In reviewing some recent requests for amputation procedures, I have run up against a conundrum that I would like input on. There are currently several procedures representing amputations of lateralized body structures, but without specifying the precise laterality. Back in 2015-16 we inactivated concepts that specified "unilateral" procedures as being both ambiguous and a threat to patient safety if added to an EHR. While the existing procedures that do not specify laterality act as org
From fhielkema
In the Dutch hospitals, laterality is recorded as a separate data item for both diagnoses and procedures. So we use those laterality-agnostic procedures extensively. Yes, for patient safety you would expect the physician to record the laterality - but it does not follow that laterality must be precoordinated into the procedure.
We have noticed an inconsistency in our review of nontraumatic vs. spontaneous injury. In some cases we make a distinction between them:
1296953008 |Nontraumatic rupture of extensor tendon of left hand (disorder)|
321371000119100 |Spontaneous rupture of extensor tendon of left hand (disorder)|
whereas in other cases we treat them as synonymous:
image.png
In determining the meaning of nontraumatic vs. spontaneous, we have found that nontraumatic means injury not caused by an exter
From jpierson
Great discussion. Attached is an analysis, which may or may not be helpful.
Jim, I agree with Monique that having clear definitions should help us to determine if there is synonymy and how to move forward.
Also, all things being equal, I think “nontraumatic” is better as an FSN because “spontaneous” is harder to pin down.
A number of diseases exist in which the literature describes the potential for there to exist a recognised set of associated "systemic manifestations". In an attempt to model these systemic manifestations there has been a requirement to identify a modelling pattern which lies somewhere between the concepts of "Co-occurrent" and "Due to".
The issue arose from a discussion on how we should model the systemic manifestation of Sjögren's syndrome and the thread relating to this has been inclu
To summarize the issues as I see it, we want to distinguish between two types of disorder associations, one in which a finding or disorder is a manifestation of a multi system disorder for which the manifestation and the underlying disorder may share a common pathological process and morphology and the other in which there are 2 discrete disorders that are found together more than would be expected by chance alone and may be related by a common predisposition. I think you are suggesting to use associated with for the former and simple co-occurrence for the latter. Jim seems to be suggesting to use simple co-occurrence for the former and temporally related to for the latter. In a separate e-mail, I expressed my concern about using temporally related to which is essentially a symmetric property to relate two conditions where neither one is secondary to the other. I would like to propose the following solution:
For the situation where a disorder or finding is a manifestation of a multisystem disorder, create a new attribute, is manifestation of (note there is currently a link assertion “417318003 |Is manifestation of (link assertion)|”.
Another option would be to use as Jim suggested temporally related to where the manifestation is temporally related to the underlying systemic disorder. A manifestation may precede and/or occur during the underlying disorder but would never as far I know occur after the underlying disorder has resolved.
For two distinct disorders that may share a common predisposition, represent as simple co-occurrence with a due to relationship to the predisposing factor which may be one or more findings or disorders such as a mutation, substance, organism, physical force or event or some combination of the above. If the predisposing factor is unknown, then a due to relationship would not be included.
The semantics of historical associations, quality of the corpus of already authored associations, and future editorial guidance in their authoring and end-user processing.
Hi jrogers, many thanks. I will copy this across into the subproject page.
PS - Anne is away on annual leave for 3 weeks so she has suggested we progress without her. I will send round a further doodle poll for the next couple of weeks.
This discussion will determine the appropriate editorial guidance for acceptance of and content development of responses to questions in surveys and questionnaires. Initial topics include:
Content acceptance criteria:
Only assessment instruments that are in the public domain or with expressed permission will have their response values added.
IP-restricted assessment values may only be added upon permission of the publisher. It is the responsibility of the requester to secure that permiss
Ad item 7 from the Jan 2018 EAG meeting: Data on the range of 'procedure without procedure' type codes and their actual utilisation rates within UK primary care settings
The majority of X absent concepts are in the findings hierarchy rather than the situation hierarchy. If we think it is appropriate to keep these as findings then Jeff's suggestion might work.
Discussion surrounding the proposal to retire from use the WAS-A historical attribute and the inactivation of the existing relationships. The issue originated when a concept slated for inactivation served as a destination concept for a WAS-A relationship to a limited status concept. The tooling required reconciliation of the WAS-A relationship to an active concept. It was reported that historically there was some push back inactivation of a WAS A from a limited inactive concept pointing
A summary of a discussion with JTC/GRE/JRO can be found at:
https://docs.google.com/document/d/17dOZwNITk0cZIqalSbXvG_702lsWlLOhS-FPNSGOv8o/edit https://docs.google.com/document/d/17dOZwNITk0cZIqalSbXvG_702lsWlLOhS-FPNSGOv8o/edit
Until the batch fix to the issue is applied, the following steps should be taken when the target of a WAS A relationship is inactivated:
Assign the next proximal parent as the target of the WAS A relationship
Do not make changes to the inactivation status or add additional historical relationships.
At the Wellington meeting it was determined that the current definition of "Product" was both too broad and included terms that were not universally useful. It was determined that to address the needs of the new Drug Concept Model and to make sure that the definition of products in the International release is consistent with the content.
Current definition Editorial Guide July 2016: "This hierarchy was introduced as a top-level hierarchy in order to clearly distinguish drug products (products) from their chemical constituents (substances). It contains concepts that represent the multiple levels of granularity required to support a variety of uses cases such as computerized provider order entry (CPOE), e-prescribing, decision support and formulary management. The levels of drug products represented in the International Release include Virtual Medicinal Product (VMP), Virtual Therapeutic Moiety (VTM), and Product Category.”
Following up from the Editorial AG cal 22-Aug, additional examples from existing content have been identified. Note that examples from the Product hierarchy have been excluded as specific guidelines for this hierarchy will be developed and the hierarchy does not include ranges (with isolated exceptions).
Midwife attends 1-10 days post-discharge (finding)
Midwife attends 25-28 days post-discharge (finding)
On examination - height 10-20% over average (finding)
On examination - weight
Jim Case