Jim Case

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Jim Case

SNOMED CT contains a large number of concepts that were initially obtained from ICD-9 relates to spinal fractures and dislocation with associated spinal cord "lesions". After discussion with the Medical and Scientific Advisory Committee of WHO, it was agreed that in the case of spinal cord injuries, the term "lesion" was used synonymously with "damage". This has prompted a review of the use of "lesion" in ICD-11, which is acknowledge to be a supertype of "damage". However, there was also a discussion on the appropriate use of "incomplete spinal cord syndromes" in conjunction with spinal cord injuries. The syndromes represent the clinical manifestations of the injuries. It was stated on the MSAC call on May 7, 2020, that the presence of the damage does not always equate to the presence of the clinical syndrome.

Remodeling of "spinal fractures with incomplete spinal cord lesion" has recently been undertaken and has been assigned a parent of the syndrome related to damage of the spinal cord.

Question: Given the MSAC discussion, should SNOMED CT not make any assumptions of the presence of the clinical syndrome in the presence of spinal lesions/damage? E.G.

Discussion:

• Jim Case Implement modeling decision regarding assignment of syndromes to lesions.