1

Welcome and role call

BGO

2

Review of previous meeting minutes and actions

BGO

YGA

• Addition of during and during and/or after roles to associated with role hierarchy
  Proposal endorsed by anesthesia SIG

• As GCIs not supported by current SNOMED DL (and unlikely to be implemented in near future) it was suggested that secondary x could be modeled using domain-specific templates (or a general template) in protege and classified descendants then added to SNOMED CT. Yong will investigate. He will post his OWL file.

E-mail sent to MHA to bring to anesthesia SIGAdvised to confirm that anesthesia SIG comfortable with perioperative complication as during and/or after surgery as opposed to before, during and/or after surgery.

Model using GCIs presented. Another approach that could be adopted presently is to fully define in SNOMED CT the specific high level ancestors of the specific secondary disorder e.g. for secondary diabetes, diabetes after procedure, diabetes caused by substance, diabetes due to other disease. Also noted that associated still used in model (e.g. disorders secondary to procedures) but associated with does not necessarily imply secondary to.

The link to the OWL file: Secondary disorder concept modeling

3

Revisions to editorial guidelines

BGO

• Relationship governed by the point of coding?  

  • Example of Myocardial infarction due to coronary artery thrombosis - although fits the general pattern of due to as thrombosis not necessarily still present with myocardial infarction, during a particular evaluation both thrombosis and myocardial infarction may be known to be co-occurrent. ? Document presence of both with 2 statements X due to Y and Y? KP had created "combo codes of the type DM with diabetic complication X associated with 2 CPT codes

• Domain-specific guidelines for complications

  • Need to address issue that only some complications may inherit the causative life phase

• Finding due to disorder

  • Is this a finding or a disorder?

• Authors test

  • Have only received completed tests from Phil and David.

• Question from David Sperzel re. if a disorder (CLP) is modeled with 2 stated parents, are those parents always necessarily co-occurrent?

General agreement that in this situation, co-occurrence can be documented using 2 codes, 1 for the causative relationship and one for the causation. How combined disorders in ICD-11 will eventually be represented is still not certain. Options include 1:1 mapping of a single code in ICD-11 to a single code in SNOMED CT (which may require both co-occurrent and due to and due to flavors) or mapping a single code in ICD-11 to more than 1 code in SNOMED CT by querying SNOMED CT for individual codes and providing rules for their combination into postcoordinated SNOMED CT expressions.

Similar argument as above. Most important to capture the causative relationship. Co-occurrence if present can be captured using 2 codes.

If finding is a manifestation of a disorder, model as a disorder for now. Using clinical life phase approach ideally need to separate observation result from CLP

Being reviewed in weekly SNOMED authors meeting

If a combined disorder is modeled with 2 stated parents then there is a period of time when the conditions represented by each parent are both present (i.e. co-occurrent)

7

AOB, adjourn

ALL

• Next meeting 7/11/2016 2100 UTC