SNOMED CT Templates

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StatusIn PROD
Version

1.0

Replaced by version

2.0

Descriptions:

Termdescription typeLanguage/acceptabilityLanguage/acceptabilityCase Significance

[Access] [Approach] insertion of stent into [body structure] using [imaging] guidance with [contrast] (procedure)

FSNus:Pgb:Pci
[Access] [Approach] insertion of stent into [body structure] using [imaging] guidance with [contrast]PTus:Pgb:Pci

example: 397057006 |Insertion of stent into femoral vein (procedure)|


Concept model:

Attribute Group CardinalityAttribute cardinality

Attribute in Group Cardinality

AttributeValue
0..01..10..0


116680003 |Is a (attribute)|


71388002 |Procedure (procedure)|

0..1
1..1

260686004 |Method (attribute)|

[imaging] <<   360037004 |Imaging - action (qualifier value)|   


0..1

405813007 |Procedure site - Direct (attribute)|

<   442083009 |Anatomical or acquired body structure (body structure)|


1..1

363703001 |Has intent (attribute)|

429892002 |Guidance intent (qualifier value)|


0..1

1..1
1..1


260686004 |Method (attribute)|


<<  257867005 |Insertion - action (qualifier value)|


0..1


405814001 |Procedure site - Indirect (attribute)|


[body structure] <  442083009 |Anatomical or acquired body structure (body structure)|


1..1

363699004 |Direct device (attribute)|

<<  65818007 |Stent (physical object)|


0..1

260507000 |Access (attribute)|

[access] <<  309795001 |Surgical access values (qualifier value)|


0..1

[approach] <  103379005 |Procedural approach (qualifier value)|


0..1

425391005 |Using access device (attribute)|

<<  37270008 |Endoscope, device (physical object)|

Definition status:  


900000000000073002 |Defined (core metadata concept)|

Applies to:


Template language:


71388002 |Procedure (procedure)|   : 
[[~0..1]]{
[[~1..1]]   260686004 |Method (attribute)|   = [[+id(<<  360037004 |Imaging - action (qualifier value)|   ) @imaging]],
[[~0..1]]   405813007 |Procedure site - Direct (attribute)|   = [[+id(<  442083009 |Anatomical or acquired body structure (body structure)|   ) @bodyStructure]],
[[~1..1]]   363703001 |Has intent (attribute)|   =   429892002 |Guidance intent (qualifier value)|   ,
[[~0..1]]   424361007 |Using substance (attribute)|   = [[+id(<<  385420005 |Contrast media (substance)|   ) @contrast]]
}, 
[[~1..1]]{ 
[[~1..1]]   260686004 |Method (attribute)|   = [[+id (<<  257867005 |Insertion - action (qualifier value)|  )]], 
[[~0..1]]   260507000 |Access (attribute)|   = [[+id (<<  309795001 |Surgical access values (qualifier value)| ) @access ]], 
[[~0..1]]   405814001 |Procedure site - Indirect (attribute)|   = [[+id (<  442083009 |Anatomical or acquired body structure (body structure)|   ) @bodyStructure]], 
[[~1..1]]   363699004 |Direct device (attribute)|   = [[+id (<<  65818007 |Stent (physical object)|   )]],
[[~0..1]]   425391005 |Using access device (attribute)|   = [[+id (<<  37270008 |Endoscope, device (physical object)|   )]], 
[[~0..1]]   424876005 |Surgical approach (attribute)|  = [[+id(<  103379005 |Procedural approach (qualifier value)|  ) @approach]]}

Link to the misaligned concept report:

https://docs.google.com/spreadsheets/d/13rIHdE7jxc8qgDwZqaY0CrzizoJKoFIBQLcqfN6GBTQ/edit?pli=1#gid=0

Rules for description generation: 

  1. Apply General rules for generating descriptions for templates;
  2. Apply Enhancements for the Template Language;

JIRA ticket:

INFRA-9835 - Getting issue details... STATUS






20 Comments

  1. Elaine Wooler

    There is a seperate template for Fluoroscopic angiography and insertion of stent.

  2. Elaine Wooler

    Hi Yongsheng Gao could you have a look at this template please when you can.  Access and surgical approach added to allow for percutaneous transluminal/endovascular procedures as previously discussed.  These would also be modelled with 425362007 |Surgical insertion - action (qualifier value)|

    Thanks

    Elaine

    1. Yongsheng Gao

      Hi Elaine Wooler It looks good and I only updated the cardinality in the language section to align with the model. Please run the template alignment report and add the link. 

      Cheers,

      Yong

  3. Elaine Wooler

    Hi Yongsheng Gao  I've added in USING ACCESS DEVICE as there were a number of endoscopic procedures in the misaligned.  Updated template and reran misaligned.  If you can have a look when able thanks.

    1. Yongsheng Gao

      Hi Elaine Wooler , I have updated the ranges to align the model and template language. There are about 20 procedures for aneurysms. They could be excluded from the template and addressed separately e.g. domain: << 103716009 |Placement of stent (procedure)| MINUS (<< 103716009 |Placement of stent (procedure)| : << 363700003 |Direct morphology (attribute)| = *). Alternatively, a new optional role group would be needed.

  4. Elaine Wooler

    Thanks Yongsheng Gao I'll exclude aneurysms from this and update the domain range.

  5. Elaine Wooler

    Hi Yongsheng Gao This is ready for implementation if you can take a final check please.

    1. Yongsheng Gao

      Hi Elaine Wooler , I have simplified the ECL expression for the domain and made the following changes:

      425391005 |Using access device (attribute)|  = [[+id (<< 37270008 |Endoscope, device (physical object)|  )]] is also presented in the imaging guidance group. This will need to be checked with the Endoscopic procedure model. The option is to exclude endoscopic procedures in the domain constraint. So, the concept model will be checked by the endoscopic procedure template. e.g. 433134004 |Endoscopic retrograde cholangiopancreatography with insertion of biliary plastic stent using fluoroscopic guidance (procedure)|

      Procedures modelled by morphology are not covered in this template. The domain constraint is changed to |Procedure morphology| to exclude procedures with indirect morphology. 

      The constraint |Percutaneous approach - access| on |Access (attribute)| has been extended to 309795001 |Surgical access values (qualifier value)| to cover the open insertion of a stent, e.g. Open insertion of bile duct stent (procedure)

      Then, the misalignments are reduced from 23 to 7 concepts for the updated template. Please address these misalignments or mark them as expectations if no further changes to the template. 


  6. Elaine Wooler

    Hi Yongsheng Gao 

    One concept needed editing the remainder are expected exceptions.  Not on main yet as QI project not yet promoted.  But you can see https://docs.google.com/spreadsheets/d/1HGAzLuqVAqM8cdq_XBcYmhijQQK4-6WQ10Nc9NT3AV0/edit#gid=0

    All ready to go.

    Thanks.

    1. Yongsheng Gao

      Hi Elaine Wooler  It is handed over to the technical team now. 

      Cheers,

      Yong


  7. Elaine Wooler

    Hi Yongsheng Gao I was just trying to use this in production template but the template has been added with a mandatory imaging RG and it should be optional.  Can you request the change or can I?

    1. Yongsheng Gao

      Hi Elaine Wooler  You can raise a ticket from the authoring platform and ask the technical team to fix the issue. 

  8. Peter G. Williams

    Hmm, I think I've written this elsewhere but I can't find it now.

    103716009 |Placement of stent (procedure)|  has been inactivated and replaced with 1296925008 |Insertion of stent (procedure)|.  Can that be replaced in the "Applies To" section above please Elaine Wooler and then we can get that pushed through to Production and clear the template error being reported in our QI Stats see INFRA-12629.   Thanks!

  9. Elaine Wooler

    Ah should have realised, have changed and will also request the mandatory imaging group is changed to optional.

    Yongsheng Gao Peter G. Williams 

    1. Yongsheng Gao

      Hi Elaine Wooler  I have created a new version 1.1 for this. It is not as straightforward as I thought. There are about 50 concepts that are not aligned after the domain update. Could you please review the report and check if any further changes are needed for the updated template?

  10. Elaine Wooler

    Hi Yongsheng Gao I'll have a look thanks.  I've made the request to have the imaging RG optional.

  11. Elaine Wooler

    Hi Yongsheng Gao 

    We had agreed to add in the domain constraint  |Procedure morphology| to exclude procedures with indirect morphology.  Once I add this in to ECL the number reduces to 30.

    https://docs.google.com/spreadsheets/d/1zpapqmVlwrbGrKEoXuGB5BBjuMvDpavEVURQBlsdBKU/edit#gid=0

    Then on reviewing the majority of the concepts that are misaligned, this is because of DIRECT DEVICE being added to the imaging RG late last year for these concepts.  I suppose if we view the imaging guidance as primarily for the insertion of the device then this is appropriate and we can add DIRECT DEVICE as optional in the imaging RG of this template. Let me know what you think.

    I've asked the tech team to pause the update requested regarding the optional imaging group as looks like we will be implementing a new version of the template.

    1. Yongsheng Gao

      Hi Elaine Wooler  great analysis. The direct device can be optional for the imaging guidance role group. I have updated the template v1.2 to include this attribute and restriction on the domain. There are only 7 misaligned concepts that have been covered by your review. I do not see any reason why "has intent" should not be included in 429806006 Fluoroscopic dacryocystography with insertion of stent (procedure). If you can fix this concept. Then, the new template should be good for implementation. 

  12. Elaine Wooler

    Thanks Yongsheng Gao fixed the concept in DAILYPROMO-6912 and misaligned reduced to 6 (smile)

    1. Yongsheng Gao

      Thanks Elaine Wooler  the new version of Insertion of stent (procedure) - v2.0 has been submitted to the technical team for implementation.