Paul Amos

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Paul Amos

None stated.

Discussion:

There does not appear to be any evidence that a cataract in a diabetic has characteristics that are any different to those identified in a cataract associated with advancing years. There is evidence that supports the notion that cataracts may begin at an earlier age and/or progress more quickly in diabetics than in those who are not diabetics.

Decision:

Given that there is no evidence that cataracts are causally related to diabetes the consensus is that existing content should be inactivated as erroneous with a historical association to:

• 193570009 |Cataract (disorder)|
• 816120008 |Cataract of right eye (disorder)|
• 816119002 |Cataract of left eye (disorder)|

as appropriate.

Update:

Literature, including statements by WHO while not supporting the causal relationship between diabetes mellitus do confirm that there is an apparent increase in incidence of cataracts and that they tend to appear earlier in diabetics. It is also noted that ICD-11 assumes a causative link

Do the group agree, and if so, should we consider changing existing content from 43959009 |Cataract of eye due to diabetes mellitus (disorder)| to "Cataract of eye with diabetes mellitus" where the "with" indicates that the associated disorder is co-occurrent with diabetes but no causal relationship is thought to exist and this would be reflected in the modelling?

AK

Some of these concepts include adjectives:

• Advanced
• Clinically significant
• High-risk/Non-high-risk

Is it possible to define these in a way that supports interoperability?

Discussion:

Content within the Macular disorder and Proliferative and non-proliferative retinopathy sections are impacted by the use of these adjectives. While there is often a lack of consistency and/or vagueness in the definition of these adjectives there are some used in retinal screening and elsewhere that have reasonably well accepted definition.

Depending on the context some clinicians will record individual retinal findings whereas others may simply review a retinal photograph and grade it according the accepted protocol.

Decision:

The group will review existing content where adjectives have been used and identify those concepts that have an internationally agreed definition and those that do not, where possible providing references, for discussion at the next meeting.

Discussion 20211005:

Review of definitions:

• Paul Amosto collate the concepts and distribute to the group.

• Paul Amos to arrange