December 12, 2019 Allergy CRG meeting minutes

1

Welcome and role call

@Bruce Goldberg

• Welcome and roll call

2

Goals/accomplishments for CRG

@Bruce Goldberg , all

• What are CRGs?

  • CRGs provide a framework to facilitate discussion between clinicians focused on specific clinical specialties or topic areas, and dialogue between clinicians and SNOMED International. 

• The purpose of the CRGs is to enlist specialty clinicians to assist with necessary changes and updates required to maintain accuracy and currency in specific domains of SNOMED CT, and advise on content and products e.g.subsets which can be provided to support the implementation of SNOMED CT.

• As to the above goals, I have not been successful in recruiting additional allergy specialists to this CRG. Myself and Russ Leftwitch are the only allergists currently on this group

• I have thus been asked to delineate what we want to accomplish with this CRG so that our clinical engagement team can assist in recruiting additional allergy specialists to join this group

1. Review legacy content for currency and accuracy

   1. Assist with Allergy to substance remediation project

   2. In addition to substances and allergy conditions, need review of other allergy content areas such as allergy tests, patch and other allergen extracts, desensitization procedures

2. Suggest new content in order to represent current knowledge in the field of allergy and adverse reactions and to be consistent with the new ICD-11 chapter on allergies and hypersensitivity

3. Provide input on development of subsets required for implementation of allergy-specific content in EHRs

4. Provide guidance for developers of decision support

5. Harmonize SNOMED content with HL-7/FHIR
   
   
   

Suggestion made to perhaps also add general physicians including pediatricians as well as dermatologists as well to group.

@Bruce Goldberg will post discussion in order to obtain additional recommendations from members of group that were unable to make today's call.

Will send final purpose and goals to @Jane Millar so she can reach out to international community in order to recruit more allergy specialists.

Recommended contacts:

WAO

EAAACI

AAAAI

Luciana Tano and Pascal Demoly (ICD-11)

3

Severity scale for anaphylaxis

@Bruce Goldberg

• Request from Netherlands (@Natasha Krul) to add severity scale for anaphylaxis

• Anaphylaxis Mueller grades.pptx

Is the above model correct?

• Replace 472964009 |Allergic process (qualifier value)| with 769260004 |Immunoglobulin E-mediated allergic process (qualifier value)|?

• Should these be created under 254291000 |Staging and scales (staging scale)| or 273249006 |Assessment scales (assessment scale)|

  • Above hierachy does not contain the individual grades

  • Needs more discussion

4

Allergy to animals

@Bruce Goldberg

• Followup form September call

  • @Bruce Goldberg to obtain a list of desired organisms from @Natasha Krul and @Marie-Alexandra Lambot

From @Natasha Krul

List allergens Bruce.xlsx

@Marie-Alexandra Lambot to translate above list into English. Will use list to determine scope of project to enable role chaining to link allergy to organism substance to allergy to oprganism

5

Allergen and Allergy to substance refset for Belgium

@Bruce Goldberg, @Marie-Alexandra Lambot

• Followup form September call
  
  

  • @Marie-Alexandra Lambot will add the missing allergy to substance concepts to her local extension and evaluate usage for eventual inclusion into the SNOMED core

  • @Bruce Goldberg to ask @Cathy Richardson and @Monica Harry about which countries may be using SNOMED allergy to substance concepts rather than just documenting allergies using substances and products

  • @Marie-Alexandra Lambot mentioned that many descendants of 411123000 |Diagnostic allergen extract (product)| and 104381000 |Allergen specific immunoglobulin E antibody measurement (procedure)| are not represented in SNOMED CT as corresponding allergy to substance concepts

• https://confluence.ihtsdotools.org/display/cmag/2019/12/06/Concepts+used+to+document+allergies+-+input+sought - blog post

• @Marie-Alexandra Lambot to post list of allergens in hor subset to see if any other countries are using

6

Allergy to substance remediation project

@Bruce Goldberg, ALL

• Begin group review

• Tabled for a future meeting

7

Allergy to alpha-gal and alpha-gal syndrome

@Bruce Goldberg

• Task completed in SCA. Under review

• Tabled for a future meeting

  • https://authoring.ihtsdotools.org/#/tasks/task/INTQA/INTQA-2587/edit

8

Adjourn

@Bruce Goldberg, All

• AOB

• Next call Thursday January 9, 2020 20:00 UTC

• https://snomed.zoom.us/j/934143312

  Meeting ID: 934-143-312