Date: 2023-01-23
Time:
0600 - 0730 PDT
1400 - 1530 UTC
Zoom Meeting Details
Hi there,
Jim Case is inviting you to a scheduled SNOMED International Zoom meeting.
Topic: SNOMED Editorial Advisory Group - Conference Call
Time: Jan 23, 2023 06:00 Pacific Time (US and Canada)
Join from PC, Mac, Linux, iOS or Android:
https://snomed.zoom.us/j/81470843244?pwd=SVgvYWNMY2QrRGxqaFZYUTZ6a0pYZz09
Password: 626212
Meeting ID: 814 7084 3244
Password: 626212
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Or Skype for Business (Lync):
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Attendees
Chair:
AG Members:
Invitees:
Observers
Apologies:
Meeting Files:
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 |
| |
| 2 | Conflicts of interest and agenda review | None noted. | ||
| 3 | Intermediate primitive parent and definition status of subtype | Postponed to future meeting. | ||
| Expansion of range for HAS INTERPRETATION | Scenarios where qualifier values are not sufficient; e.g. at risk findings, coma score subscore results From GC-1248 - Getting issue details... STATUS In developing the model for defining risk findings, we have run up against an issue with describing the specific risk factor as the range of HAS INTERPRETATION is limited to << [260245000 |Finding value (qualifier value)||http://snomed.info/id/260245000] OR There are two approaches to modeling specific risk factors.
Example 1: 1184692002 |At increased risk due to lack of fire extinguisher in residence (finding)| Clinical finding: DUE TO Inadequate fire extinguishing equipment in residence (finding) {INTERPRETS = Risk level, HAS INTERPRETATION = Increased} Example 2: 1184692002 |At increased risk due to lack of fire extinguisher in residence (finding)| Clinical finding: {INTERPRETS = Risk level, HAS INTERPRETATION = Increased} {INTERPRETS = Risk factor, HAS INTERPRETATION = Inadequate fire extinguishing equipment in residence (finding)} Currently, there is no way to assign values to the Observable 80943009 |Risk factor (observable entity)| due to the limitations of the range of HAS INTERPRETATION. Existing use of the 80943009 |Risk factor (observable entity)| has been restricted to a few concepts that also use DUE TO as the relationship to the factor with no HAS INTERPRETATION VALUE (e.g. 1162398002 |Adverse health risk due to mold in residence (finding)|) There is a similar issue with assigning the values associated with assessment instrument Observables There is a huge risk in extending the range of HAS INTERPRETATION, but using this pattern is a better representation of the definition than the implied relationship using the DUE modeling pattern. Discussion: | |||
| Mechanical Complication of device | Jim Case | Should "Mechanical complication of device" be a disorder or a finding? Current situation: 111746009 |Mechanical complication of device (disorder)| has 216 subtypes, all of which refer to a failure of a device without specifying a deleterious effect on the patient. e.g. 285961000119107 |Mechanical breakdown of prosthetic heart valve (disorder)| We also have disorder concepts that refer to a patient condition due to mechanical failure of a device e.g. 5053004 |Cardiac insufficiency due to prosthesis (disorder)| Without specifying the resultant condition associated with device mechanical issues, is it appropriate that these are represented as patient disorders, or should they be findings that may be related to disorders in the patient? Discussion: | ||
| Potential for inactivation of navigational concepts | Jim Case | It was suggested at a recent Modeling Advisory Group meeting that SNOMED should consider inactivating the 363743006 |Navigational concept (navigational concept)| hierarchy. A list of 635 primitive concepts that are unable to be defined due to their highly contextual use. The concern is that because they are more or less "orphan" concepts, and provide no analytical advantage, they would be discouraged from use in medical records. However, because many of these descriptions are those that are commonly used in clinical records, with organizationally specific meaning, they are being entered into EHRs. UK has high usage of a few of these: CONCEPTID FSN USAGE 2011-2022 394617004 Result (navigational concept) 48,227,610 160237006 History/symptoms (navigational concept) 10,146,392 309157004 Normal laboratory finding (navigational concept) 581,209 267368005 Endocrine, nutritional, metabolic and immunity disorders 160,475 243800003 Test categorized by action status (navigational concept) 108,176 250541005 Biochemical finding (navigational concept) 100,632 It is unclear how these are used in clinical records although from the above list it appears they may be used as document headers . An inquiry to the UK resulted in an interesting observation that some of these highly used concepts are primarily found in only one of two major primary care systems, and some that were not used much a decade ago are beginning to increase in usage. It was proposed to SNOMED that aside from the highly used concepts above, the remainder of the navigational concepts could be inactivated without much impact on users. However, we would need to consider carefully before inactivating the above concepts without suitable replacements due to their high, albeit incorrect, usage. Question: Should these be replaced with Record artifact concepts or something else? Discussion: | ||
| Review of Surgical approach and definition of Surgical procedure | Issue reference: GC-1142 - Getting issue details... STATUS The summary of the proposal is that many procedures, both surgical and non-surgical can use the same approach (e.g. 386745004 |Transurethral cystoscopy (procedure)|); however, currently the only approach attribute available is 424876005 |Surgical approach (attribute)|, so many non-surgical procedures that include an approach are not modeled with the appropriate APPROACH relationship. The proposal is to replace this attribute with the more general "Procedure approach". There are additional questions related to the definition of surgical procedures and what the scope of a surgical procedure should be in the background document . They are included hereto inform the SNOMED definition of surgical procedure:
Discussion: | |||
| 10 | AOB | EAG | ||
| 11 | Next meeting | EAG | ||