Summary
SNOMED International has been doing analysis and collection of input from experts in the area of angiography. Part of this work has confirmed that the procedures computed tomography angiography and fluoroscopic angiography always use contrast. As a result of this there will be a need to make some changes to 418272005 |Computed tomography angiography (procedure)| and subtypes as well as 420040002|Fluoroscopic angiography (procedure)| and subtypes. This will impact 866 concepts (current as of the Jan 2020 release). The changes proposed are:
- The addition of 424361007 |Using substance (attribute)|=385420005 |Contrast media (substance)| in the relationship group
- Change to the FSN e.g. 418272005|Computed tomography angiography (procedure) to 418272005|Computed tomography angiography with contrast (procedure)
- Inactivation of any equivalence e.g. 241553009 |Computed tomography of abdominal aorta (procedure)| will be the same as 444968003 |Computed tomography of abdominal aorta with contrast (procedure). Where this occurs the concept which explicitly states "with contrast" would be the concept that is remains active.
Prior to undertaking this work the issue of whether this change should be considered "substantive" enough to require inactivation and replacement of the concepts impacted is being considered. To support determining this the CMAG is being asked would implementers view the change detailed above as a substantive enough that the inactivation and replacement should be undertaken. Please note in this instance we have given a slightly shorter turnaround than normal. If this is an issue for you please email Cathy Richardson
Relevant documents
Actions:
Date | Requested action | Requester(s) | Response required by: | Comments |
|---|---|---|---|---|
| 19 March 2020 | Please state the preferred response for implementers in your country |
| Please post your final responses in the Country response table below. Discussion comments can be made as comments. |
Country response
| Country | Date | Response |
|---|---|---|
| Australia | 25/03/2020 | We support this. I think the revision to FSN without churning the concept is acceptable. The use of a contrast agent would seem to be implicit in these procedures. For those that don't specify CT/fluoroscopic, I presume no change? (as could be Radionuclide). One side note is that 385420005|Contrast media (substance)| is arguably a role... |
| Norway | 27/03/2020 | Agree to change. |
| Canada | 2020-04-08 | Fluoroscopic Angiography- for the most part uses contrast to visualize the anatomy relevant to the procedure. There are instances where it is not always used. ie. portacath insertion, or permacath insertion. However, there are times where of course this is not always feasible as there may be trouble accessing the initial vein, so contrast is used to confirm access. Otherwise we agree with the proposed change. |
| US | 2020-04-08 | OK |
| UK | 09-04-2020 | With apologies for the delay in replying, but we are obviously having to prioritise COVID-19 work. This impacts the SNOMED CT maps to 428 National Interim Imaging Procedures used in every imaging department in the UK, so we were prefer revision to the FSN without inactivation. However this also impacts our NICIP-OPCS mapping table. We are currently investigating the impact of this, and will get back as soon as possible. Our preference would also be to contact our imaging community about this change if time can be given for this to be done? Though in the present circumstances of COVID-19 these people are probably very busy and may not respond quickly. |
| Member countries without a CMAG rep |
CMAG response
| Date | CMAG Response | Next steps |
|---|---|---|
Final outcome:
Date: