Jim Case

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Jim Case

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Paul Amos

Jeremy Rogers

Jim Case

Inactivation of Ambiguous Concepts - review of comments and problematic examples

From Jim Case  Ambiguous concepts identified by member

208493001 |Open fracture finger distal phalanx, multiple (disorder)|

208488004 |Open fracture finger middle phalanx, multiple (disorder)|

208482003 |Open fracture finger proximal phalanx, multiple (disorder)|

These are confusing concepts and it is unclear from the current wording what is intended.  As one would expect, these are most likely derived from ICD-9 (e.g. 816.13 Open fracture of multiple sites of phalanx or phalanges of hand), which is also open to interpretation.  In the recent remodeling of these concepts, the representation in some cases is that multiple phalanges or digits are involved, in other cases such as abrasions and open wounds, they are modeled as multiple morphologies on a single digit.

Given that the original source of these concepts was ambiguous as to whether one or more digits were involved, these concepts should be inactivated as ambiguous and replaced with concepts with more specific FSNs, i.e.

"Open fracture of distal phalanx of multiple fingers" and "Multiple open fractures of distal phalanx of finger".  The latter is an example of a concept that most likely would never occur, but would need to be created in order to conform to the requirements associated with AMBIGUOUS inactivation reason from the concept inactivation workgroup.  Thus it too would be inactive (Paul Amos, what would be the inactivation reason?)

Discussion:

Decision:

Based on international consensus pressure ulcer stages are now referred to as pressure injuries. A new model and terming is required and was presented.  Pressure injuries are currently defined as traumatic injuries.  The modeling proposal is to remove the DUE TO event and creating new morphologic abnormalities. 

Discussion:

Need to evaluate whether "suspected" and "deep tissue injury" are equivalent.

Do we need a CAUSATIVE AGENT relationship? The reason is to get these terms to classify under a grouper term that was derived from ICD.  If/when the grouper term is inactivated, the CAUSATIVE AGENT relationship could be removed.  

Decision: 

Add Erythema as a parent to Stage 1 pressure injury.

Remove the CAUSATIVE AGENT relationships.

• Pressure injuries.pptx
• Bruce Goldbergto implement changes as discussed for pressurre injuries