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Date: 2021-02-24

Time:

1830- 2000 UTC

1030-1200 PDT

Zoom Meeting Details

Hi there,

Jim Case is inviting you to a scheduled SNOMED International Zoom meeting.

Topic: SNOMED Editorial Advisory Group Conference Call
Time: This is a recurring meeting Meet anytime

Join from PC, Mac, Linux, iOS or Android:
https://snomed.zoom.us/j/99997961770?pwd=TWRiclpVeTU3RG1kUE1lTWNkVFBCZz09
Password: 287392

Meeting ID: 999 9796 1770

Password: 287392
International numbers available: https://snomed.zoom.us/u/abTbQn2e26

Or Skype for Business (Lync):
https://snomed.zoom.us/skype/99997961770


Meeting Files:

View file
nameConcept inactivation EAG 20210224.pptx
height250

Meeting minutes:

The call recording is located here.


Objectives

  • Obtain consensus on agenda items

Discussion items

ItemDescriptionOwnerNotesAction
1Call to order and role call

Start recording!


2

Conflicts of interest and agenda review


No conflicts noted



3FSN naming for "Pathologic neoplastic fractures"Jim Case

Search of the literature yielded very few references with a consensus naming for this type of fracture.  Search terms included:

  • "Neoplastic fracture"
  • "Neoplastic pathologic fracture"
  • "Metastatic fracture" 

As was agreed, these are not fractures DUE TO the neoplastic disease and have been modeled as co-occurrent. As there is no consensus naming for these, potential terming includes:

  • "Fracture of X with neoplastic disease"
  • "Fracture of X in neoplastic disease"
  • "Fracture of X co-occurrent with neoplastic disease"
  • "Neoplastic disease with pathologic fracture of X"
  • "Neoplastic fracture of X"
  • Other...

Discussion:

Consider "Fracture of X with neoplastic bone disease".  Is the neoplasm the cause of the weakened bone or is it possible that treatment or extranous condition resulted in the fracture? Prior uses implied that the neoplasm was in the bone.  Suggesed "Fracture of X with neoplasm of X ".  Treatments leading to osteoporosis could be classified under osteoporotic fractures.  Additional discussion  "Fracture of X at site of neoplasm" or "Pathologic fracture of X at site of neoplasm".

Decision:

Group consensus is to use "Pathologic fracture of X at site of neoplasm".

  •  Jim Case to implement decision on naming of Pathological fractures
4Concept Inactivation update and proposals

A presentation summarising the proposals detailed in the document 'Concept Inactivation - Proposed Amendments

A request for the members to review and feedback on the  document found on the Confluence web page: Concept Inactivation - Proposed Amendments

A short discussion on 'where do we go from here'

Discussion:

Presentation covered and EAG tasked with review of the document and comments for the next EAG Call.

  •  Paul Amos to post slides to agenda and minutes
  •  EAG members to review concets inactivaiton documentation and send comments to Paul Amos
5Glascow coma score and assessment scale components

Based on a discussion at the Anesthesia CRG and Observables Project there is a requirement to add more content

to express Glasgow coma scores. 

for Glasgow Coma Scale

Please see full discussion here: https://confluence.ihtsdotools.org/display/ACRGT/Glasgow+Coma+Score

Presentation included with this agenda item suggesting common observables definitions.

References to Standarization of the GCS:

https://zibs.nl/wiki/GlasgowComaScale-v3.2(2020EN)

https://ckm.openehr.org/ckm/archetypes/1013.1.137/printable

https://www.glasgowcomascale.org/

Draft document from Anesthesia CRG: https://drive.google.com/file/d/1lZJlarREeIIRPk5E1zVtZUktLQlPH3G5/view?usp=sharing

Discussions within Observables Project Group and and review of assessment scores deployed at Nebraska have proceeded with extended proposal for inclusion of assessment scales in use in Sweden as well as US.   

Modelling proposal added to Attachment

added

s summarizing Assessment Scale Score Observables development

with Observables Project and Deployment at Nebraska

: Clinical Scale Scores_

20210121.pptx

20210224.pptx.  Proposal promotes expanding content model for full definition of scales such as co-morbidity, Glasgow Coma Scale and SOFA scores.

Anesthesia CRG wishes to explore further the best model for including definitions/explanations of Ordinal Scale score Value sets used in calculated scores.

Discussion:

Ongoing discussions with anesthesia and Observables groups.  Scope expanded.  Continued to the nest meeting.

  •  James R. Campbell and Andrew Norton to provide example of observables for assessment scales
  •  EAG to review document for examples of findings that clinicians would like to see
Modeling "without" conceptsYongsheng Gao

Options for modeling concepts containing the term "without" in the absence of negation in the DL profile.

Prior discussions suggested that these terms may have clinical utility and should be retained in spite of their limitations.  The CMAG has been asked to provide usage data to see if they are of actual use.  

Discussion:

Suggestions have been made to allow for additional DL properties by Alejandro Lopez Osornio or to create a new attribute by Yongsheng Gao.

What does without mean?  Is it truly logical negation?  There are two meanings, one is not A, but the other is A without B.

6ECE TopicsBruce Goldberg
  • Additional considerations for disorder association modeling
  • Updated model for contact dermatitis

Discussion: 

Suggested that the use of DUE TO be constrained to the immediate cause as opposed to the entire causal chain. Combined disorders would always be considered co-occurrent. 

Modeling of multiple CLINICAL COURSE:  For concepts where there are two clinical courses required, suggest adding the clinical course to each of the RGs representing the combined disorders.   Some issues are whether the existing terms actually represent a proper term, such as an acute disorder due to a recurrent disorder. (Presentation is always acute).

Including CLINICAL COURSE in the RG would require remodeling of many thousands of existing concepts. 

Question regarding adding the DUE TO relationship to RGs as well.  This requires additional discussion. 

Contact dermatitis discussion continued to next call in March 2021

Decision:

Combined disorders would be modeled as co-occurrent and a DUE TO relationship will be added for the immediate cause, if applicable.

7
KCA: Support that “without” does not mean logical negation, it is rather an absence of a measurable/observable thing.
Evaluation to Observables (E2O project) update
James R.

Daniel Karlsson@James Campbell

Current status of project to coalesce evaluation procedures and Observable entities

Attachment summarizing project added: Migration of Evaluation Procedures to Observables Inception-Elaboration.docx

Discussion:

Looking at common laboratory procedures.  Around 7,000 measurement concepts are being looked at (those with "Measurement - action") . A template is being developed to allow for an automated or batch process to convert existing evaluation procedures to Observable entities.

  • Proposal for transfer of concepts from <<Evaluation Procedures to Observable entities under going model development in Protege for Phase 1 (Lab testing procedures) in order to test hierarchy build and revisions.

8Congenital aplasia modeling reduxJim Case

Issues observed with inferences based on the original proposal have arisen that require a revised modeling pattern.  Discussion located at: 

Re: Proposed remodeling of Congenital absence concepts - For discussion (revised)

  •  EAG members to review changes and comment.
9
ECE TopicsBruce Goldberg
  • Additional considerations for disorder association modeling
  • Updated model for contact dermatitis
  •   
Next meetingEAG

March 24, 2021