SNOMED CT Templates

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StatusIn progress
Version

0.5

Descriptions:

Termdescription typeLanguage/acceptabilityLanguage/acceptabilityCase significance[
Sepsis due to [infectious disease]/associated with [device](disorder)FSNus:Pgb:Pci
Sepsis due to [infectious disease]SYNus:Pgb:Pci


Concept model:

Attribute Cardinality

AttributeValuerole group numberRole Group Cardinality
1..1

116680003 |Is a (attribute)|

0

N/A

0..1

42752001 |Due to (attribute)|


<<  40733004 |Infectious disease (disorder)|

0N/A
0..1

47429007 |Associated with (attribute)|

< 49062001 |Device (physical object)|

0N/A
1..1

370135005 |Pathological process (attribute)|

769256002 |Dysregulated host response (qualifier value)|

1N/A
1..1

116676008 |Associated morphology (attribute)|

409774005 |Inflammatory morphology (morphologic abnormality)|

1N/A
1..1

363698007 |Finding site (attribute)|

113343008 |Body organ structure (body structure)|

1N/A
0..1

246075003 |Causative agent (attribute)|

  <<  410607006 |Organism (organism)|

1N/A

Definition status:  


900000000000073002 |Defined|

Applies To:

<<  91302008 | Sepsis (disorder)|

Template language:

Link to the misaligned concept report:


Rules for description generation: 

  1. Apply General rules for generating descriptions for templates;
  2. Apply Enhancements for the Template Language;

JIRA ticket:

  1. GC-1073


15 Comments

  1. Yongsheng Gao

    Hi Bruce Goldberg ,  I updated the domain and description template.  Should attribute 'occurrence' be included for modelling the existing content?

  2. Bruce Goldberg

    Hi Yongsheng Gao. I added [due to infectious disease] in brackets for the descriptions in order to define "sepsis" itself because we don't want to say sepsis due to infectious disease. In terms of adding course to infectious disease, I was thinking (but willing to be educated) that the infections would necessarily be acute. 


    Bruce

  3. Monica Harry

    Yongsheng Gao Bruce Goldberg - Could we add Substance as a Causative agent as in Colitoxemia = Infection due to E. coli toxin.

  4. Bruce Goldberg

    Hi Monica Harry I think it is a little more complicated than that. Colitoexemia is not an infection due to E. coli toxin nor is it a kind of sepsis. It is the presence of E. coli endotoxin in the blood. Gram negative sepsis is due to endotoxemia. Endotoxemia is a blood stream finding due to gram negative bacteremia caused by bacterial endotoxin. See attached Powerpoint.

    Sepsis – additional refinement of model.pptx

    Bruce

    1. Monica Harry

      Thanks Bruce Goldberg - I am going to move this to the QI follow-up sheet then. Monica

    2. Yongsheng Gao

      Hi Bruce Goldberg, it looks like that inactivation of server sepsis has not been implemented. 

      "As the Sepsis-3 consensus has eliminated the use of severe sepsis (all sepsis is severe) and considers sepsis a kind of organ dysfunction, these concepts should also be retired and replaced by sepsis equivalents".

  5. Monica Harry

    Remodelled 91302008 |Sepsis (disorder)| https://authoring.ihtsdotools.org/#/tasks/task/QIJAN20/QIJAN20-844/edit

    1. Monica Harry

      Bruce Goldberg - would you mind taking a look at the task please and see question from Jim. thanks, Monica

  6. Bruce Goldberg

    Done. Please see my comment.

  7. Bruce Goldberg

    Hi Yongsheng Gao. There are 24 Severe sepsis concepts. Would you like me to take on this task as part of the disorder association QI work?


    Bruce

    1. Monica Harry

      Hi Bruce, thanks for offering but if we already have a solution, then I will allocate an author. We need your expert knowledge to tease apart the more complex combined disorder questions. (wink) Monica

  8. Bruce Goldberg

    Hi Monica. Now that I think about it, based on yesterday's decision on the EAG call, the sepsis model may need to be revised.

    1. Use due to only for direct causality: Sepsis is not directly cause by an infection but rather the dysregulated host repsonse to the infection
    2. Would need to capture the infectious disease in an additional axiom.

    Maybe need a new concept Dysregulated host reponse to infection (disorder)?

    I neeed to evaluate this further.

    1. Monica Harry

      Hi Bruce, that does not interfere with the inactivation of the duplicates e.g. below ... the changes you decide upon as regards modelling can be applied when agreed. The change below will be applied to all similar duplicate concepts. Yongsheng Gao Nicola Ingram- I am going to launch a task and make the changes. 


      127381000119100 |Severe sepsis with acute organ dysfunction caused by Serratia (disorder)| will be inactivated as duplicate to:

      449084002 |Sepsis caused by Serratia (disorder)|

  9. Monica Harry

    I added the Associated morphology and Causative agent attributes making the later optional. 

  10. Bruce Goldberg

    Hi Monica. The causative agent should be expanded to include fungi and viruses.

    This would seem to be an exception to the model for combined disorders agreed upon at the last EAG call for which we would use the co-occurrent and due to pattern and the valuer of due to would need to be the direct cause of the primary disorder. On the other hand, this is not really a co0mbined disorder as we had agreed in the past that sepsis is not a kind of infection.