of concepts with SPECIMEN SOURCE IDENTITY as a stated relationship: Number of concepts with "from patient" in the FSN: 8 The primary issue is that because of the very broad range of values that can be used for SPECIMEN SOURCE IDENTITY, the inferences that result cause substantial fragmentation of the content (for example, Specimen from blood bag from patient is not a subtype of Specimen from patient). It is possible that if the problem were more pervasive, there would be justification to look at revamping the concept model for specimens; however, the small number of affected content should at this time be handled as exceptions. Currently editorial guidance does not specify a soft default, so the context is provided by the information model in which the concept is used. Recommend tabling this topic. | ||||||||||
| 10 | Quality improvement project update | JCA | Review of the proposed approaches to the structural improvements that are being applied to the Clinical findings hierarchy. 10 | |||||||||||||
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| 12 | Update of EAG Workplan | JCA | Review and revision of current workplanContinued to next call due to lack of time. |
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| 13 | Future meetings | JCA | TBD |
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