2018-08-20 - OBSERVABLE Meeting

1

Welcome & apologies

@Daniel Karlsson

• Remember recording!

2

Conflicts of interest

@Daniel Karlsson

• None stated

3

Previous minutes

@Daniel Karlsson

4

Susceptibility

@Suzanne Santamaria

@Farzaneh Ashrafi

@Daniel Karlsson

@Former user (Deleted)

• Mapping of LOINC component for Susceptibility LOINC terms

• There will likely be a new "diagnostic product" hierarchy parallel to the medicinal product hierarchy, reusing attributes and patterns from that hierarchy. The priority of this work is currently unknown

  • The new category would need modeling guidance (cf. Clinical Drug (CD) Concept - Pattern 1a, permission needed!). Some of the items that should be considered are as follows (from Farzaneh and Toni):

  • Do we need a new semantic tag?

  • Can the concepts be modelled with a single pattern/template or are there multiple patterns/templates needed?

  • Can we reuse of some of attributes in medicinal product and CDs? Do we need to create new ones?

  • Does the hierarchy require groupers?

  • Do any concepts have strength ranges?

  • If a concept specifies more than one substance, does each substance have an associated strength?

  • See this page for discussion: Diagnostic products

  • Draft editorial guidelines: Editorial Guidelines for Diagnostic Products Used for Susceptibility Testing

5

Diastolic arterial pressure 

@Suzanne Santamaria

"Diastolic arterial pressure - please can you review current content regarding diastolic arterial pressure and add a new concept for Diastolic arterial pressure. There is a concept that is inactive. This would match 72313002|Systolic arterial pressure (observable entity)|, and thus provide the required Observable targets for all GP composite BP readings.

There are currently two observable entity concepts for the recording of 271649006 | Systolic blood pressure (observable entity) and 72313002 | Systolic arterial pressure (observable entity) but the diastolic observable entity concept (271650006 | Diastolic blood pressure (observable entity)) has the synonym of 2620223019 | Diastolic arterial pressure. Please can you review this concept and add a new concept for Diastolic arterial pressure? 

Primary care composite BP readings (of which there are a few billion to be migrated...) are generally recorded against two READ2/CTV3 codes, one for the systolic and one for the diastolic element. These need mapping to SCT observables. The 'obvious' targets of 271649006|Systolic blood pressure (observable entity)| and 271650006|Diastolic blood pressure (observable entity)| are IMHO in fact inappropriate because they're groupers: they subsume, for example, the notions of target BP. This is potentially a problem in querying contexts; I'd rather move the 'random' BP readings further down the taxonomy. A suitable concept already exists under 271649006|Systolic blood pressure (observable entity)|, but the proposed solution requires the other half instating under 271650006|Diastolic blood pressure (observable entity)|.

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292017000600005 https://www.ncbi.nlm.nih.gov/pubmed/18469640"

I reviewed the Vital signs I/E document again ( https://snomed.atlassian.net/wiki/x/j4-OBw) and didn’t find this specifically addressed except the mention of the above description. Some questions I have:

• Do we need a concept which is “Systolic arterial blood pressure at single point in time?” or “Random systolic arterial blood pressure?” (and equivalent diastolic arterial pressure)?

• Do we need to reactivate 67726005 |Diastolic arterial pressure (observable entity)|?

• Do we need to remove description “SAP - Systolic arterial pressure” from 271649006 |Systolic blood pressure (observable entity)|?

• What is intended relationship and difference between 271649006 |Systolic blood pressure (observable entity)| and 72313002 |Systolic arterial pressure (observable entity)|? Currently they are supertype-subtype.

6

Target observables

@Suzanne Santamaria

...two member countries (US and UK) have requested a series of target observables in the past (2011?). The request was "hidden" in a JIRA ticket rather than both being in CRS so they have not been on our radar. There is a chance they could be added to SNOMED CT if: 1) SI and the US agree to add the content; 2) the precoordination pattern was unblocked (PCP-5 artf223120-Target range/value for <X> (observable entity) is an “unreviewed” and blocking pre-coordination pattern, but could be reviewed shortly). Before I proceed in inquiring about the above, we wanted to seek modeling advice for these type of concepts. Could they be modeled or would they need to be primitives at this point in time?

Previous discussions: 2016-10-24--26 - OBSERVABLE Meeting

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Next meeting

@Daniel Karlsson

• Next meeting is on on 2018-09-17

• Face-to-face meeting agenda

• As the LOINC project is on hold, we will shift to monthly Observables calls

8

AOB

@Daniel Karlsson