1

Welcome and role call

BGO

2

Review of previous meeting minutes and actions

BGO

• Perioperative complications

• Minutes from anesthesia SIG meeting 7/26/2016:

  • Professional guidance on Perioperative Medicine e.g. the Royal College of Anaesthetists guidance: https://www.rcoa.ac.uk/sites/default/files/PERIOP-2014.pdf clearly regard perioperative medicine as encompassing care before, during and after a surgical intervention.

  • A major focus of the discussion was whether a perioperative complication could arise before the specified procedure. One example discussed was perioperative anxiety. Andrew Marchant suggested an elegant example in the use of bowel preparation before a gastrointestinal procedure leading to dehydration and a fall. The view of the Anesthesia SIG was that this had to be regarded as a perioperative complication occuring before the procedure, as bowel prep would only have been administered as part of the package of surgical care.

• Refer to discussion item operative complications

3

IHTSDO-836 “Concept Model: Presence"

DSP

• David is asking for feedback from this group on representing observation results about “Clinical life phases.”

4

Combined disorder test 2

BGO, PHE

New test for authors, based on the following 4 heuristics to determine if they improve the consistency of modeling:

• For all resultant conditions that represent manifestations of a multisystem disorder, model as co-occurrent and due to.

• For all causative conditions that are systemic and non-curable, model as co-occurrent and due to.

• For all combined disorders where a cause can be either a disorder or a material agent (e.g. gallstones), model as caused by material agent.

• Use pattern 1, simple co-occurrence very sparingly - only for 2 conditions that are related by a common predisposition or represent an overlap syndrome.

5

Fetal or neonatal effect of X

PBR

• There are quite a few ICD 11 concepts of this format:
  Fetal or neonatal effect of fetal blood sampling

  Fetal or neonatal effect of maternal malnutrition

  Fetal or neonatal effect of maternal periodontal disease

  They mean findings in the fetus or newborn due to conditions associated with the mother. Existing related concepts in SCT subordinate to Fetal damage from disease in the mother (disorder) SCTID: 609429008 e.g.

  Fetal damage from maternal rubella (disorder) SCTID: 609434007

  - the SCT concept is modelled the following way >

  Occurrence → Fetal period

  Causative agent → Rubella virus

  Associated with → Viral disease

  I am unaware of existing rules concerning modelling these concepts and they are in effect combined disorders in different individuals - using the above example it would be tempting to express it in the alternative way:

  Disease

  Occurrence → Fetal period

  Causative agent → Rubella virus

  Due to→ Rubella

  IS_A Fetal damage from disease in the mother [SCTID: 609429008]

  But of course this fails to express the fact that the Rubella disease was present in the mother whilst pregnant with fetus - although one could argue that if the mother had rubella the fetus had it too - so the suggested model goes as far as it can.

6

HTLV-1 and adult T-cell leukemia//lymphoma

PBR

X following Y, X due to (and co-occurent) Y, X caused by Y

7

AOB, adjourn

ALL

• Next meeting 8/22/2016 19:00 UTC