Date: 2018-03

1600 UTC

Zoom Meeting Details

SNOMED Int'l Editorial Advisory group

SNOMED International - Editorial advisory group conference call
UTC

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https://snomed.zoom.us/j/807454545

Attendees

Chair:

Jim Case

AG Members

Observers:

Apologies

Meeting Files

Amyloid fibril proteins and amyloidosis chemical identification and clinical classification International Society of Amyloidosis 2016 Nomenclature.pdf

Meeting recording

The folder containing the meeting recordings is located here.

Objectives

Obtain consensus on agenda items

Discussion items

Item	Description	Owner	Notes	Discussion	Action
1	Call to order and role call	JCA
2	Conflicts of interest Approval of minutes Jan 2018 conference call	JCA	No conflicts reported	No conflict of interest reported.	Minutes approved
3	ECE Update	BGO	Reactive arthritis and modeling extraarticular manifestations using simple co-occurrence Test of allergic disorder model as pathologic structure Sepsis Sepsis 1. Agreement to add dysregulated host response as a pathological process. 2. Agreement not to add pathological process infectious process which would result in sepsis being defined as organ dysfunction syndrome co-occurrent and due to infectious disease. Test of device complications model Device complications Problems with the device itself should be a finding and not a disorder. This would allow some rearrangement of the current device problem findings. The modleing structure would be to use the INTERPRETS/HAS INTERPRETATION pair to define the findings. Should also create a more specific "device failure" to segregate from general external equipment failure. desire to see more examples for each of the three patterns.		Bruce Goldberg to test modeling of sepsis both with and without the PATHOLOGICAL PROCESS Bruce Goldberg to test the three patterns related to devices. Tracker item to be developed. See Events, Conditions, Episodes Project Group meeting agenda 2-12-2018
4	Drug Model Update	TMO	Toni Morrison to provide an update on the status of the drug project
5	Observables Model Update	DKA
6	Revision of Amyloidosis	JCA	On the ICD-11 MSAC call recently, a discussion ensured about the recent changes to nomenclature for Amyloidosis, with an emphasis on etiology (i.e. the type of amyloid) with secondary interest in the anatomical location of the amyloid deposition. This is contrary to the current way SNOMED classifies amyloidosis, which focuses on the site of deposition as opposed to detailed information about the type of amyloid. WHO description: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clinical signs and biochemical type of amyloid protein involved. Most amyloidoses are multisystemic, 'generalized' or 'diffuse'. There are a few forms of localized amylosis. The most frequent forms are AL amyloidosis (immunoglobulins), AA (inflammatory), and ATTR (transthyretin accumulation).	Reference for amyloidosis nomenclature is here. Discussion points: 1) The current subhierarchy <<17602002 \|Amyloidosis (disorder)\| is mostly primitive and does not go into much detail about the biochemical characteristics of the amyloid protein. Do we want to add the specific subtypes of amyloid? 2) Do we want to align the SNOMED CT amyloidosis content to the ICD-11 approach? What is the clinical importance? Most general clinical references emphasize the underlying origin of the amyloid (i.e. genetic, inflammation, dialysis).
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9	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? Tracker: IHTSDO-1001 - Getting issue details... STATUS	No testing of options for this item has been performed since the last meeting. Issues still remaining: Eliminating the soft default (yes or no) Creating unspecified SPECIMEN SOURCE concepts only where both patient-oriented and non-patient specimens are required. Resolving issues with specimen sources that are both patient and non-patient oriented (i.e. autologous blood products) Resolution of non-patient subtypes under unspecified SPECIMEN SOURCE (i.e soft default) concepts	Jim Case to develop option to consider for solution of this specimen unspecificity issue Jim Case to present to CMAG for their input on the perceived impact of proposed options
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12	Update of EAG Workplan	JCA	Review and revision of current workplan	Continued to next call due to lack of time.	Jim Case to update workplan based on input from the EAG members.
13	Future meetings	JCA		TBD

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2018-03-XX Editorial Advisory Group Conference Call