Time:
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1230 - 1600 UTC
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Meeting minutes:
The call recording is located
here.
Objectives
- Obtain consensus on agenda items
Discussion items
| Item | Description | Owner | Notes | Action |
|---|---|---|---|---|
| 1 | Call to order and role call | This meeting is being recorded to ensure that important discussion points are not missed in the minutes. The recording will be available to the SNOMED International community. Joining the meeting by accepting the Zoom prompt declares that you have no objection to your comments being recorded | ||
| 2 | Conflicts of interest and agenda review | None recorded | ||
| 3 | Update on "Abnormality of X" | Discussion page at Re: Proper terming of "Abnormality of X (body structure)". After reviewing HPO content that generated this issue, SNOMED will be looking to add these concepts as "Structural abnormality of X" for precision for HPO terms that refer to morphology. If the abnormality is also modeled as a congenital disorder, the FSN will include the word "congenital" in the FSN (e.g. "Congenital structural abnormality of bone"). For those HPO concepts that group both functional and structural abnormalities, they will be left in that form, e.g. HPO - Abnormality of the gastrointestinal tract has subtypes "Abnormal gastrointestinal tract morphology" and "Functional abnormality of the gastrointestinal tract". To account for both the structural and functional abnormalities, the grouper concepts will be modeled with GCIs to represent the functional and structural models for the appropriate subtypes. Early testing of approaches for these grouper concepts has exposed an issue with the Functional disorder hierarchy and will need to be addressed in later tasks. The focus for this issue is the terming for HPO concepts that represent structural abnormalities. Discussion: Seeking consensus for the terming approach. Decision: | ||
| 3 | Bypass graft and shunt modeling proposal update | The analysis paper: Review of 48537004 |Bypass graft (procedure)| v0.2.0 is attached to this agenda. Previous discussion resulted in suggested edits to the following revised definitions:
It was also proposed that the concepts 360021005 |Bypass - action (qualifier value)| and 424208002 |Shunt - action (qualifier value)| would be inactivated. However, upon further testing, there were situations where the use of these two concepts were useful. Alternative solutions are provided. Discussion: Decision: | ||
| 4 | Endoscopy and endoscopic procedures | An analysis document "Endoscopy, endoscopic procedure and related procedures" is attached for discussion. The consistent distinction between an endoscopy and an endoscopic procedure is inconsistently represented as the initial distinction was made based on whether a procedure other than visualization was performed. This is a difficult distinction to make as it is unknown when an endoscopy is performed whether an additional procedure will be added (such as a biopsy). The proposal seeks to eliminate this false distinction as well as propose other modeling changes for this hierarchy. Discussion: Decision: | ||
| 5 | Replacement procedures | An analysis document "Review of the replacement procedure hierarchy" is attached for discussion. The issues related to the use of a single concept "Replacement - action" to model replacement procedures are discussed an alternative modeling constructs proposed. Consistent use of the Procedure site attributes for Replacement procedures is also discussed. Discussion: Decision: | ||
| 6 | Conversion procedures | Conversion procedures primarily in the orthopedic space have been historically represented as two separate concepts: i.e. "Conversion from X" and "Conversion to X". This mimics the approach taken in OPCS4 and was done ostensibly to prevent a large combinatorial explosion of terms that represented both aspects of a conversion procedure. Recently SNOMED International has received requests for combined conversion procedures (e.g. Conversion from X to Y"). There are currently: 39 "conversion from" orthopedic concepts 44 "conversion to" orthopedic concepts There are also conversion procedures related to laparoscopy where a procedure is converted from laparoscopic to open, as well as other procedures unrelated to the orthopedic domain. The question to be answered is whether SNOMED should continue to represent orthopedic conversions using two concepts or whether we would allow combined conversion procedures? The affected concepts are listed in the attached worksheet. The number of combined concepts would not be a cross product of conversion from and conversion to concepts (i.e. 39 x 44 = 1716) as many are site specific. For knee, for example it would be 4 x 6 = 24 combined concepts; for hip it would be 6 x 6 = 36 combined concepts, etc. Discussion: Decision: | ||
| Cellulitis | Jim Case | Cellulitis is most commonly caused by a bacterial infection; however, there are cases where it can be caused by fungal infections or even non-infectious causes. The majority of definitions of cellulitis refer to it as a result of a bacterial infection as that is by far the most common clinical presentation. SNOMED currently has 234 concepts under 128045006 |Cellulitis (disorder)| including a subconcept of 402929007 |Bacterial cellulitis (disorder)|. Most concepts just state "cellulitis of X" resulting in the lack of subsumption under "Bacterial infectious disease". It has been noted in the literature that the use of the term "cellulitis" in cases other than bacterial infections is a misnomer. In many cases the causative agent is unable to be identified, so the disease is diagnosed on clinical signs and response to therapy. Given the rarity of non-bacterial cellulitis conditions:
It is proposed that the current top level concept 128045006 |Cellulitis (disorder)| be retained in order to group the non-bacterial types under a common header. References: https://jamanetwork.com/journals/jama/article-abstract/2533510 "Cellulitis is a bacterial infection of the skin, presenting with poorly demarcated erythema, edema, warmth, and tenderness." https://www.njmonline.nl/cntpdf.php?t=i&id=210#page=6 "Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired." https://www.medical.theclinics.com/article/S0025-7125(21)00047-X/abstract "Cellulitis is a skin infection typically precipitated by entry of bacteria through a breach in the skin barrier" https://www.clinicalkey.com/#!/content/clinical_overview/67-s2.0-7dabbf3c-ea31-4472-8aea-72dc2b003cab"Cellulitis is a spreading, acute bacterial skin infection of the dermal and subcutaneous tissue that presents clinically with skin erythema, calor, induration, and tenderness" https://pmc.ncbi.nlm.nih.gov/articles/PMC5466351/ Fungal orbital cellulitis https://pmc.ncbi.nlm.nih.gov/articles/PMC10058517/ Aseptic orbital cellulitis Discussion: Decision: | ||
10 | AOB | EAG | ||
| 11 | Next meeting |
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