Conflicts of interest

Approval of minutes Jan 2018 conference call

• 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.

6

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).

Further review of the issue suggests that this is not a significant problem and that while exceptional conditions exist in the terminology, the number of affected concepts is very small.

Number of concepts with SPECIMEN SOURCE IDENTITY as a stated relationship:

Number of concepts with SPECIMEN SOURCE IDENTITY as a stated relationship:

Number of concepts with "from patient" in the FSN: 8

The primary issue is that because of the very broad range of values that can be used for SPECIMEN SOURCE IDENTITY, the inferences that result cause substantial fragmentation of the content (for example, Specimen from blood bag from patient is not a subtype of Specimen from patient).

It is possible that if the problem were more pervasive, there would be justification to look at revamping the concept model for specimens; however, the small number of affected content should at this time be handled as exceptions.

Currently editorial guidance does not specify a soft default, so the context is provided by the information model in which the concept is used.

Recommend tabling this topic.

Review of the proposed approaches to the structural improvements that are being applied to the Clinical findings hierarchy.

Pilot project