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Date & Time

10:00 to 11:00 UTC, Thursday 13th July 2023

Location

Zoom meeting link

Goals

  • Review draft ECL Guide updates for ECL 2.2 enhancements: Alternate Identifiers (LOINC) and top/bottom operators (GPS)
  • Any other topics

Attendees 


Agenda and Meeting Notes

Advanced Tables - Table Plus
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Description

Owner

Notes

Welcome and agenda

All


Any feedback on syntax changes

All


LOINC semantics update

All

Following:

  • Concerns about the semantics of LOINC:
    • We need to understand the semantics of the LOINC SNOMED CT Edition so that we can provide advice about how these LOINC alternate identifiers in ECL should be used. Kai Kewley to contact Jim more information. Should LOINC attributes be used?
    • DK- The LOINC domain is fairly flat.
      • Subtypes may come in when one concept may have a method specified and another code is very similar but does not have method specified.
      • Loinc parts may also have subsumption 

Review Draft ECL Guide Updates

All

Topics for Oct Conference

All
  • DK: Discussion of postcoordination transformations for Level 1+ or Level 2
    • use of template language?
    • Transformation choice interactive?
  • KK: PCE expression maintenance
  • JR: History supplements - Deprecate the WAS-A historic association? Causes implementation issues.
    • Bring in other groups? Editorial EAG
The items below are currently on hold
URIs for language instances


ON HOLD
ECL v2.1 - Requirement proposals (to be archived)All

ON HOLD -

Potential requirements for ECL v2.1 - Discussion and brainstorming

  • Daniel's comments
  • Context supplements - e.g.
    • << 56265001 |Heart disease|  {{ + CONTEXT }} – This syntax is too general, as there is a risk of including absent finding, not-done procedure and family history
    • << 56265001 |Heart disease| {{ + CONTEXT-DEFAULT }} ? – What would this mean?
      • Brief form:
        • [[@ecl_query]] {{ + Context (Temporal = [[ @temporal_value]] }}
      • Expanded form:
        • [[ @ecl_query ]] OR  (< 243796009 |Situation with explicit context|:
                  { ( 246090004 |Associated finding| = ( [[ @ecl_query ]] ) 
                         OR |Associated procedure| = ( [[ @ecl_query ]] )
                   ( |Procedure context| = |Done| OR |Finding context| = |Known present|),
                      |Subject relationship context| = |Subject of record|,
                       |Temporal context| = [[ @temporal_value ]] } )
      • Example 1: << |Heart procedure| {{ + Context (Temporal = *) }}
        • <<  |Heart procedure| OR  (< 243796009 |Situation with explicit context|:
                  { 246090004 |Associated finding| = << 56265001 |Heart disease|,
                      |Procedure context| = |Done|,
                      |Subject relationship context| = |Subject of record|,
                       |Temporal context| = * } )
        • Example 2: (<< |Heart disease| OR << |Heart procedure| ) {{ + Context (Temporal = *) }}
          • <<  |Heart procedure| OR  (< 243796009 |Situation with explicit context|:
                    { ( 246090004 |Associated finding| = (<< |Heart disease| OR << |Heart procedure| ) 
                           OR |Associated procedure| = ( << |Heart disease| OR << |Heart procedure| ) )
                        ( |Procedure context| = |Done| OR |Finding context| = |Known present|),
                        |Subject relationship context| = |Subject of record|,
                         |Temporal context| = * } )
      • << 56265001 |Heart disease| {{ + Context (Temporal = *, FindingContext=<<|Known present| }}
        • Will return all types of heart disease, plus concepts like 394886001 |Suspected heart disease (situation)|, and 429007001 |History of cardiac arrest (situation)|
        • Expands to: 
          • << 56265001 |Heart disease| OR
              (< 243796009 |Situation with explicit context|:
                    { 246090004 |Associated finding| = << 56265001 |Heart disease| } )


    • However, you may want to exclude (or include) specific contexts - for example:
      1. To ensure that the finding was about the subject of the record (and not a family history, e.g. to exclude 429959009 |Family history of heart failure (situation)|), you could say:
        • << 56265001 |Heart disease|  {{ + CONTEXT (relationship = 410604004 |Subject of record| }}
      2. To ensure that the finding was 'Known present' (e.g. to exclude 394926003 |Heart disease excluded (situation)|), you could say:
        • << 56265001 |Heart disease|  {{ + CONTEXT (finding_context = << 410515003 |Known present| }}
      3. To ensure that the finding was about the subject of the record AND known present, you could say:
        • << 56265001 |Heart disease|  {{ + CONTEXT (relationship = 410604004 |Subject of record|, 
                                                                                                    finding_context = << 410515003 |Known present| }}
      4. ?? Is there any use case for restricting adding temporal context? (e.g. temporal != << 410513005 |In the past|)
    • Is any more syntactic sugar required? E.g.
      • {{ + CONTEXT (relationship = self, finding context = present, temporal != past) }}
      • {{ + CONTEXT (self, present, ! past) }}
    • Other ideas? Common profiles?
  • --------------------------
  • Ability to return attribute types (see proposal below)
    • [ attributes ] << 125605004 |Fracture of bone (disorder)|
    • << 125605004 |Fracture of bone (disorder)| . Attributes
    • << 125605004 |Fracture of bone (disorder)| . (<< 125605004 |Fracture of bone (disorder)| . Attributes )
    • [ attribute, value] << 125605004 |Fracture of bone (disorder)|
  • -------------------------
  • Reverse membership (see below)
    • Which reference sets "contain" the given concept(s) - e.g. 421235005 |Structure of femur|?
      • 421235005 |Structure of femur| . Refsets
      • 421235005 |Structure of femur|. Refsets [ referencedComponentId ]
      • 421235005 |Structure of femur| . Refsets [ targetComponentId ]
  • --------------------------
  • Other?
Returning AttributesMichael Lawley

ON HOLD -

  • Currently ECL expressions can match (return) concepts that are either the source or the target of a relationship triple (target is accessed via the 'reverse' notation or 'dot notation', but not the relationship type (ie attribute name) itself. 

For example, I can write: 

<< 404684003|Clinical finding| : 363698007|Finding site| = <<66019005|Limb structure| 

<< 404684003|Clinical finding| . 363698007|Finding site| 

But I can't get all the attribute names that are used by << 404684003|Clinical finding| 

    • Perhaps something like:
      • ? R.type ? (<< 404684003 |Clinical finding|)
    • This could be extended to, for example, return different values - e.g.
      • ? |Simple map refset|.|maptarget| ? (^|Simple map refset| AND < |Fracture|)
Reverse Member OfMichael Lawley

ON HOLD -

What refsets is a given concept (e.g. 421235005 |Structure of femur|) a member of?

  • Possible new notation for this:
    • ^ . 421235005 |Structure of femur|
    • ? X ? 421235005 |Structure of femur| = ^ X
Dynamic Templates
  • ON HOLD -
  • Continue discussion on dynamic templates
    • Inter-attribute dependencies
      • Acute/Chronic and Inflammation - Adding a clinical course requires specializing the inflammation morphology (question)
        • E.g. |Pyelonephritis| : |Clinical course| = |Chronic|
          should be
          |Pyelonephritis| : |Clinical course| = |Chronic|, |Associated morphology| = |Chronic inflammation|
        • E.g. |Pyelonephritis| : |Clinical course| = |Sudden onset AND/OR short duration|
          should be
          |Pyelonephritis| : {|Clinical course| = |Sudden onset AND/OR short duration||, |Associated morphology| = |Acute inflammation|
      • Infectious Causative Agents - Adding a |causative agent| = |Domain Bacteria| or |Virus| requires adding a |Pathological process| = |Infectious process|
        • E.g. |Nephritis|: |Causative agent| = |Domain bacteria|
          should be
          |Nephritis|: |Causative agent| = |Domain bacteria|, |Pathological process| = |Infectious process|
      • Congenital and Acquired - Adding an |Occurrence| of |Congenital| to a focus concept with an abnormal morphology, requires adding a |Pathological process| of |Pathological development process|
        • E.g. |Koilonychia|: |Occurrence| = |Congenital|
          should be
          |Koilonychia|: |Occurrence| = |Congenital|, |Pathological process| = |Pathological developmental process|
      • Situations with Explicit Context 
      1. if the procedure context = |Planned|, then the temporal context should be << |Current of specified time|
        1. If the procedure context = |In progress|, then the temporal context should be << |Current|
        2. If the procedure context = |Performed| or |Done|, then the temporal context should be << |Current or past (actual)|
      • Note: for this use case (of |Procedure with explicit context|) perhaps we just recommend (or require) that the full role group is spelled out.
      • Next steps
        • Representation of the content rules
          • Who creates the complete list of rules and how?
            • What formalism?
            • Determine which are mandatory and which are optional
          • Implementation of content rules - e.g.
            • Guided data entry by pre-populating role groups in expression template based on definition of focus concepts (for design-time use, such as mapping)
            • Mandatory content rules could be added to transform process
URIs for Extended Editions

ON HOLD - How to refer to an 'extended edition' using a URI - e.g. "International Edition plus the following 2 nursing modules: 733983009  |IHTSDO Nursing Health Issues module|and 733984003 |IHTSDO Nursing Activities module|

Use Case - Need to execute an ECL, that refers to "^ 733991000 | Nursing Health Issues Reference Set (foundation metadata concept) |" and/or "^ 733990004 | Nursing Activities Reference Set (foundation metadata concept) |", where the substrate includes the international edition, plus the modules that include these reference sets

July 2020 International Edition URI: http://snomed.info/sct/900000000000207008/version/20200731

July 2020 International Edition + nursing modules URI ?? - For example:



Attachments

Agenda and Meeting Notes