2021-10-04 - MBH-CRG Meeting

1

Phobia

@Piper Ranallo PhD @Elaine Wooler

386808001 |Phobia (finding)| - Descriptions

FSN:     Phobia (finding)

PT:       Phobia

SYN:     Abnormal fear

SYN:     Fear of

Suggest that synonyms of the type – Fear of X should be inactivated as these aren’t synonymous with phobia.  If appropriate a new concept created under 1402001 |Fear (finding)|.

Is "abnormal fear' correct or could this be better expressed?

There are also subtypes of 386808001 |Phobia (finding)| that do not seem to be phobias and have no description with the word phobia present e.g. 288251000119107 |Fear of injury (finding)| - which may well be rational for example in someone who is frail.

Review notes from previous discussion in Mar 2020:

• Phobia findings , move from |Phobia (finding)| => | Fear (finding)|

  • ‘Irrational fear of X’ as FSN for concepts under phobia finding that are clinical findings only 

• Phobic disorders

  • ‘Phobic disorder’ for FSN of concepts that represent true phobic disorders

  • ‘Phobia of X’ for preferred term

SYN: Fear of

Claims Matrix:

Open

2

Fearful mood/Fear

@Elaine Wooler

Siblings 1402001 | Fear (finding) and 367545001 | Fearful mood (finding)
The distinction between these two concepts seems difficult to justify in day to day clinical practice and the modelling is identical for both.

All but one of the 59 descendants of 367545001 | Fearful mood (finding) are also descendants of 1402001 | Fear (finding) with the exception of 231508009 | Examination fear (finding)

It is suggested that 367545001 | Fearful mood (finding) is inactivated as a duplicate of 1402001 | Fear (finding) which would be the preferred FSN representation.  

Options:

• Optiion 1: Inactivate | Fearful mood (finding) |   as a duplicate of 1402001 | Fear (finding) |

• Option 2: Keep  | Fearful mood (finding) | to represent the idea of  a longer duration / baseline emotional state of 'fear' and move any child concepts of  | Fearful mood (finding) |  that reflect fearful state (versus fearful mood) under concept  | Fear (finding) |

Open

Open

For existing child concepts of |Fearful mood (finding)|

For concept  |Fear (finding)|

For concept | Fearful mood (finding) |, keep it for now

Open

Notes:

CRG discussed the ambiguity inherent in the use of the terms 'mood', 'emotion', 'affect'; terms are used inconsistently in practice, in theories, in the literature, and in text books.

Questions asked:

• Should SNOMED included concepts for all possible meanings of these terms and focus on FSNs, narrative defs, and explicitly modeling that makes the nuanced distinctions clear? (Does not meet URU criteria)

• Should SNOMED include the core concept (e.g., emotion) and none of the nuanced distinctions with the understanding that the concept when captured can only be assumed to mean "any or all" of the many definitions clinicians have in mind when using the concept? (meets URU crtieria)

• Agreed that this is a bigger piece of work that require more reserach, discussion, and therefore will table for now

3

Anxiety

@Piper Ranallo PhD @Elaine Wooler

For later discussion:

What is the relationship between 

• Emotion  (finding) 

• Emotional state (finding)

One option:

Open