Taking into account the Member response and prioritisation criteria the group is determining the priority for these components.
Focus AreaTrackers: XXX some may be more than one component (total excludes last row) | Scope of Content | Member Priority Summary | Member Comments | Daniel
| Linda | John | Cathy
| Elaine | Group member comments | Final rating |
---|---|---|---|---|---|---|---|---|---|---|
Concept Modelling, Attributes and ValuesTrackers: 45 Modelling Review
| This area focuses on the review (or addition) of attributes and the values that can be applied to them. While not a clinical area per se, work in this area supports the defining and quality of content which in turn supports implementations and secondary use. | 2 countries high, 1 country medium. | (2+3+3)/3=2.67 | (2+3+3)/3=2.67 I think this component and the Qualifier Value are quite linked | (2+3+3)/3=2.67 Overall rating using tracker priorities - recommend high. | (2+3+3)/3=2.67 | CRI: Clinical impact difficult to determine so went for average as I would expect there to be some. DKA: Agree that clinical impact is difficult. A wide clinical range of issues in this box. User and terminology impact can be assumed to be high. However, given the diversity the component level might not be the right level of prioritization for this one. EWO: I'm not sure many clinicians are focused on the complexities of SCT yet. Clinicians may do subsumption based queries but are more concerned that content looks correct in the patient record - no errors, odd abbreviations etc But any work to correct/assign parents would be seen as very useful indeed so some tracker items more clinically high priority than others. | |||
Qualifier ValueTrackers: 18 Pattern Review Hierarchy Cleaning Modeling Review | Remodeling related to new attributes and new content. Clarification of meaning of existing content. | 1 country high, 2 countries medium | Singapore: Better clarification of qualifier values would be beneficial as we use this hierarchy in our drug product concepts rather extensively. Comments: It would be good for us to be updated of the changes made as it might have impact to our Singapore Drug Dictionary. | (2+3+2) At least 85 requests → high user impact. Hard to determine terminology impact as most of Qualifier value hierarchy is not used in definitions. Qualifier values are tightly coupled to the domains in which they are used. | Here is my raking if the drug concepts are dealt rather in the Drug Project.(2+3+3)/3=2.67 Here is my raking if this work is not part of the Drug Projec(3+3+3)/3=3 I think this component and the previous one are quite linked | (2+3+3)/3=2.67 Overall rating using tracker priorities - recommend high. | (2+3+3)/3=2.67 | CRI: Clinical impact difficult to determine so went for average as I would expect there to be some. DKA: Yes, clinical and terminology impact hard. Also, component level prioritization might not be helpful here. EWO:agree it would be useful to look at in more detail though there is increasing interest in post-coordinated expression from clinicians. | ||
Clinical Finding: NeoplasmTrackers: 21 Pattern Review Hierarchy Cleaning Modeling Review
| Naming conventions reviews and improvement of modeling of malignant disorders. | 2 countries high | UK: As well as a general clean-up, we could suggest the creation of precoordinated cancer >disorders< which are currently expressible only as morphology concepts. (we could provide input in making suggestions on identifying these). | (3+?+3) User impact: cannot see how many CRS tickets are related to this. Terminology impact: 3644 matches "neoplasm" (disorder, group by concept). 55342001 | Neoplastic disease (disorder) | has 7515 descendants (~ 10 % of all disorders), used to define 485 other concepts. Are not used to define other concepts. | (2+2+2)/3=2 Should that work be part of the collaborative work with WHO? | (3+2+2)/3=2.33 Overall rating using tracker priorities - recommend high. | (3+3+2)/3=2.67 | CRI: Neoplasm work here basically outside of the WHO collaborative work. EWO: on searching CRS for Neoplasm in inception/elaboration there are 96 requests. | ||
Clinical Finding: ObstetricsTrackers: 14 Pattern Review Hierarchy Cleaning Modeling Review | Revision work on abortion concepts and the modeling of antenatal and postnatal content. | 2 countries high | UK: Disambiguation of therapeutic/iatrogenic abortion versus spontaneous abortion ('miscarriage') would be especially welcome albeit no small task. | (2+?+2) Terminology impact: 198609003 | Complication of pregnancy, childbirth and/or the puerperium (disorder) | has 1315 descendants, 248982007 | Pregnancy, childbirth and puerperium finding (finding) | has 1979 descendants (489 in common w Complication...) + some other ones spread out. Are not used to define many other concepts (62 and 188 respectively). | (1+2+2)=1.67 I saw in other component tickets obstetrics, perhaps all ticket on that topic should be grouped together | (2+3+1)/3=2 Overall rating using tracker priorities - recommend - medium | (3+2+2)=2.33 | CRI: did a search added Clinical Finding Obstetric issues. There is a small number of procedure ones as well which given interest should also be considered. EWO: Some highly emotive content so rated high clinically. Couldn't see how many requests were linked so rated 2 based on other explanations. | ||
Procedures/Qualifier Value: PathologyTrackers: 27 Pattern Review Hierarchy Cleaning Modeling Review | Issues include cancer synoptic reporting, hierarchy reviews, specific issues e.g. measurement activity vs. quantity, units of measure, specimens | 2 countries high | (2+2+3) Terminology impact: high, as Observables is a new area, might require update of concept model guidance. | (2+2+2)=2 There seem to be duplicated ticket in the different component trackers. Linkage and dependencies should probably be determined before tackling this one. | (3+3+3)/3=3 Overall rating using tracker priorities - recommend high. | (3+3+3)/3 | CRI: Units of measure in this group also covered under Qualifier Value and the Units of Measure tracker. EWO: There a lot of implementations in this area and high focus at present internationally for cancer and genomics
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Observable EntityTrackers: 20 Pattern Review Hierarchy Cleaning Modeling Review | Large review of observables and investigation procedures - including modeling but also specific areas such as functioning observation results | 1 country high, 1 country medium | (2+3+3) Clinical impact: hard to assess as it spans a wide range of clinical domains. User impact: 20 trackers, 28 CRS tickets (+ everything related to LOINC mapping) Terminology impact: high, as Observables is a new area, might require update of concept model guidance. Observables used to define 26721 other concepts (mostly findings). | Would the functioning observation results mean there would be a need to model more content in other hierarchies? | (3+3+3)/3=3 Overall rating using tracker priorities - recommend high. | (3+3+3)/3=3 | ||||
Procedure: Diagnostic ImagingTrackers: 8 Pattern Review Hierarchy Cleaning Modeling Review | Remodeling and naming pattern review of imaging procedures and sub hierarchies such as gastrointestinal imaging, angiographies, Ultrasound scan - obstetric, Radiography vs. X-ray and others | 1 country high, 1 country medium | (2+?+3) Terminology impact: 5352 descendants of 363679005 | Imaging (procedure) | used to define 595 other concepts. | (1+2+2)=1.67 | (2+2+2)/3=2 Overall rating using tracker priorities - recommend - medium | (3+3+2)/3=2.67 | EWO: Heavily used content with large number of implementations and impacts high priority clinical areas. | |||
Qualifier value: Units of MeasureTrackers: 4 Pattern Review Hierarchy Cleaning Modeling Review | Reviewing of possible duplicated content and remodeling to align to agreed patterns. | 1 country high, 1 country medium | Singapore: The usage of Qualifier Value: Units of measure is heavily used in our drug product concepts. Better refined UOM would be of good assistance. | (1+1+1) Clinical/user impact: there are other standards (UCUM) Terminology impact: 1177 descendants of used to define 0 (zero) concepts | Here is my raking if the drug concepts are dealt rather in the Drug Project.(2+3+3)/3=2.67 Here is my raking if this work is not part of the Drug Projec(3+3+3)/3=3 | (3+3+2)/3=2.67 Overall rating using tracker priorities - recommend high. | Agree with Linda re relationship to drug work so either 2.67 or 3 | |||
Situations/ContextTrackers: 23 Pattern Review Hierarchy Cleaning Modeling Review | Reviewing patterns and concept modeling for content such as: No known allergies and other Non-x concepts, Resolved concepts, Seen in clinic, and others. Relocation of concepts from Findings and Procedures that have context. | 1 country high, 1 country medium | UK: Reviewing patterns and concept modeling for content such as: ... Seen in clinic, and others. Relocation of concepts from Findings and Procedures that have context. | (2+?+3) Terminology impact: 4430 concepts, impact on other hierarchies due to delimitation issues (wrt findings). | (2+2+2)=2 Not sure of the terminology content impacted | (2+3+3)/3=2.67 Overall rating using tracker priorities - recommend high. | ||||
Procedure: Interventions, Plans and GoalsTrackers: 14 Pattern Review Hierarchy Cleaning Modeling Review | Remodeling of sub hierarchies as such as: Care plan, Types of encounter, Screening intent vs. Screening type, Prevention vs. Preventive regime, and others. Better define the meaning of Treatment vs. Therapy, Plans and Regimes and others, and adjust accordingly | 2 countries medium | Singapore: As part of our Care Plan documentation, it is definitely beneficial if the contents are classified into sub hierarchies such as interventions / plans, etc. | (2+?+3) (why goals? should be findings and/or observables) Terminology impact: Entire procedure hierarchy in scope! | (2+2+2)=2 Not sure of the terminology content impacted | (2+3+3)/3=2.67 Overall rating using tracker priorities - recommend high. | ||||
Procedure: Surgical ProcedureTrackers: 19 Pattern Review Hierarchy Cleaning Modeling Review | Remodeling of Intraoperative concepts, Surgical procedures not subsumed by Surgical procedure concept, Aspiration procedures, Needle biopsies & Fine needle aspiration biopsy procedures, Implantation (procedure) hierarchy . New patterns for Anastomosis from X to Y, Reamputation of <site> and others | 2 countries medium | Singapore: We are planning to synchronise TOSP (Table of Surgical Procedures) codes with SNOMED. The remodelling of Surgical Procedures may help in our future exercise. | (2+3+3) User impact: Several CRS tickets implies many users. Terminology impact: 20 000 concepts used to define 1742 other concepts. | (2+2+3)=2.33
Will this be part of the collaborative work for the CPT alignment? | (2+3+3)/3=2.67 Overall rating using tracker priorities - recommend high. | ||||
Clinical Finding: Congenital, Hereditary, Genetic and FamilialTrackers: 9 Pattern Review Hierarchy Cleaning Modeling Review | Remodeling, hierarchy and naming pattern review - mainly congenital disorder modeling and definition and clarification of descriptions relating to familial, genetic and inherited. | 2 countries medium | UK- Genetics please | (3+?+3) Terminology impact: large number of concepts, e.g. 66091009 | Congenital disease (disorder) | subsumes 6870 used to define 379 other concepts. | Should that work be part of the collaborative work with that Genomic group? | CRI: SNOMED International is working collaboratively to develop a Genomics strategy. | ||||
Clinical finding: Diabetes MellitusTrackers: 4 Hierarchy Cleaning Modeling Review | Improvement in Diabetes Mellitus content. | 1 country high | (3+1+1) Terminology impact: 120 concepts subsumed by 73211009 | Diabetes mellitus (disorder) | used to define 353 other concepts. | (3+1+2)=2
| (3+2+1)/3 = 2 Overall rating using tracker priorities - recommend medium. | CRI: 3 out of 4 of these trackers have had some work done on them. | ||||
Clinical Finding/Event: Mental HealthTrackers: 12 Pattern Review Hierarchy Cleaning Modeling Review | Overall review/update of psychiatry and mental health terminology. Also specific areas of concern such as substance abuse/misuse, neurosis descriptions and modeling, | 1 country high | UK: Any improvement of subsumption, naming and rationalisation of content would be welcome. | (2+?+2) Terminology impact: 74732009 | Mental disorder (disorder) | has 1499 descendants used to define 97 other concepts | (1+1+2)=1.33 | (2+1+1)/3=1.33 Overall rating using tracker priorities - recommend medium. | ||||
Clinical Finding/Observables: Presence and AbsenceTrackers: 8 Pattern Review Hierarchy Cleaning Modeling Review | Issues relating to the presence or absence of a disorder. Links to observables redesign work also. | 1 country medium | Singapore: We noted the lack of clarity over certain diagnosis (i.e.) ConceptID: 106074003 | Electrocardiogram finding in hypertrophy, infarction AND/OR ischemia (finding) - so is that "And" or "Or"? It would be better if concepts like these are better defined. | (1+?+1) Terminology impact: “presence” occurs for 83 concepts, modeling issues are present though... | (2+1+2)=1.67 I think this component and the Situation/context are quite linked | 2+1+2)=1.67 Overall rating using tracker priorities - recommend medium. | ||||
EnvironmentTrackers: 2 Hierarchy Cleaning
| Review of entire hierarchy - content examples include inpatient, outpatient settings. | 1 country medium | (1+1+1) Terminology impact: 308916002 | Environment or geographical location (environment / location) | subsumes 1820 used to define 2 other concepts. | (1+1+1)=1
| (1+1+1)=1 Overall rating using tracker priorities - recommend Low. | |||||
Clinical finding vs. Procedure: Administrative Statuses ContentTrackers: 2 Pattern Review Hierarchy Cleaning | Revision work on Administrative statuses content. Overlap of referral content between Clinical Findings and Procedures. | 1 country medium | (1+1+1) Clinical impact: there are other solutions (information models), international level concepts? | (1+1+1)=1 | (1+1+1)=1 Overall rating using tracker priorities - recommend Low. | |||||
Clinical finding: Temporal contextsTrackers: 13 Pattern Review Modeling Review | Remodeling to align to patterns. Issues which have a temporal aspect e.g. period of life, during an event etc. | 1 country medium | (2+2+2) Terminology impact: hard to assess, many tough issues but might not impact content outside the area as they are typically not used to define other concepts. | (1+1+3)=1.67
This component seems to include complex issues. Perhaps some issues should be moved over to other components, like the Modelling Attributes & values? | (2+2+2)=2 Overall rating using tracker priorities - recommend medium. | CRI: Two of these are also from the Obstetrics component. The ECE project group has been doing work on combined disorders and temporal context. Machine Readable Concept Model changes are currently being made to the authoring tool for new subtypes of the Associated with attribute plus an extension of the range for the Due to attribute. See: 6.1.4 Disorder combinations 6.1.5 Complications and Sequelae The X with Y component had a number of trackers with temporal context but this hadn't been explicitly stated. This link has now been added. | ||||
Content Issues for AuthoringTrackers: 82
| Content includes: issues identified as small or simple enough to be managed in the authoring tool and issues that have progressed through the content development process and are ready for the construction phase. Some may be in construction review. | Not on listing for members | This tracker seems to include tickets that should be part of other components. A review should be done to reallocate where possible to proper components, like attributes and qualifier values issues, neoplasms, Diagnostic Imaging issues.. Examples: artf222786-Concept model: Presence of X (situation) - presence of X (finding) artf6217-Allergies and adverse reactions
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