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Date

Thursday, August 9, 2018

Schedule
2nd Thursday of every month
Time: 20:00 UTC


GoToMeeting Details

https://snomed.zoom.us/my/allergycrg


Meeting ID: 733 996 0359

International numbers available: https://snomed.zoom.us/zoomconference?m=EochJjO8ozm1ZiDr_x9p-bFJCbIBwgqV

Objectives

  • See discussion items below:

Discussion items

ItemDescriptionOwnerNotesAction
1Welcome and role call


  •  
2New membership



3Allergy Content changes for January 2019 release

Bruce Goldberg

  1. Hypersensitivity/Allergy/Non-allergic hypersensitivity condition classes defined using GCIs
  2. Propensity to adverse reaction and Allergic disposition moved from disorders to findings
  3. New Allergic disorder (disorder) hierarchy representing abnormal structures (associated morphology inflammation + finding site X e.g. Allergic rhinitis)
  4. New Intolerance to substance (finding) hierarchy created under Propensity to adverse reaction (finding) as a sibling of Hypersensitivity disposition (finding)
  5. Allergic disorder and Allergic reaction now subsumed by Disorder of immune function (disorder)

Release notes for Jan. 2019

  • The revision of about 2,000 hypersensitivity conditions have been remodelled following the new editorial guide (exclude hypersensitivity reaction):

    1. Hypersensitivity/Allergy/Non-allergic hypersensitivity condition classes defined using General Concept Inclusion (GCI) axioms in order to encompass disorders, dispositions and processes (reactions).

    2. Propensity to adverse reaction and Allergic disposition moved from disorders to findings. They are remodeled using the proximal primitive parents with a role group consisting of 719722006 |Has realization (attribute)| with value of allergic process or its subtype. The new convention for descriptions are Hypersensitivity/Allergy/Non-allergic hypersensitivity to X (finding).

    3. New Allergic disorder (disorder) hierarchy representing abnormal structures. The allergic disorders are modelled by associated inflammation morphology + allergic process or subtype + finding site X e.g. Allergic rhinitis)
    The contact hypersensitivity conditions have been remodeled by the new concepts of Immunoglobin E-mediated allergic contact hypersensitivity process (qualifier value) and Non-immunoglobin E-mediated allergic contact hypersensitivity process (qualifier value).

    4. New Intolerance to substance (finding) hierarchy created under Propensity to adverse reaction (finding) as a sibling of Hypersensitivity disposition (finding)

    5. 414029004 |Disorder of immune function (disorder)| is remodeled and defined by using a pathological process of 769247005 |Abnormal immune process (qualifier value). As a result, it subsumes allergic disorders and allergic reactions.

    6. Pseudoallergy condition and Pseudoallergy disposition renamed to Non-allergic hypersensitivity condition (finding) and Non-allergic hypersensitivity disposition (finding) and they have been remodelled following the new concept model.

    The following two points need to check with release notes for substance to avoid duplications.
    7. Inactivate “Allergy to X" concepts where X is a modification of a base substance and replace it with Allergy to the base substance.

    8. As the result of Allergy project requirements, the following top level groupers/Allergen classes in substance hierarchy are inactivated by assigning their children to appropriate structural and/or functional parents :
    • 414052000 | Drug allergen by structure |
    • 414057006 | Drug pseudoallergen|
    • 414053005 | Drug allergen or pseudoallergen|
    • 414058001 | Drug pseudoallergen by function|
    Note: Other top level groupers (as specified in Allergies-19) will be inactivated in the future releases.



4Project proposal for groupBruce Goldberg

Allergy to substance (finding) hierarchy has a large number of descendants many of which likely do not represent allergy at all. These need to be identified and eventually moved under another hierarchy such as propensity to adverse reactions, intolerance to substance or non-allergic hypersensitivity to substance

  • Volunteers needed
  • Bruce Goldberg to create and upload a Google sheets document containing the descendants of 419199007 |Allergy to substance (finding)|
  • David Woods to upload an e-book on mechanisms of adverse effects to substances to use as an additional resource


5WHO ICD-11 definitions of Allergy and hypersensitivityBruce Goldberg

Does the WHO ICD-11 definitions of Allergy and hypersensitivity make sense?

  • Jim Case to bring my concerns to Medical Scientific Advisory Committee (MSAC) (JTC Note: Submitted to the MSAC for consideration on the December conference call)
  • General agreement that ICD-11 definitions require clarification
6Allergy dispositions
  • Requirements for adding new content
  • Potential add: allergy to alpha-gal (galactose-alpha-1,3-galactose) - red meat allergy
  • Bruce Goldberg to create a draft proposal for requirements for adding new content under 419199007 |Allergy to substance (finding)|
  • Bruce Goldberg to develop concept model for allergy to alpha-gal (galactose-alpha-1,3-galactose) - red meat allergy
7Allergen refset
  • ETA for top 300 allergen list
  • Use cases
8Adjourn

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