2019-2-18 - NCPT CPG Meeting

All,

Sorry i missed the last meeting and had wanted to get my homework in prior to the next meeting tomorrow.

One key thing that probably needs to be clarified is the context for these discussions. i.e. are we looking at these as

• Substances, that are consumed and contain nutrients

• Pharmaceutical / Biological products, that are administered/prescribed as interventions  to treat patients

• Clinical findings , i.e. dietary findings/ finding of food and drink intake/ findings of nutrient intake

• Observable entities  e.g as characteristics of eating  such as intake

• Qualifier values i.e how much of one nutrient type consumed or eaten mg/ grams / portion sizes etc

We do need to have a consistent hierarchy of  the following, below is a crude attempt and this may be different what has already been agreed posted below as a framework that we need to consistently apply when reviewing terminology

• Dietary Intake ( i.e the intake of substances that contain nutrients )
  
  

  • Oral intake (substance)

    • Food (solid or liquid i.e. including  beverage)

    • Supplements ( food snacks, supplementes and enteral feeds)

  • Other intake ( i.e enteral and parentral) (Pharmaceutical / biological product)

    • Feeds and supplements not taken orally

    • Expressed breast milk and infant formula 
      
      
      

  • Nutrient intake

    • This is a quantifier value based on the composition of oral or other intake

The reason for this is that unless you are clear on the lens through which you are evaluating a term to put on your list you can end up going around in circles.  The context in which the term is used is not completely interchangeable and can vary to a degree.  Had tried to highlight some of the issues and the hierachy that is currently in SNOMED CT in the attached file.   

Well when i find out how to attach it that is 

Thanks,

Nathan

placed a PDF here  Re: Proposed Hierarchy Discussion Prior to 18.02.18 meeting

All,

Penni had shared this https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/DietarySupplements/ucm381189.htm which is a useful term.  I think internationally "Beverage" , like Bill had mentioned is a social construct.  Beverage looking at the FDA definitiion appears to be any nutrient containing liquid that is NOT a dietary supplement. 

We may need to look at this within the context of the edible substance hierarchy to do this 762766007 |Edible substance (substance)| and then once this is in the approved hierarchy apply this to how we classify Nutrient intake  of interest is that this has the following has the following children all of which are not yet fully specified terms and appear to address some of the complexity we have been re litigating in our meeting

•  226465004 |Drinks (substance)|

• 255620007 |Foods (substance)|

• 229979003 |General food and drink types (substance)|

• 440551000124102 |Bioactive substance (substance)|

• 735252001 |Protein and protein derivatives (substance)|

• 59533004 |Food additive (substance)|

Not sure that helps but if we were to work on sorting out these terms we could then use these "edible substances" as part of Dietary, oral and Nutrient intake.  

Let me know what you think and how we can work on making the above more usable and fully specified 

Thanks,

Nathan

ps will repost this in the discussion forum, sign up as watching get notified when others  post and share thoughts asyncronously prior to next meeting