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Reminder to record call

1

Welcome and role call

@Bruce Goldberg

3

Allergy Implementation guide

@Bruce Goldberg

@Marie-Alexandra Lambot

alo@snomed.org

• Review published Allergy implementation guide and tool

  • How do we get feedback on the guide/answer questions on the guide: Is “Questions” the place in the allergy guide document to ask questions/add feedback?

  • Can we add a sentence to say it’s the place to put in questions and say when use the feedback button. Ask during meeting to Alejandro.

  • Where do we get to see those questions as Allergy CRG chairs so they are not drowned in all our confluence notifications.
    Methodology of handling questions in the CRG: how often do we look, who’s looking, when do we present the questions to the group, …

SNOMED CT Clinical Implementation Guide for Allergy, Hypersensitivity and Intolerance

4

SNOMED and LOINC - representing allergy testing in SNOMED

@Bruce Goldberg

igr@snomed.org

@pwi@snomed.org

• Is there a need to represent allergy testing in SNOMED using LOINC content?

  • If not should existing content be deactivated?

• Ask the member countries what they use to represent allergy testing so we can know if there is any interest in representing allergy tests in SNOMED CT?

5

367428009 |Desensitization therapy (regime/therapy)|

@Marie-Alexandra Lambot

• Review of 367428009 |Desensitization therapy (regime/therapy)|

  • Recent addition of 1284973003 |Immune tolerance induction (regime/therapy)|

Question:

SNOMED is involved in a mapping project with MedDRA, and MedDRA has a procedure, ‘Immune tolerance induction’.  We think this isn’t quite the same as SNOMED’s 182678001 |Allergen immunotherapy (regime/therapy)|.  Immune tolerance induction [ITI] has been used in Hemophilia A, so it’s not just for allergies but autoimmune disorders and post-transplants.

1.     Is ITI the same as 243196004 |Immunoglobulin desensitization therapy (regime/therapy)|? 
2.     If so, should then 243196004 |Immunoglobulin desensitization therapy (regime/therapy)| be a sibling of 182678001 |Allergen immunotherapy (regime/therapy)| instead a subtype?  
3.     Should the above concepts have any relationship to 127785005 |Administration of substance to produce immunity, either active or passive (procedure)|?  Currently, they do not.

(My) Answer:

1. Immune tolerance induction’ is not the same as SNOMED’s 182678001 |Allergen immunotherapy (regime/therapy) although 182678001 |Allergen immunotherapy (regime/therapy) could be considered a kind of Immune tolerance induction’.
   2. 243196004 |Immunoglobulin desensitization therapy (regime/therapy)|. There are few references to what this actually means but I am thinking that it refers to the administration of (high dose) immunoglobulin for inflammatory and autoimmune diseases in which the immunoglobulin has an immunomodulatory effect and so can be considered to be a subtype of Immune tolerance induction (See attached article). This is not related to 182678001 |Allergen immunotherapy (regime/therapy)|but may be a sibling under a new parent of Immune tolerance induction
   3. 127785005 |Administration of substance to produce immunity, either active or passive (procedure) is not related to Immune tolerance induction as the former is focused on inducing a protective immune response while the latter suppresses a damaging immune response.

6

Drug Allergy

@Bruce Goldberg

• Review of literature re. drug hypersensitivity literature re. classification and mechanisms for possible inclusion in SNOMED CT

  • Not well represented in  in SNOMED CT or ICD-11

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Cross reactivity

@Bruce Goldberg

• Is there an interest in representing allergen cross reactivity for substances (and ? allergy testing) in SNOMED CT

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Adjourn

@Bruce Goldberg

• Any other topics for October business meeting?