1

Welcome and role call

@Bruce Goldberg

2

Injuries

@Bruce Goldberg

Follow-up modeling traumatic and non-traumatic injuries for benefit of @Jim Case who was not present during last call

• Injuries.pptx

• @Jim Case will review slide deck above

• Topic will be presented during next EAG call
  
  
  

3

Re-examination of definition of complication

@Bruce Goldberg

Complication as an unexpected outcome of a disease, event, condition

• Re-examination of definition of Complication.pptx

Discussion centered around whether we should continue to assert complication for disorders due to other disorders

Attached below is a summary of our discussion by@Phil Brown from Feb. 2017

Options:

1. Eliminate the use of complication and sequela in FSNs and model all content using causal and or temporal relationships with FSNs reflecting the ECE naming conventions for combined disorders and disorders with procedures. Complication and sequela can be used as synonyms or perhaps as preferred terms. The downside is that the complication hierarchy is relatively large (848 concepts) with multiple large subhierarchies and the terms complication and sequela are common clinical parlance.

2. Assign all combined disorder and disorder + procedure content as children of complication, sequela or both.

   1. If modelled using a due to relationship, assign complication as a parent

   2. If modelled using after, assign sequela as a parent.

   3. If modelled using due to and after, assign complication and sequela as parents.

   4. Intermediate nodes can be defined as above and will autoclassify more specific content underneath.

 As an interim approach, I believe your suggestion to model and name combined disorders and disorders with procedures according to the ECE guidelines and not to assert complication and or sequela as parents while awaiting the creation of intermediate fully defined concepts is a sound one.

4

Development of new models/modeling templates based on review of 12,000 complex concepts

@Bruce Goldberg

Following concepts identified thus far requiring new models:

• Genetic diseases – Jim Campbell

  • Mutations and causative relationships

• Substance abuse

• Accelerated rejection of transplant

• Accidental/traumatic injury

• Poisoning

• Need to modify Deformity of [body structure] (finding) template to include after relationship

• Paraneoplastic syndrome

• Acute and subacute inflammation

• Complication of AIDS

• >2 conditions

• Complication during [and after) a procedure

• Prosthetic cardiac valve regurgitation.

• Pregnancy complications

• X disorder of X and Y body site – conjunction vs. inclusive or

• Atopic dermatitis

• Atopic dermatitis.pptx

• Poisoning.pptx

Poisoning:

1. Decision to retain 75478009 |Poisoning (disorder)| as a primitive concept. Subtypes can be defined using causative agent relationships.

2. Retire 35331000 |Toxic substance (substance)|

Atopic dermatitis/eczema:

1. Model skin itching using interprets/has interpretation

2. Add 43116000 |Eczema (disorder)| as a parent

3. Retire 238540004 |Constitutional eczema (disorder)| and add Constitutional eczema as an additional description to 24079001 |Atopic dermatitis (disorder)|

Vesicular eczema:

1. @Bruce Goldberg to refine model using GCIs

2. Need to decide upon best name for this entity

5

Sepsis

@Bruce Goldberg

Additional refinement of model

• Sepsis – additional refinement of model.pptx

1. Sepsis vs. septicemia

   1. Retire all concepts with Septicemia in FSN maybeA Sepsis + maybeA Virema/Bacteremia/Fungemia

2. Retire all concepts with Severe sepsis with acute organ dysfunction in FSN maybeA Sepsis

3. @Bruce Goldberg to remodel proposals for Endotoxicosis and Endotoxemia by removing due to relationships

4. For revised model of 449082003 |Sepsis caused by Gram negative bacteria (disorder)|, need to assert finding site in role group

6

Editorial policy for simple co-occurrence

@Bruce Goldberg

Should simple co-occurrence be restricted at this point to just multisystem rheumatologic diseases (and other multicomponent syndromes)

• Editorial policy for simple co-occurrence.pptx

• Simple co-occurrence.xlsx

Topic tabled for a future call

7

AOB, adjourn

ALL

Next call Monday, September 9, 2019 at 20:00 UTC.