Andrew Norton Andrew Marchant Steven Dain Patrick McCormick Martin Hurrell Maria Hendrickson Terri Monk Monica Harry Ian Green Jane Millar Maria HendricksonZac Whitewood-Moores Ian Green Ellen Torres Jeremy Rogers Toni MorrisonSteven Dain Andrew Norton Andrew Marchant Steven Dain Patrick McCormick Martin Hurrell Maria Hendrickson Terri Monk user-b7840 Patrick McCormick user-7e841
user-619d4 Sander Mertens Ingrid Mertens
Present: Andrew Norton Andrew Marchant Jane Millar Monica Harry user-619d4 Maria Hendrickson Patrick McCormick James R. Campbell Martin Hurrell
Anesthesia Clinical Reference Group
Time: Mar 23, 2021 19:00-20:30 UTC / 19:00 - 20:30 UK / 15:00-16:30 ET
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Meeting ID: 963 2246 7605
International numbers available: https://snomed.zoom.us/u/avs0qL3Fx
|1||Introductions and Apologies|
Matters arising from the previous meeting notes
Were agreed to be a correct record of the meeting
Jane Millar will contact Stephen Dain about the e-mail discussions and requests for information from the American Society of Anesthesiologists regarding intellectual property and copyright in modelling the ASA physical status classification as observables as part of the ongoing work regarding assessment scale modelling (item 4)
|4||Assessment scale modelling||Andrew Norton|
Update on discussions with observables project groups.
GCS & Mallampati qualifier scale values terms.docx
Anesthesia Ordinal Scales.pptx
James R. Campbellgave an update on the proposals developed through the Observables group for the modelling of assessment scales scores as observables. Observables could be fully defined in terms of property attributes.
The example of the Mallampati scale was discussed in detail. The grade numbers equating to the clinical grade findings would be regarded as an ordinal set of values to be modelled in the qualifier hierarchy. It was proposed that this would be supplemented by a supporting refset of clinical descriptions forming the definitions of scale points. It was felt that this approach would support clinical analysis from EHR's and applications such as machine learning.
It was noted that existing content was in the form of clinical finding primitives. The Anesthesia CRG was asked to consider proposals for clinical observation results vs clinical findings as illustrated in examples in Anesthesia Ordinal Scales.pptx.
Martin Hurrell will consider these proposals as they relate to use in HL7 FHIR observation resources
|5||Requests for additional SNOMED terms||Steven Dain|
Document from an e-mail detailing a number of requests and suggestions for terms
Requests and comments from Steven Dain on SNOMED content.docx
Deferred to next meeting due to time constraints and apologies from Steven
|6||ISO19223 ventilation modes and patterns|
Vent modes 19223 batch template.xls vent patterns 19223 batch template.xls
user-619d4had sent useful comments on the spreadsheet of ISO 19223 ventilator modes, and modifications will be made accordingly.
There were two main issues for discussion:
1) Syntax - it was agreed that hyphenated compound nouns as used in ISO 19223 would be acceptable within SNOMED editiorial guidance. Unicode / and \ will need to be handled as words describing the meaning.
2) Depth of coding, adjuncts and possibilities of combinatorial explosion. The current spreadsheet models for SNOMED all modes outlined in table E1 of ISO19223. If adjuncts were modelled full as precoordinated mode descriptions there would be huge combinatorial explosion as illustrated by an ISO11073 document outlining mode combinations for Drager ventilators. Such an approach would also create problems with manufacturer specific terms that would not be acceptable for SNOMED CT user-619d4 suggested that the depth and detail of mode modelling should include non selectable adjuncts (ACAP - assured constant airway pressure) but exclude all selectable adjuncts (e.g. tube compensation, compliance compensation). This would equate to a mode table equivalent to the content of ISO19223 table E2.
user-619d4 will supply suggestions for wording and content and would be available for further discussion and input during completion of the modelling.
Consideration would be given to some further SNOMED submissions to model selectable adjuncts as qualifier values for a post coordination representation of ventilator modes including adjuncts.
|7||Device related terminology in HL7 FHIR||Martin Hurrell|
Report from a conference call to discuss device related terminology in FHIR and the role of SNOMED CT & LOINC.
Martin reported that he had attended a conference call and was a co-chair of a group under the HL7 terminology authority considering device integration and alignment with FHIR. It had been noted that there is no integration between ISO11073 and FHIR and that considerable use is being made of LOINC.
Monica Harry noted that SNOMED is engaged in a clean up of device terminology in SNOMED and would be interested in attending some of the meetings. Martin Hurrell will forward relevant details.
|8||Anesthesia CRG sessions at SNOMED April Meeting|
Currently scheduled Monday 19th & Tuesday 20th April 1600-1800 UTC
Clinical webinar & keynote address is Thursday 22nd April 1200-1500 UTC
Jane Millar noted that draft schedule for the April meeting was published and SNOMED will be publicising the specialty CRG meetings taking place during the meeting in order to encourage new attendees. The agenda for the Clinical webinar and keynote address on Thursday 22nd April is not yet finalised
|9||Any other business|
|Date of next meeting - Tuesday May 25, 2021|
April IHTSDO Spring meeting sessions as above in item 8
This is line with the usual schedule of 4th Tuesday alternate months