Descriptions:
| Term | description type | Language/acceptability | Language/acceptability | Case Significance |
|---|---|---|---|---|
| Infected [Morphology] of [ site ] due to [bite event] caused by [organism] (disorder) | FSN | us:P | gb:P | ci |
| Infected [Bite event] [morphology] of [site] caused by [organism] | SYN | us:P | gb:P | ci |
| Infected [Morphology] of [ site ] due to [bite event] caused by [organism] | SYN | us:A | gb:A | ci |
Concept model:
| Attribute Cardinality | Attribute | Value | role group number | Attribute Group Cardinality |
|---|---|---|---|---|
| 1..1 | 0 | N/A | ||
| 1..1 | 0 | N/A | ||
| 1..1 | [morphology] << 3404009 |Bite (morphologic abnormality)| | 1 | 1..1 | |
| 0..1 | ||||
| 1..1 | ||||
| 0..1 |
Definition status:
900000000000073002 |Defined (core metadata concept)|
Applies To:
<< 283682007 |Bite - wound (disorder)|
Rules for description generation:
- Apply general rules Template for simple template of disease;
- Preferred term should have a structure such as "Wound of upper arm due to animal bite" or " Open wound of upper arm due to dog bite"
- If description of event is part of description of associated morphology, the description of event can be omitted to avoid redundancy, e.g. Open bite wound of thigh (disorder) is modelled by due to = bite (event) and associated morphology = Open bite wound (morphologic abnormality)
- If description of associated morphology is part of description of event, the description of associated morphology can be omitted to avoid redundancy, e.g. Dog bite of forehead (disorder) is modelled by due to = Dog bite (event) and associated morphology = bite (morphologic abnormality)
- Remove 'caused by [organism]' from the description is |causative agent| is not present in the concept model
JIRA ticket:
QI-57 - Getting issue details... STATUS
INFRA-3041 - Getting issue details... STATUS
20 Comments
Bruce Goldberg
Just a thought but the FSN and PT of [Morphology] of [ site ] due to [bite event] with infection (disorder) seems a little ambiguous as it does not explictly state that it is the wound that is infected although it is modeled that way. Infected wound due to bite would imo be more precise.
Yongsheng Gao
I have added the causative agent for description template and also rules related to morphology, event and causative agent for generating descriptions. Should the descriptions be refined as Bruce suggested?
Jim Case
Yongsheng Gao, Bruce Goldberg, I was rereading Bruce's comment and agree that the terming should be specific that the infection is of the bite wound. That's just not the way ICD names them (heh, heh)
Yongsheng Gao
Jim Case, I updated the description patterns and rule for generating descriptions. If you are okay with the changes, I will mark this as Ready for implementation.
Jim Case
Looks good. How do we get it into the queue.
Yongsheng Gao
Thanks Jim, The INFRA-3041 has been added for technical team to pick up.
Monica Harry
Jim CaseYongsheng Gao - I have amended the template "Wound of body structure due to event" by adding new optional attribute Pathological process and Physica force as value for Causative agent, as discussed.
However, Q - would it be better if we broadened this and included.
Jim Case
Monica Harry, what is ti you would like to include?
Monica Harry
Jim Case - the last words got chopped off - "would it be better if we broadened this and included here instead" i.e. broaden the Values for DUE TO to include events other than bites... and adding Physical object and Physical force as possible values for Causative agent. That would mean the template name would be Infected wound of site due to event (disorder). Which brings up a question, can we change template once it is in production.
Jim Case
Monica Harry - As I mentioned on the last QI call, I am all for more general templates that can be applied more broadly. There will be lots of concepts that are DUE TO events (trauma comes to mind)...If we find that we need to tighten it down later, then we will jump off that bridge once we come to it.
I don't know what is possible after a template goes into prod.. asking Yongsheng Gao and/or Michael Chu
Monica Harry
Jim Case - thank you, will wait to hear back about the template in prod. Q before proceeding.
Peter G. Williams
For sure anything can be changed (I'm sure Michael Chu will agree), although there might be some lead time / prioritisation to consider when changing production systems. That said, the work I'm doing in QI has it's own copy of these templates so I'm happy to update them locally, immediately. I believe we also have the option of versioning a template, so V1 could remain in production status while we discuss a V2 which could be "In Progress"
Michael Chu is there a standard form for how template versioning should be done - is the name just added to the page title?
Michael Chu
Peter G. Williams Currently we update existing templates in prod with "OUTDATED" to state that these should not be used for new concepts authoring or template transformations. They can only be used for template searching. Yes we also update the confluence page title with version e.g V1-OUTDATED
Penni Hernandez
I am trying to fit this CMT request into this template but I am wondering about the past tense of "infected":
Infected wound of left elbow due to nonvenomous insect bite (disorder)
Or should this be termed?
Infection of wound of left elbow due to nonvenomous insect bite (disorder)? Too wordy?
Jim Case Bruce Goldberg Monica Harry Yongsheng Gao
The lion's share of the existing concepts are "Infected wound of x"
Jim Case
Penni Hernandez , in this case the word "infected" is used as a n adjective, not a verb, so it is tenseless. I agree with your and Bruce's comments on the terming of the FSN.
Bruce Goldberg
Based on the proposed model, I think Infected wound of left elbow due to nonvenomous insect bite fits the proposed model better.
Bruce
Yongsheng Gao
I would prefer Infected wound of X due to Y bite as FSN. If the word "infection" is useful for searching, we can include it as a synonym.
Penny Livesay
There are two organisms involved in these disorders - the one doing the biting and the one doing the infecting. The guidance should, I think, explicitly state which of these the Causative agent in this template is used to represent. I would guess that it's the infecting organism, but either the guidance should specify that or (as a more robust safeguard against inconsistent modeling) only subtypes of organisms capable of causing infection should be permitted as values in the template.
If the Causative agent relationship in the template is intended to represent the infecting organism, that does raise another question - can/should the biting organism be represented in the definition of the disorder or the event?
Jim Case
Penny Livesay , the differences you suggest are implied in the template. The organism doing the biting is represented in the DUE TO relationship and the organism doing the infecting is in the axiom for the infectious process. The biting organism is currently represented in the event. While this represents a nested relationship, is there a compelling use case for it to be at the first level?
Penny Livesay
No, I don't think it's necessary to represent the biting organism at this first level in the template. As yet, it doesn't appear that the biting organism is actually represented in the event, as the event concepts in question are currently modeled without any such relationship per the Daily Build browser, but it would certainly be reasonable to represent the biter as the "causative agent" for the <animal> bite (event).
Past experience does lead me to believe it would be prudent to add explicit guidance on this point and (perhaps ideally) constrain the template for bite wound disorders to prevent the addition of a vertebrate, insect, or arachnid as the value for Causative agent. When different modelers can reasonably make different assumptions about how a given type of content should be modeled, it does generally lead to inconsistencies.