2023-10-31 - Eye Care CRG Meeting

1

Glaucoma Diagnoses Update

Ian Rodrigues/Anthony Khawaja

2

Glaucoma Exam/Findings Update

Sally Baxter

Review final proposal document for gonioscopic grading framework - make any remaining adjustments

Plan for approval processes with AGS and EGS 

Josh Stein sending proposal to AGS

Anthony will present to EGS but as part of other items as well (preferred terms, severity staging, etc.)

• Elaine will ask Jane Millar for template of how changes are presented to societies (e.g. dental, epilepsy)

Request to update anatomical regions related to the eye in SNOMED

Sally Baxter

Request from OMOP workgroup lead Kerry Goetz to evaluate need to update anatomical regions related to the eye in SNOMED - see link below

Eye - SNOMED CT Editorial Guide - SNOMED Confluence (ihtsdotools.org)

The editorial guide is not a comprehensive list of anatomic regions

Examine SNOMED International browser to check eye structure concepts (1500 concepts) - Sally and Shahin

Sally will share OMOP medical imaging workgroup info

Looking at glaucoma procedures (and potentially medications?)

Ian has already started looking at procedures

• Not sure if brand name devices/implants can be named?

• Cardiac stent example: code the generic procedure, then devices named in individual country extensions

• Brand name procedure more useful in glaucoma 

Medications

• unclear what the overlap is with RxNorm - may not need to replicate

• branded products coded separately by country (generic medications coded in SNOMED international)

• Just an example of a generic product in SNOMED: 408614000 |Product containing precisely latanoprost 50 microgram/1 milliliter and timolol (as timolol maleate) 5 milligram/1 milliliter conventional release eye drops (clinical drug)|

• May not necessarily be needed? (current coding may be comprehensive enough)

• Field for number of glaucoma medications? vs. derived data element? – issue of updating med list, also issue of whether pt is actually taking the medication (medication adherence coding?)

Procedures - UK group

• Elaine will look into feasibility of coding specific device names

• Generic descriptions in GMDN (Global Medical Device Nomenclature): https://www.gmdnagency.org/

  • check for existing coverage here

• May be worth checking other coding systems (often country-specific)

• Implementation consideration - could have code on the back-end and then different display name on the front-end 

  • can have a crosswalk between trade name, generic description, and code 

Ian will generate initial draft and distribute for review

Medications - Eric will examine coverage of glaucoma medications / medication classes 

• question of whether compounded medications would be represented

• initial analysis of UK and US 

• Is laterality represented? (may be in route)