During our last OIDM Web conference, I failed to include an important group of concepts related to antimicrobial resistance. The present discussion is mostly about the fate of a few "odd" organisms but the conversation also has bearing on an eventual need to discuss a proper "fit" for organisms in laboratory results, disorders, etc. meant to convey information about resistance. I'd appreciate any time you could take to review the attached documents (see attachments on drop-down menu for this page).
4 Comments
Xavier GANSEL
I agree with your proposal and would also add the following.
Should not we treat 409792002 |Antimicrobial resistant organism (organism)| the same way ?
409792002 has 3 subtypes, 2 having no descendant themselves (I have not checked for the number of relation those are involved in)
This would translated into
409822003 |Superkingdom Bacteria] <- Is_a-- 409793007 |Antimicrobial resistant bacteria|
+ the depreciation of 09794001 & 409795000
would this make sens ?
any though ?
Xavier
Jeff Wilcke
I would interpret your comment to mean that 09794001 |Antimicrobial resistant fungi and 409795000 |Antimicrobial resistant virus are not especially useful and can be deprecated. I would agree but to edit "conservatively" I would point out that they also do not present serious logical problems. They are properly descendants of Kingdom Fungi and Virus respectively - so they can be treated in the same way we're suggesting for 409793007 |Antimicrobial resistant bacteria.
So, I was not proposing to deprecate / retire 09794001 |Antimicrobial resistant fungi and 409795000 |Antimicrobial resistant virus but rather simply place them as first generation descendants of 414561005 | Kingdom Fungi and 49872002 | Virus. At least for now. (see documents attached to this discussion).
I think we need to consider carefully how we manage antimicrobial resistant / antimicrobial susceptible concepts in the organism hierarchy and save final disposition for another discussion on another day. I suspect we need a model... (sigh)
Xavier GANSEL
understood for
lets move step by step to clean-up the highest level in the hierarchy.
If I correctly understand, your proposal is to end-up with
<- Is_a-- 409793007 |Antimicrobial resistant bacteria (organism)|
<-Is_a-- 418248000 |Antimicrobial susceptible bacteria (organism)|
and also the inactivation of
Am I correct ?
Xavier
Jeff Wilcke
You are correct. The last two (inactivations) worry me because they are associated with disorder definitions that MUST be handled. I don't have a very positive opinion about the affected disorder classes. Here they are:
3 and 4 can be removed from this list as their causative agent can/should be the more specific 'resistant fungus and resistant virus.' I do not believe and cannot prove that the remaining 5 were EVER intended to relate to "organism of ANY class resistant to X". I believe that in a clinical record, more specific concepts (likely all related to bacteria) would be preferred. I don't believe that there is great value in retrieving, aggregating and analyzing resistance across unrelated organisms (resistance in viruses and fungi related to resistance in bacteria??). So personally, I have no problem retiring these 5.
The fundamental problem we have with retiring 409792002 | Antimicrobial resistant organism is that (to me) it triggers the retirement of disorders 1,2,5,6 and 7.