2022-09-26 - CMAG Meeting

5 mins

• Apologies - nil
• Declarations of Interest:
  • None at meeting.
  • Request to CMAG reps to review and update DOI page by 31st October

Potential inactivation: << Finding reported by subject or history provider (finding)

See slide 6 for examples. Issues include broadness, vagueness. 

Similar content - Complaining of concepts previously inactivated. 

Discussion: 

• Subtypes: Some concepts have.
  • Impact of removing groupers on searching raised.
  • Concepts did come from READ version 2 and would have had subtypes in the past. Changes since that time have resulted in these subtypes moving to other places in the hierarchy.  
• Symptom vs sign
  • Symptom - a finding reported by the patient, can't be objectively evaluated
  • Sign - a finding that can objectively seen and evaluated by a clinician
• Normally difference managed in an information model. 
  • Concepts very old - from the time of impoverished information models where the ability to note this wasn't available. 
• Part of QI work.
• Impact of this work on the |Finding informer| attribute? Something for the information model?
  • Attribute is infrequently and inconsistently used. 
• Impact on OHDSI? 
• Used by one member in their GP refset. Comments will be added to the confluence page.
• Usage data from UK available. 

Feedback due: 30th November

Confluence link: Symptom Content - Potential Inactivation

Background provided:

Work stems from a freshdesk ticket asking about the presence of this content in both the finding and situation hierarchies. Most is in the finding hierarchy.  

Discussed at EAG in April: 2022-04-05 SNOMED Editorial Advisory Group Meeting

Objection to move presented by Nursing CRG. Please see documents attached to this page:

1. Original discussion at EAG in April 2022
2. Response from Chief Terminologist

Current content includes type of risk e.g. increased, decreased and also concepts without specification of level of risk. The latter are usually understood to mean increased risk.  

Goal of moving: defining of content

Options to manage content presented to CMAG

• Keep in Finding hierarchy with new concept model to support defining of content. Includes using the Has realisation attribute and extending the range of values permitted. 
• Move to Situation and use model to represent to type of risk. Would require additional concepts as subtypes of 410519009 |At risk context (qualifier value)| 

Examples were shown using authoring platform. 

1. Briefing note: Delivered/ not delivered concepts
2. TOR
3. 2023 work plan
4. CRS guideline updates - updated promotion process

• Discussion on what is being provided e.g. what is useful, how much is too much etc.

• Malignancy
• No future meetings scheduled at this point in time. 
  • Will look at the potential to have a meeting at the April business meetings, if required.