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Date: 2022-06-15
Time:
1030 - 1200 PDT
1730 - 1900 UTC
1830 - 2000 BST
Attendees
Chair:
AG Members
Invitees
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
| - Recording of meeting approved by participants.
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| 2 | Conflicts of interest and agenda review | | |
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| 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 - Are familial relationships Roles or Persons?
- Given "X of subject" is primarily used as the value for this attribute, should these concepts be moved out from the Person hierarchy into their own "value set"?
- Is Person the correct hierarchy for these to be placed?
- How do we handle "Fetus of subject" given the sensitivity of some members of having a (person) semantic tag? This is needed when procedures or conditions are performed/recorded in a fetal record as opposed to a maternal record.
Discussion: Previous discussion has been moved to Confluence discussion page at: X (Person) and X of subject (person) - Changing roles in family structure requires a distinction between biological relationships and non-biological familial relationships.
- Existing "Person" hierarchy is in need of review and updating.
- Suggestion has been made by multiple people to handle this issue through reorganization of the values for "subject relationship context" (separate hierarchy?)
- "Role" hierarchy exists. Values imply a relationship to a physical entity (e.g. 766941000 |Therapeutic role (role)| implies a substance or product)
- Also has been suggested to create new attributes that allow for more specificity
- Need to consider that subtypes of "Person" are also used as values for the FINDING INFORMER attribute.
- The reference paper provides two mechanisms to represent "fetus"
- Creation of a robust fetal anatomy hierarchy
- Use of a SUBJECT RELATIONSHIP CONTEXT value (provided subject relationship context values were moved out of the person hierarchy)
Decision:
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| 8 | Measurement Findings: Proposed changes to FSNs | Paul Amos | - Proposed changes to FSNs: Please read the attached Briefing before the meeting and if possible return your comments for discussion at the meeting.
- This meeting will address the following issues:
- Concepts representing "borderline" levels
- Concepts representing "therapeutic medication levels"
- Concepts representing "Abnormal" or "outside reference range" levels
Decisions to date: - Following the discovery of a decision made in 2010 that within the context of measurement findings "increased" = "above reference range" and "decreased" = "below reference range" the EAG members agreed to support a change in FSN rather than inactivation.
- In the rare event that a user has interpreted and used one of these concepts to represent a relative increase or decrease in measured value; advise use of 442387004 |Increased relative to previous (qualifier value)| and 442474009 |Decreased relative to previous (qualifier value)| with clear FSN e.g. Increased blood glucose level relative to previous level (finding) for implementation at the local level.
- There was agreement that the notion of "normal" is context dependent and similarly "within reference range' should be interpreted within the context of the whole clinical record. Therefore, it was agreed that concepts representing "within reference range" will have their FSN/PT updated and a synonym description of "normal" should be retained or added as appropriate.
Decision: |
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| 10 | AOB | EAG |
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| 11 | Next meeting | EAG | | |
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