Date: 2022-06-15
Time:
1030 - 1200 PDT
1730 - 1900 UTC
1830 - 2000 BST
Zoom Meeting Details
Attendees
Chair:
AG Members
- Alejandro Lopez Osornio (ex officio)
- Keith Campbell
- Jeremy Rogers
- Monique van Berkum
- James R. Campbell
- Jeffrey Pierson
- Paul Amos (ex officio)
Invitees
Observers
Apologies:
Meeting Files:
Meeting minutes:
The call recording is located here.
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 |
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| 2 | Conflicts of interest and agenda review | |||
| 4 | X (person) vs. X of subject (person) | Jim Case | A question from a member country on when to use "X (person)" vs. "X of subject (person)" has exposed issues with determination of equivalence in information models that either split the relationship from the condition vs. using a precoordinated Situation concept to represent the SUBJECT RELATIONSHIP CONTEXT. 3/15/2022 - Update A report on the use of person concepts as values for the SUBJECT RELATIONSHIP CONTEXT attribute is located at: https://docs.google.com/spreadsheets/d/1LTPSInpRC_HMPniQANM8NL86WCieSAttoPYDS_yxjno/edit#gid=1
Discussion: "X of person" was introduced to support the SUBJECT_RELATIONSHIP_CONTEXT of Situations. Monique van Berkumwill look for some history on why they were added. Suggested that the ECE might have some history on these. Question is whether we need to separate out the relationship values from "persons" as a class? The main distinction made in the reference paper is that between an "Entity" and the "Role" played by an Entity. However, this distinction is not made within the person hierarchy, with << 444148008 |Person in family of subject (person)| primarily representing roles that Person entities play being in the same Person hierarchy. Since the 444148008 |Person in family of subject (person)| is primarily used as values for the SUBJECT RELATIONSHIP CONTEXT attribute, we can question why it is in the Person entity hierarchy. A question raised by the reference provided is whether a well-established role (e.g. father) can also exist as an entity? Can a father exist as a standalone entity without the establishment of a relationship to another entity? 4/5/2022 We are not separating roles from entities in the current hierarchies. Because these are classes and not instances, we are constrained in how we can represent them. This is more challenging in the current context of changing family constructions. Father/mother and other familial relationships need to be explicit in that what is being referred to is the hereditary/genetic relationship between the patient and the subject relationship context. Need to consider the social context in this as well. Do we need to separate out biological from social familial structures? In general, there is a feeling that we need to represent both the genetic and social constructs of familial relationships. The X of subject (person) concepts were developed to support a specific attribute and should they be separated out. Fetus of subject is another issue. Do we need to be more specific in the definition of the SUBJECT RELAITONSHIP CONTEXT so we define explicitly what type of relationship we are trying to represent. Is this an entity to entity relationship or an entity to role relationship? A related question to fetus. How do we distinguish between the mather and the fetus in some procedures and disorders. This is an issue in mental health as well that crosses over the biological and social aspects of relationships. Decision: Background will be investigated. The person hierarchy needs some review and rationalization. Background document posted above. Will review for next meeting. | |
| 6 | Change to definition of 246454002 |Occurrence (attribute)| | Jim Case | The current definition of the Occurrence attribute is: "This attribute refers to the specific period of life during which a condition first presents. However, conditions may persist beyond the period of life when they first present." In many cases, the presentation of a condition occurs after the period of life in which it is observed. This is especially true when there is a continuum of time periods; where it can be determined that a disorder actually began prior to the time in which it is observed. New additions to the 282032007 |Periods of life (qualifier value)| hierarchy to support maternal pregnancy and fetal development phases warrants a revision of the definition of this attribute. A proposed new definition for the Occurrence attribute is: "This attribute refers to the specific period of life determined to be the period of onset of a condition. This may be prior to the actual initial observation and conditions may persist beyond the period of life when they first present." This issue arose during a remodeling of Birth trauma, where it can be determined that the trauma occurred prior to or during delivery of the child, but is not necessarily noticed until after complete delivery. Discussion: Proposed to change the last words of the definition from "when they first present" to something representing when the condition actually started (is realized). 4/12/2022: revised wording: OCCURRENCE: The specific period of life determined, possible retrospectively, to be the period of onset of a condition, as opposed to the period when the condition first presents or is diagnosed. The condition may persist beyond the period when it was first determined to have occurred. Decision: Definition will be reworked and sent to the EAG for review. |
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| 8 | Measurement Findings: Proposed changes to FSNs Update on Positive/Negative findings | Paul Amos |
Discussion: Decision: | |
| 10 | AOB | EAG | ||
| 11 | Next meeting | EAG | ||