Anesthesia Clinical Reference Group

Time: Tuesday, September 27, 2022 14:30 - 16:30 UTC / 15:30 - 17:30 UK & Lisbon / 10:30 - 12:30 ET

Or Telephone:

+1 646 518 9805 (US Toll)
+44 203 481 5237 (GB Toll)
+1 587 328 1099 (CA Toll)

International numbers available:

1Introductions and Apologies

Apologies Zac, I should probably resign this group and suggest that the current ‘chair’ of Nursing CRG is invited or suitable representative. Unfortunately I no longer have flexible time I can commit at this point. Many thanks. 


Matters arising from the previous meeting notes

2022-07-26 Anesthesia CRG Meeting

3SNOMED Update

New CRGs - neurology & ophthalmology

Some focus on content issues, some on mapping to other terminologies

Implementation Guides - provides guidance to vendors on the best way to implement SNOMED

4Anesthesia Refset Review

  • Anesthesia Refset
  • Difficult Airway Intensional Refset
  • Difficult Airway Refset
  • Pediatric Difficult Airway Syndromes

Refsets require regular maintenance and need to be used. (for example, Nursing Assessment Refset became ICNP)  Currently none of these are used.


Steven Dain - working on local project to map ICU flowsheet to SNOMED terms (also see Docbox and HL7 FHIR); Charles Gutteridge suggests this would be an area of utility and interest

National Emergency Critical Care Network (NECCN) - has interest in critical care SNOMED terminology

Assessment scales - SNOMED has many, from Aachen aphasia test to Zung's self-rating anxiety scale.  SNOMED doesn't always associate findings with scales in part due to intellectual property concerns.  This group can identify gaps within SNOMED.

UK uploads ICU data to ICNARC.  USA has MPOG.

Ventilation modes - Steven Dain notes at least 70 modes in most recent specification ISO 19223 and IEEE 11073-10101 (still in press).  Sophie Klopfenstein Difficult to compare devices because names different while mode is technically similar, so mapping would be welcome. 

Professional organization liaisons - Am Soc Anesthesiologists (ASA) is aware and available for consultation.  Would like liaisons with UK groups

Sophie Klopfenstein Alarm gap assessment; currently they are procedures but should be a different kind of concept. Steven Dain : see IEC 60601-1-8 medical alarm standard.  Charles Gutteridge : look at SNOMED early warning score modeling.

Brief discussion of commercial vocabularies - First Data Bank and Cerner Multum for medications; IMO for procedures and diagnoses.

Potential Program of Work:

  • ICU flowsheet gap assessment
  • Assessment scale gap assessment
  • Ventilation mode gap assessment

5SNOMED for Analytics

Data Analytics with SNOMED CT -

The power of SNOMED CT lies in both its content coverage and ontological basis. The session will look to explore the content coverage related to Anaesthesia, the content modelling and how this can be leveraged to support analytics and querying through the use of the SNOMED CT Expression Constraint model, with practical examples provided.

Demonstrated how to use ECL builder to search SNOMED.  Example used:

<< 404684003 |Clinical finding (finding)| : << 363698007 |Finding site (attribute)| = << 39607008 |Lung structure (body structure)|, << 246075003 |Causative agent (attribute)| = << 243607003 |Family Coronaviridae (organism)|

Results in 3 matches for pneumonia caused by coronavirus.


Dates of next meeting:

Tuesday, November 22, 2022

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1 Comment

  1. I note the zoom link is visible on the public page of confluence (i.e. without logging in). This  may be by design, but it can open the door to bots so I just wanted to flag that up.