Date: 2021-09-07
Time:
16:00 - 17:00 UTC
17:00 -18:00 BST
Zoom Meeting Details
Topic: Diabetes Clinical Project Group Conference Call
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Password: 507496
Meeting ID: 968 0322 0530
Skype for Business (Lync):
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Attendees
Chair:
DCPG Members
- Anthony Khawaja
- David Rocha
- Steve Jackson
- Charlie Stuart-Buttle
- Alasdair Warwick
Observers:
Apologies:
- Cathy Richardson
- Grahame Sterling
- Peter Davis
- Tasso Gazis
Meeting Files:
Meeting minutes:
The call recording is located
Objectives
- Obtain consensus on agenda items
Discussion items
Item | Description | Owner | Notes | Action |
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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. If a majority of participants object to recording, only written minutes will be available, otherwise, anyone objecting to recording is requested to exit the meeting. |
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2 | Conflicts of interest and agenda review | None stated. | ||
3 | Combining diabetic complication with the type of diabetes | ALL | Many of the existing concepts relating to complications due to diabetes include an association with a specific type of diabetes:
A number of the reviewers have suggested that the focus of the concept should be on the disorder and reference to the type of diabetes is redundant as the patient record should already have a record of this at the time of diagnosis. See also KP Diabetes requests.xlsx Discussion: Combined concepts of the type 421920002 |Cataract of eye due to diabetes mellitus type 1 (disorder)| are expressing 3 facts about the patient, firstly that they have a cataract, second that they are diagnosed with Type 1 diabetes mellitus and thirdly that there is a causal relationship between the cataract and diabetes mellitus type 1. The focus of the concepts representing complications that are due to diabetes is the complication itself and not the type of diabetes. A decision regarding the type of diabetes will already have been made and recorded within the patients record. Therefore, from a clinical management perspective it makes more sense to record these 2 disorders separately as they may/will require separate clinical management. It is important to recognise and record the relationship between a disorder and its cause where that cause has been been proven to be due to and specific to another disorder. Therefore, we would recognise and wish to record that someone with diabetic retinopathy has a retinopathy which is clinically evidenced as being due to the diabetes. However, the only reason for recording the type of diabetes is if if there is a clinically identifiable difference between the retinopathy caused by diabetes mellitus type 1 and diabetes mellitus type 2. Finally, there are some additional untoward effects from creating content that specifies a particular complication against each of the diabetes types; firstly, a significant increase in content (combinatorial explosion) e.g. for each complication that occurs in a single organ we would require more than 100 concepts rather than a single concept that relates a complication to diabetes irrespective of its type. Secondly, retrieval and analytics becomes more difficult as we no longer know whether the diagnosis of type of diabetes is represented within the complication or as a separated coded entry. What happens where the diabetes type differs between the record of the complication and the record of the initial diabetic diagnosis? Decision:
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4 | Can one distinguish between a diabetic cataract and a senile cataract? | ALL | Discussion: Decision: | |
5 | Macula disorders | ALL | Some of these concepts include adjectives:
Is it possible to define these in a way that supports interoperability? Discussion: Decision: | |
6 | Glaucoma and Diabetes Mellitus | AK/ALL | Discussion Decision: | |
7 | Proliferative and non-proliferative retinopathy | ALL | Some of our group feel that these concepts are predominantly available to serve the purposes of the diabetic screening services and that from the perspective of day to day management of the diabetic patient they are less helpful. The intention is to discuss this in depth at our next meeting as part of the feedback from Eye Complications 2 but to introduce the topic now in preparation for the next meeting Discussion: Decision: | |
9 | AOB | ALL | ||
10 | Next meeting | ALL | Next conference call to be agreed |