Allergies/Hypersensitivity and Intolerance Clinical Reference Group

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Marie-Alexandra Lambot

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Hi,

In the allergy models document, I didn't see the Clinical Building Blocks (CBB) information model for allergies. NICTIZ has made a CBB model for the capture of clinical information around allergies/intolerences. The CBBs have been adopted as standard in Belgium where the e-Health authority plans to make their use mandatory for the transmission of this type of clinical information by the hospitals to the official state registries. https://www.healthdata.be/doc/cbb/index.php5/The_Clinical_Building_Blocks_%28Belgian_version%29

It's not that easy to match the meanings captured in the CBB format and what is found in precoordinated SCT concepts. Does anyone have experience with the implementation of the CBBs or a similiarly "dissected" model of allergy/intolerence capture separating the reaction type from the substance and the manifestation of the allergy and on how to reconcile identical information recorded with precoordinated concepts "allergy to x" with info that would be recorded with the CBB so the two would be logically equivalent?

Thx.

Contributors (3)

8 Comments

  1. Bruce Goldberg

    Marie, will you be joining tomorrow's call and if so, would you be willing to present this topic?

    Bruce

  2. Marie-Alexandra Lambot

    I'll do my best to attend even though it'll be 22pm here. I'll be delighted to present you what we have done, why, the challenge we face here in Belgium and get feedback from you experts on our job on allergies. Allergy registration in SCT is our test use-case, our proof of concept for our group of 25 hospitals (that's about one third of all the acute hospitals of Belgium), to see if we can manage together to implement at least some SCT in our EHRs. It's very important for us to succeed in this test-case and to learn through it and identify through it the pitfalls before we step up to a wider implementation of SCT in our EHRs.

    1. Bruce Goldberg

      Great. Hope you can make it.

      Date: August 10, 2017

      Time: 20:00 UTC

      Meeting link: https://snomed.zoom.us/my/allergycrg

    2. Bruce Goldberg

      Marie. I have had the opportunity to discuss the document you sent containing several identified issues with allergy documentation in SNOMED CT with Toni Morrison who chairs the substance hierarchy redesign project. Our comments are in the document attached to tomorrow's agenda (SCT allergy group - questions lma_responses BG-TMOComments.docx). We plan to discuss with the group during tomorrow's call. I hope you can make the call as I realize it is quite late for you.


      Bruce

      1. Marie-Alexandra Lambot

        Hi Bruce, I plan to attend the call unless I can't make it out of domestic organization problems (unless there is some monster under the bed of my girl at the time, that is ^^ ). I'm less sure about finding the time today to read the answers to my questions in your document beforehands. Unfortunately SNOMED isn't the only projet I'm leading here and allergies not my only SNOMED projet either. But I'll do my best to come prepared and I thank you already wholeheartedly for the answers. I did seek advice about the pseudoallergy question with our allergologists, and I forwarded them the latests documents you posted yesterday however I haven't received their answer yet on the pertinence of the term pseudoallergy.

        Best regards

        M-A

  3. Marie-Alexandra Lambot

    Hi Bruce, could you kindly give me the email of the person from NICTIZ that attended today's meeting, that I could set up a collaboration with her for the creation and dutch translation of the various concept lists for the allergy CBB? We, belgian SNOMED CT Consortium, have been working on this for 6 months now, working first on French lists of clinical terms matched to SCT concepts then transated those lists in Flamish but we can do the reverse just as easily. It would be more effective if we teamed up directly with the persons in charge at NICTIZ.

    Thanks beforehands and thanks for allowing me to participate to your meeting. I really look forward to the changes in the allergy concept model and hierarchy. Is there some work our group can help with in all this? Some topics you'd like me to present to our allergology clinical experts to get their opinion, like what we discussed shortly today about pseudoallergies? Our group clinical experts are Pr Georges Casimir and Olivier Michel, both recognized specialsts in this field with years of clinical experience and university teaching of the disciplin.

    1. Bruce Goldberg

      Hi Marie. I am not completely sure because it doesn't look like the meeting got recorded but my guess is that it was Elze de Groot as she is a member of this group and is from NICTIZ. Unfortunately, I don't have an e-mail address for her. You might post a request on this confluence page as it goes out to all members. 

      Thank you for the offer to provide additional expert opinion regarding allergy content in SNOMED CT. As the allergy revision project progresses, I will let you know if we have specific questions.


      Bruce

    2. Elze de Groot

      Hi Marie, my email address is groot @ nictiz.nl. It was good to see what you are doing in Belgian and that you (are trying to) use the CBBs. An allergen refset is a challenge though. We now made an intensional substance refset, but actually alot of the allergen substances are irrelevant (going too much in detail). We excluded the drug allergens because we have our own national system for drugs (that we'll have to map to snomed in the future).