2021-09-20 NCPT CPG Meeting

1

Welcome/Roll Call

• Reminder that calls are recorded

• Register for the SNOMED Expo! October 28-29, virtual and free

C. Papoutsakis

Attendees were welcomed to the call.

2

Agenda review and approval of minutes

2.1 August 2021 minutes

C. Papoutsakis

The agenda and minutes were approved by consensus.

3

January 2022 SNOMED release

• Progress

• Monthly updates

3.1 JIRA nutrition project tracking

D. Pertel

The Jan 2022 release progress was reviewed. Nutrition project items are tracked by SNOMED CT in JIRA. All but 8 of the 66 projects are resolved. One of the most important projects outstanding is the Substance project, which when completed should help resolve subsumption of some of the nutrition concepts where relationships between fatty acids and fat are lacking.

4

Template compliance reports

4.1 A nutritional intake (observable entity)

4.2 Nutrition intake (finding)

4.3 Modified substance diet (regime/therapy)

D. Pertel

A nutritional intake: 223concepts aligned to the template. 11 are expected to be misaligned because concepts require a different property than (Quantity rate, specifically mass over 24 hours): percentage, grams in one meal, and general quantity (which use mass). Shared during the call is that the attribute, Process acts on, is now available to replace Process output which is currently used. A batch change will be initiated for all of these concepts that use Process output.

Nutrition intake finding: 100 aligned concepts; 4 misaligned concepts pre-existed in SNOMED CT and since the CPG was unable to define them, these will remain misaligned.

Modified substance diet: 191 aligned concepts. 13 misaligned concepts as expected because the substance lacking (energy and diets free of something (eg, gluten free)) and Has focus is lacking for a few because it does not exist in NCPT. A few fatty acids/triglycerides lack relationship to fat so it is hopeful that these will be resolved with work SNOMED is doing on Substances.

5

Nutrition counseling remodeling discussion

5.1 Theory/approach drafts

D. Pertel

The nutrition counseling concepts that are associated with theories/models were discussed. This was an area of the pilot project reviewed in December 2020. The goal was to associate the concepts with their theories. Discovered in the process was a question about whether 

441201000124108 |Counseling about nutrition using cognitive-behavioral theoretical approach (procedure)| Is A 228557008 |Cognitive and behavioral therapy (regime/therapy)|. 

• From attendees (Switzerland, Sweden, Australia) it is not clear if every instance of nutrition professionals using cognitive behavioral theory is cognitive behavioral therapy.

• @Elaine Woolerwill raise this question with the Mental Health CRG for their input.

• @Elaine Wooler will also raise a question with Jim Case and/or the Mental Health CRG about promotion of the models for Health belief model, Social learning theory, and Transtheoretical model and stages of change from the US extension to SNOMED CT. If this is done, they will be useful for defining these concepts.

The next step is to model the nutrition counseling concepts that use strategies (motivational interviewing, goal setting, etc.) to see how these might look once authored.

6

Adjournment

The next call is Monday, November 15 at 14:00-15:00 Central Standard Time US (UTC-6).