1

Welcome and role call

BGO, all

2

 Allergy/hypersensitivity editorial guidelines

BGO

• Update on allergy/hypersensitivity model and allergy to x revision project

• Input from Allergy-hypersensitivity clinical reference group

  • The term "pseudoallergy" is obsolete as discrete pathophysiologic mechanisms have been identified. Recommendation is to replace with non-allergic hypersensitivity which will align more closely with WAO/EAAAI nomencalture

• Addition of Clinical finding to domain for has realization slated for end of August

• Allergy to x revision project delayed due to hold on batch edit functionality

• Use of towards attribute to associate material entities with intolerance disposition

• BGO to propose revision of model for pseudallergy to include more granular pathophysiologic processes.

3

Concurrent vs. co-occurrent

BGO

• Question as to whether to use co-occurrent vs. concurrent in FSNs for pattern 2 and 3 combined disorders

• See attachment/comments

• Analysis/summary from @Phil Brown

concurrent.docx

• Comment from @Jim Case

"If I can weigh in late here, as I have mentioned in the past a few times, we are striving to make our FSNs both specific and explicit. Given Phil's concern that the term "concurrent" might carry some baggage (I feel the same way, but do not have objective evidence), I feel that we are OK with using co-occurrent. To try to further justify this, where there is simple co-occurrence, we use "X and Y", as Bruce mentioned. Where there is both co-occurrence and causality we allow for a description that uses only DUE TO (since many do not care specifically whether there is a temporal association). So from a retrieval aspect, I think we are putting any undue burden on folks trying to find a specific concept.

While it is unfortunate that the term "co-occurrent" has most use in NLP, it still works well to allow for the specificity we are looking for".

4

Modeling fetal and maternal related concepts

PBR

Alternate model using occurrence role

fetal_maternal_modelling.pptx

Tabled for a future meeting

5

Alternate model for complications 

YGA

Define complications using complication (attribute) - unapproved. Use GCIs to define Complications as of disorders or procedures 

6

Complications and sequela

BGO

• Assigning a parent of Complication for co-occurrent and due to pattern

From editorial guidelines:

Complications and the co-occurrent and due to pattern

A parent of 116223007|Complication (disorder) should not be assigned to combined disorder concepts modeled using the co-occurrent and due to pattern as there is no mechanism to indicate that only the resultant condition represents the complication.

• For all causative conditions that are systemic and non-curable, model as co-occurrent and due to. o Example: 21921000119103 |Dementia due to Pick's disease (disorder)|=Dementia co-occurrent and due to Pick’s disease

• Issue identified is that in some cases it would be desirable to assign Complication as an additional parent to a co-occurrent and due to pattern.

  • Example: Diabetic complications

• See attached for proposed model

  • Complications co-occurrent and due to diabetes.pptx

7

Modeling of CVAs due to thrombosis/embolus - follow-up

BGO, PBR

• Proposed model was to use specific artery/vein thrombosis concepts as value of due to along with an associated morphology of 78195007 |Occlusive thrombus (morphologic abnormality). Issue raised that occlusive thrombus (morphologic abnormality) as residing in role group 0 would refer to theCVA rather than the thrombosis. Suggested solution is to create specific occlusive artery/vein thrombosis concepts as the value of due to

• Revised model presented. Same parents inferred as original model. Question of need to revise model as it would require creating many new precoordinated classes

• Questions also arose as to the overloading of the morphology hierarchy with structures that increasingly specify a simple morphology by including an underlying cause such as Hemorrhagic infarct (morphologic abnormality)

• It was suggested that guidelines need to be developed for when to use a highly specific morphology vs a simple morphology with additional relationships in order to define certain concepts

• Question arose as to use cases for developing above guidelines

  • Modeling consistency

  • Queries/data aggregation

• Stroke_Modelling.docx

Tabled for a future meeting

8

Sepsis/organ dysfunction syndrome

YGA

• There are 43 subconcepts under 238151006|Sepsis-associated organ dysfunction (disorder)|. They need to be reviewed and revised following the Editorial Guide on X with Y associations. Some specific issues need to be addressed:

1. Which pattern should this concept and its subconcepts belong to, e.g. due to vs. co-occurrent and due to?

2. Should these be implemented as description changes of FSNs or inactivation of concepts?

3. Should 238151006|Sepsis-associated organ dysfunction (disorder)| be subconcept of 91302008|Sepsis (disorder)|?

4. Should 91302008|Sepsis (disorder)| is a subconcept of 238149007|Systemic inflammatory response syndrome (disorder)|?

5. Should sepsis is a subconcept of 238147009|Organ dysfunction syndrome (disorder)|?

6. Should 76571007|Septic shock (disorder)| is a subconcept of sepsis?

Organ dysfunction with sepsis.pptx

9

Traumatic amputations

BGO

• Model Using morphology or amputation due to trauma?

10

AOB, adjourn

ALL

• Next meeting August 28, 2017 20:00 UTC