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  • The term "pseudoallergy" is obsolete as discrete pathophysiologic mechanisms have been identified.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

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

  • Discussion centered around need for test environment to evaluate new roles, domains and ranges, etc.. @Jim Case suggested a test project for each release cycle and said would need dialogue with @Rory Davidson. @Yongsheng Gao will follow-up.

As requested, a new Author Testing project is created for development and testing concept model project. This project disabled MRCM and promotion.

https://authoring.ihtsdotools.org/#/project/AUTHORTEST

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

• Group approved continued use of co-occurrent in FSN ("with" and "and" for PTs)

• Existing 3 concepts with concurrent in FSN need to be revised

• What about spell checker in SCA that prompts for spelling correction when co-occurrent entered?

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 

@Yongsheng Gao presented model for assigning complications for the due to pattern based on a new attribute and using GCIs. Group feeling was that although this process would address 99% of existing content, it would still require judgement to address the 1% of combined disorders modeled with due to that are not complications. Examples included myocardial ischemia due to coronary artery obstruction and gout due to elevated uric acid (dsorder due to a clinical finding).

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

@Bruce Goldberg and @Jim Case felt that proposed model would capture appropriate inferfences and that editorial guidelines should be revised to delete the statement that "A parent of 116223007|Complication (disorder) should not be assigned to combined disorder concepts modeled using the co-occurrent and due to pattern"

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

Revised definitions of sepsis and changes to modeling and terming as described in the attached file approved by group

9

Traumatic amputations

BGO

• Model Using morphology or amputation due to trauma?

@Jim Case felt morphology should be used until the time when a pathological process of trauma is approved as using due to will miss important inferences.

10

AOB, adjourn

ALL

• Next meeting August 28, 2017 20:00 UTC