Date 20171017
0700-1500 UTC
0900-1700 Bratislava time
0500-1300 Eastern Daylight Time
Zoom Meeting Details
SNOMED Int'l Editorial Advisory group
SNOMED International - Editorial advisory group conference call
UTC
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Meeting recording
Objectives
- Obtain consensus on agenda items
Discussion items
Item | Description | Owner | Notes | Discussion | Action |
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1 | Call to order and role call | JCA |
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2 | Conflicts of interest | JCA | |||
3 | Continued from 20170928: Change of name for genetic diseases | JCA | Based on requests from UKTC: The concepts are The FSN for these concepts align with Orphanet, OMIM and Genetics Home Reference. The request from the UKTC is All terms should ideally be replaced by autosomal dominant tubulointerstitial kidney disease (ADTKD) (see KDIGO report). The above terms are not necessarily the same and don’t really reflect the improved clinical descriptions of the disease based on genetics. ADTKD reflects the inheritance, common phenotype caused by different mutations and can be used for suspected cases. This is well described in the KDIGO report. They also make the point it is a simple term to use and that MCKD is frankly inaccurate! As above. I would favour not using these terms MCKD 1 and 2 even though they may be commonly used at present. ADTKD-UMOD or ADTKD-MUC1 would be the preferred names. The list of genes is also increasing making a single term more appropriate. ADTKD would be the parent and the children would be ADTKD associated with UMOD mutations and ADTKD associated with MUC1 mutations. It is anticipated that this type of request will become more frequent as the move towards genomics continues. Question: Do we go with the current naming convention to align with Orphanet (our current "Source of truth") or try to keep pace with the evolving nature of content in this area? 10/6/2017: Response from Orphanet After checking, I confirm the proposed modification of nomenclature from your contact. These modifications don't change the concepts nor the current mappings. ORPHA34149 Autosomal dominant tubulointerstitial kidney disease (Disease) Question: Do we change the FSN or inactivate and replace? In this case it is clear from the response that the "meaning" of the concept is unchanged. For organisms, we have adopted the policy that when taxonomic names change, it is not the organism that changes, but the term representing the organism, thus we rename the FSN for the concept and retain the "older" term as a historical synonym as the naming transition for searching convenience. Should we adopt the same policy for disorders, or does this constitute a substantive change compelling us to inactivate and replace? | Summary of past discussion:
Orphanet release cycle (from Maria Braithwaite): Orphanet have an ongoing cycle of release for new definitions and changes to the website, they do not currently routinely inform me of a change to the name of a particular entry but I will ask them if it is possible to provide this information. We agreed that they will provide me with a list of changes (new additions, deprecated or obsolete entries) twice per year in April and October to allow me to make content edits before we close the release. This will prevent problems I have had previously where a new concept has been published almost simultaneously with Orphanet deprecating their entry. | |
4 | Demo: Batch structural changes to existing content | GRE | |||
5 | ECE Update | BGO |
The third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) published in 2016 state sepsis is a multi organ dysfunction syndrome due to an infection or more specifically due to an dysregulated host response to infection. Current model places sepsis as a subtype of SIRS and infectious disease which is not consistent with Sepsis-3 definition. Proposed model: IsA Multiple organ dysfunction syndrome due to infection. Question: Would a new pathological process of dysregulated host response be required in order to fully define sepsis? |
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6 | Findings related to skin wounds | JCA | A number of requests related to findings related to surgical skin wounds and pressure injury findings reveal an issue with current structure. Most of the requested terms are Findings related to skin wounds, but currently 262526004 |Wound of skin (disorder)|is a disorder, so cannot be used as a parent for findings related to skin wounds. There is currently 225552003 |Wound finding (finding)|, but it is not specific to skin. 262526004 |Wound of skin (disorder)|currently has 65 immediate subtypes, many of which could reasonably be viewed as findings (e.g. “Abrasion of X”). Need to make a determination of whether observations related to wounds (i.e. color, discharge, odor) should be placed in a subhierarchy different from the "Wound (disorder)" itself. | ||
7 | Specimen from subjects other than the patient | JCA | Currently we have many concepts in the specimen hierarchy that include “from patient”as well as those that do not include it as an ancestor. Since the subject of record is the default for specimens, we would like to retire these apparent duplicates, but then we run into the problem of specimens derived from other sources such as donors or normal control patients. They cannot be subtypes if the intended meaning is “subject of record”..or can they, since the context is implied? How do we structure the specimen hierarchy to account for this? What are the analytical implications of having different sources for specimens as subtypes of one another? | ||
8 | WAS-A Inactivation redux | JCA | Concerns have been expressed about the impending inactivation of existing WAS-A relationships: "This topic has consulted with the CMAG and UKTC. The feedback from CMAG was that this should not be a priority. The size and efforts are small for content maintenance. The potential impact could be high if we make changes. The feedback from UKTC was to delay the changes until 2018 when they move to RF2. Furthermore, they still think it would be useful to provide information for WAS A by technical means centrally. " | ||
9 | Morphologic abnormalities as values for FINDING SITE | JCA | This arose during a review of "Disorder of stoma (disorder)" Currently there are 16 disorders and 23 findings that have a value of 245857005 |Stoma (morphologic abnormality)|. As the stoma is a morphologic structure within a body structure, is it legitimate to allow this as a finding site? For the most part the terms that use this value are nonspecific to the site of the stoma. Additionally, it is unclear what the use of 91241007 |Stoma site (morphologic abnormality)|, given that the site of a stoma canbe values using any anatomical site. Questions:
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10 | What is an "infected prosthesis" | JCA | We have a number of terms, both disorder and procedure that deal with "infected prosthesis". In general, prostheses themselves are not infected, but the surrounding soft (or bone) tissue adjacent to the prosthesis can become infected. This infection often does not have a demonstrable causal or temporal relationship to the procedure. Currently these are modeled with an ASSOCIATED WITH relationship: Question: How do we best represent the true nature of the infection? This is especially important when we deal with "Removal of prosthesis due to infection" and concepts such as "Infection of implanted cardiac device (disorder)".? | ||
11 | “Acquired” disorders vs. Congenital disorders | JCA |
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12 | Update of EAG Workplan | JCA | Review and revision of current workplan |
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13 | Use of the Oxford comma in FSNs | JCA | The Oxford comma is a comma added after the penultimate term in a list, e.g. For example "Disorder of head, neck, and shoulders". The purpose if its use is to make explicit the fact that the terms are part of a list. The editorial guide is silent about its use, but the example provided does not use the Oxford comma. There are currently 347 FSNs in SNOMED CT that use the Oxford comma. Most of these are terms obtained from other terminology, such as ICD and nursing. There are 2500 FSNs that contain comma delimited lists, but do not use the Oxford comma. Question: Should SNOMED CT be consistent in the use of this grammar mark or maintain fidelity to the original source of the terms that do use it? | ||
14 | Future meetings | JCA |
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