Briefing Note - Duplicate concepts in the computed tomography imaging hierarchy

I assume the combined concepts that don't have a duplicate will be remodeled to the guidance model?

For example 419734005 |Computed tomography and biopsy of thyroid (procedure)|

I agree with Elze! Inactivation is necessary to avoid confusion and discussions, but it is essential to (re)model comined procedure concepts in case of no duplicates

Elze de Groot Katrien Scheerlinck- Yes, that is the plan. Thank you for pointing that out. I ought to have included that in the note. Sorry, I did not make that clear. In every instance, if a corresponding CT guided procedure does not exist, it will be authored and the inactive will be noted SAME AS the new concept. many thanks, Monica

Hi Monica,  Our team has discussed such terms before with our Radiology expert.  We do not see these as duplicates.  For concepts like "Computed tomography and <procedure>" the modeling and is-a relationship is pointing to a "diagnostic CT imaging protocol" which is different than guidance.  I agree these should be inactivated, however, would suggest using ambiguous as the reason, since it is unclear what they are meant to represent.  Thank you!

I agree with Jeff Piersonthat these are probably more ambiguous than duplicate... Is the CT diagnostic or guidance? (Though I'm not a radiology SME)

Also, the proposed solution "the combined procedure pattern, concepts modelled as combined procedures will be inactivated as duplicate with replacement values pointing to the individual procedures" doesn't match with any of the examples in the paper.

It seems like the proposed solution should actually "the combined procedure pattern, concepts modelled as combined procedures will be inactivated as duplicate with replacement values pointing to the CT guided procedure". (Though as above, consider swapping duplicate for ambiguous).

Or it could be to replaced by the guided procedure and both "individual" procedures?

It also seems like pattern/template should isn't specific to CT imaging, and could just apply to most concepts that are some imaging procedure combing with a non-imaging intervention procedure.
ie. something like (<363679005 minus <258174001) AND (<71388002:260686004=(ANY MINUS <<360037004))

We obtained input from our radiology expert who advised that they understand this approach and agree with your argument. 

(I suppose in a case like this, a question should be asked, is there a difference in terms how the procedure is performed, between for example  Computed tomography and drainage of chest and Drainage of thorax using computed tomography guidance ? if  this is performed in the same way then there is no reason for two different codes.)

Thank you, Anna