Descriptions:
| Term | Description type | Language/acceptability | Language/acceptability | Case significance |
|---|---|---|---|---|
| Reconstruction of [Body structure] using [action1] [agent] (procedure) | FSN | us:P | gb:P | ci |
| Reconstruction of [Body structure] using [action1] [agent] | SYN | us:P | gb:P | ci |
| Reconstruction of [Body structure] with [action1] [agent] | SYN | us:A | gb:A | ci |
| [action1] [agent] reconstruction of [Body structure] (optional term) | SYN | us:A | gb:A | ci |
Concept model:
| Attribute Group Cardinality | Attribute cardinality | Attribute in Group Cardinality | Attribute | Value |
|---|---|---|---|---|
| 0..0 | 1..1 | |||
| 0..1 | 0..1 | |||
| 1..* | 0..1 | [Body structure] < 442083009 |Anatomical or acquired body structure (body structure)| | ||
| 1..1 | ||||
| 1..1 | [agent] << 256683004 |Flap (substance)| | |||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 | ||||
| 0..* | 1..1 | |||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 | ||||
| 0..1 |
Definition status:
Applies To:
<<
1202018003 |Reconstruction using flap (procedure)|
OR (<<
71388002 |Procedure (procedure)|
:
260686004 |Method (attribute)|
= <<
360032005 |Flap reconstruction - action (qualifier value)|
)
Template language:
[[~0..1]]{
[[~1..1]] 363702006 |Has focus (attribute)| = [[+id(< 404684003 |Clinical finding (finding)| )]]}
[[~1..* @reconstructionGroup]]{
[[~1..1]] 260686004 |Method (attribute)| = [[+id(<< 360032005 |Flap reconstruction - action (qualifier value)| )@flapprocedure]],
[[~0..1]] 405813007 |Procedure site - Direct (attribute)| = [[+id(< 442083009 |Anatomical or acquired body structure (body structure)| )@bodyStructure]],
[[~1..1]] 363701004 |Direct substance (attribute)| = [[+id(<< 256683004 |Flap (substance)| )@agent]],
[[~0..1]] 260507000 |Access (attribute)| = [[+id(< 309795001 |Surgical access values (qualifier value)| )]],
[[~0..1]] 424876005 |Surgical approach (attribute)| = [[+id (< 103379005 |Procedural approach (qualifier value)| )]],
[[~0..1]] 363700003 |Direct morphology (attribute)| = [[+id(< 49755003 |Morphologically abnormal structure (morphologic abnormality)| )@morphology]]}
[[~0..* @actionGroup]]{
[[~1..1]] 260686004 |Method (attribute)| = [[+id(< 129264002 |Action| )]],
[[~0..1]] 405813007 |Procedure site - Direct (attribute)| = [[+id(< 91723000 |Anatomical structure (body structure)| )]],
[[~0..1]] 260507000 |Access (attribute)| = [[+id(< 309795001 |Surgical access values (qualifier value)| )]],
[[~0..1]] 424876005 |Surgical approach (attribute)| = [[+id (< 103379005 |Procedural approach (qualifier value)| )]],
[[~0..1]] 405814001 |Procedure site - Indirect (attribute)| = [[+id(< 91723000 |Anatomical structure (body structure)| )]],
[[~0..1]] 363701004 |Direct substance (attribute)| = [[+id (<< 105590001 |Substance (substance)| )]],
[[~0..1]] 363699004 |Direct device (attribute)| = [[+id(< 49062001 |Device (physical object)| )]],
[[~0..1]] 363700003 |Direct morphology (attribute)| = [[+id(< 49755003 |Morphologically abnormal structure (morphologic abnormality)| )]],
[[~0..1]] 424226004 |Using device (attribute)| = [[+id(< 49062001 |Device (physical object)| )]]}
Link to the misaligned concept report:
https://docs.google.com/spreadsheets/d/1H1otmIkrcBo80mcqZ3A1wrxR07BXwLFkaNlXReUyOsY/edit#gid=0
Rules for description generation:
- Apply General rules for generating descriptions for templates;
- Apply Enhancements for the Template Language;
- Description rules for the combination of method and flap;
| Method | Process agent value | Pattern generated description | example |
|---|---|---|---|
| 1193841002 |Local flap reconstruction - action (qualifier value)| | remove 'flap (substance)' | local + [processedAgentValue] + 'flap' | local flap |
| 1193851001 |Local flap reconstruction by advancement - action (qualifier value)| | remove 'flap (substance)' | 'local' + [processedAgentValue] + 'advancement flap' | local fascial advancement flap |
| 1193842009 |Local flap reconstruction by rotation - action (qualifier value)| | remove 'flap (substance)' | 'local' + [processedAgentValue] + 'rotation flap' | local muscle rotation flap |
| 1196931005 |Local flap reconstruction by transposition - action (qualifier value)| | remove 'flap (substance)' | 'local' + [processedAgentValue] + 'transposition flap' | local fascial transposition flap |
| 1204227006 |Local flap reconstruction by rotation advancement technique - action (qualifier value)| | remove 'flap (substance)' | 'local' + [processedAgentValue] + 'rotation advancement flap' | local rotation advancement flap |
| 1193839003 |Distant flap reconstruction - action (qualifier value)| | remove 'flap (substance)' | 'distant' + [processedAgentValue] + 'flap' | distant myocutaneous flap |
| 1196928009 |Regional flap reconstruction - action (qualifier value)| | remove 'flap (substance)' | 'regional' + [processedAgentValue] + 'flap' | regional flap |
** if body site is intrinsic to the flap substance type no need to repeat in description and specify where harvested from.
JIRA ticket:
INFRA-9180 - Getting issue details... STATUS
21 Comments
Nicola Ingram
Fast Track document IHTSDO- 1125 Fast Track - Flap procedures
Nicola Ingram
Yongsheng Gao can you review my flap procedures Template please.
Yongsheng Gao
Hi Nicola Ingram I added my comments about the semantic differences between the approach by single role group vs. two role groups under the fast track document.
Nicola Ingram
Yongsheng Gaothanks you for your comments on the Fast Track document which have helped me to further improve the model.
I have removed the optional 2nd role group I added to this Template as there are very very few flap procedures that require this and I will deal with them separately.
Yongsheng Gao
Hi Nicola Ingram, I have extended the domain to include all procedures modelled by the flap reconstruction action. It increases the results from 178 to 395 concept against the main. The rule for description need to enhanced to cover how to include the method, e.g. local/distant in the descriptions. Do we really need to populate all descriptions in synonyms because of word order and use of 'with' or 'using'? The default for the template specification would require to populate all different forms. Or are they optional and allowed term patterns? So we do not need to populate all of them. Please also provide the link to the template compliance report.
Nicola Ingram
Yongsheng Gao Sounds good. Will update the template descriptions to include local/distant. Yes they are optional and allowed term patterns so we do not need to populate all of them. Will provide the link shortly.
Yongsheng Gaothanks for running the compliance report I have added the link -running against the project too as I have already done a lot of work
Yongsheng Gao
Nicola Ingram I would suggest the following pattern and rules:
Term pattern: Reconstruction of [morphology] of [body structure] using [method] [agent]
Rule for generating descriptions:
When method = Flap reconstruction - action, the method slot can be omitted.
e.g. Reconstruction of 'head' using 'skin flap'
When method has value < Flap reconstruction - action, the terms should be used for descriptions:
e.g. Reconstruction 'head' using 'local' 'skin flap'
e.g. Reconstruction of 'defect' of 'mouth' using 'local pedicled' 'flap'
The complexity is to combine method and agent for specific method,
The following value should be divided into two parts. The first part is placed following the pattern. The second part is placed after the agent.
e.g. Reconstruction using 'local' 'skin flap' 'by rotation'
You can test if the pattern and the similar rules could cover most descriptions.
Please carry on the revision of modeling. The description pattern and rules should not stop your QI work.
Cheers,
Yong
Nicola Ingram
Yongsheng Gaoagree skin flap - have not remodelled that area yetI have remodelled the areas of local rotation flap, local advancement flap and local transposition flap, re-terming did not take place unless urgently required but here are some examples that were done (recipient site unknown):
1197017000 |Reconstruction using local skin rotation flap (procedure)|
1197216003 |Reconstruction using local advancement flap (procedure)| - if the flap composition is specified would be e.g. Reconstruction using local fasciocutaneous advancement flap (procedure)|
Here is the terming agreed with Jim from the Fast Track (but can agree to making 2 descriptions optional):
b. Flap reconstruction site known: FSN Reconstruction of x body structure using y flap (procedure) PT Reconstruction of x body structure using y flap SYN x body structure reconstruction using y flap SYN Reconstruction of x body structure with y flap SYN y flap reconstruction of x body structure
Proposed example: FSN Reconstruction of breast using free flap (procedure)| PT Reconstruction of breast using free flap SYN Breast reconstruction using free flap SYN Reconstruction of breast with free flap SYN Free flap reconstruction of breast
I will change the descriptions above to align with the Fast Track.
Nicola Ingram
Yongsheng Gao I have done more work on this area and updated the Template - please re-review. Thanks.
Nicola Ingram
May still need to work on descriptions..
Example -Reconstruction of [Body structure] using action part 1 = (distant or local), [(( axial pattern or random pattern) (subcutaneous) (pedicle) , [action part 2 = (advancement or rotation or transposition or pedicle island or pedicle V-Y) )] agent (myocutaneous etc)] flap (procedure)
No body structure example:
Reconstruction using local axial pattern subcutaneous pedicle island flap (procedure)
Reconstruction using local subcutaneous pedicle myocutaneous flap (procedure)|
Nicola Ingram
Per GC-1018 - Getting issue details... STATUS final terming example:1204266003 |Reconstruction of skin using local subcutaneous pedicle island random pattern skin flap (procedure)|
Nicola Ingram
Yongsheng Gao have added some rows to my Template - can you review please.
Note - just ran in the Reporting Platform and working well.
Yongsheng Gao
Hi Nicola Ingram, I added a new rule for generating the descriptions. Please check if any further improvement is needed. The additional role group is very generic at the moment. Should the second role group represent harvesting the flap? e.g. direct substance = << 256683004 |Flap (substance)| and method = 1193917004 |Flap creation - action (qualifier value)|
Nicola Ingram
Yongsheng Gaothere are several different actions in addition to 1193917004 |Flap creation - action (qualifier value)| that are correct in a second role group e.g.
272381008 |Microvascular anastomosis - action (qualifier value)|
129304002 |Excision - action (qualifier value)|
282089006 |Replacement - action (qualifier value)|
Nicola Ingram
Yongsheng Gaoall looks OK to me.
Yongsheng Gao
Hi Nicola Ingram, if we allow those additional actions, the second role group is for a generic procedure. This means that the template is no longer a specific template for reconstruction using flap with or without harvesting flap. It can be a flap procedure with other procedures. Therefore, the template alignment query needs to include the complex cases. There are about 50 concepts failed. Please have a look if they can be resolved.
Nicola Ingram
Yongsheng Gao will check those 50 for improvement possibilities. Thanks
Nicola Ingram
Yongsheng Gao following the remodel of the complex procedures I have now re-run the (complex procedure) report last night only 12 concepts found not in compliance and all as expected.
Are you able to complete the review of my Template now - thanks.
Yongsheng Gao
Hi Nicola Ingram, The template is ready for implementation now. I think it might be useful for content authoring to create a sub-temple that is dedicated to flap operations only. The second role group is optional for the creation of the flaps with an editorial guide on when the second role group should be added.
Nicola Ingram
Yongsheng Gao I have created a sub-temple that is dedicated to flap operations only and has a second role group for the creation of a flap. For this Template will rename 2nd RG (currently @harvestGroup now used on sub template)
Changed method in 2nd RG to match Template <<129264002 |Action|
Yongsheng Gao
Hi Nicola Ingram , please add a link to the template alignment report.