2021-03-25 - SLPG Meeting

Welcome and agenda

@Former user (Deleted)

Postcoordination Expression Processes

All

Postcoordinated expression processes

• Generic

• Use case specific

  • Mapping (from an interface term)

  • Terminology binding (using an expression template)

  • Natural Language processing

Postcoordination Use Case Examples

All

Example 1 - Dentistry / Odontogram

• Requires an expression template to create expressions.

• Resulting expression still requires a transformation to make it classifiable

Example 2 - Terminology binding

• Uses a fixed expression template to combine codes entered into separate fields

• The procedure+laterality example still requires a transformation to make it classifiable

Example 3 - Mapping

• Design-time activity

• Map targets may not be able to be fully represented using concept model attributes

• In many cases, an extension (with primitive concepts) should be recommended where there are gaps in the mapping

• There may be some cases in which postcoordination is helpful (e.g. LOINC to SNOMED CT map)

Example 4 - Natural Language Processing

• Usually run-time activity.

• May require manual confirmation of coding suggestions (unless low clinical risk, eg for suggesting relevant patient records for manual review)

Postcoordination Guidance

@Former user (Deleted) , @Anne Randorff Højen , @Kai Kewley

Practical Guide to Postcoordination

• Proposal - Use syntax (i.e. braces) to distinguish refinement vs new role group

  • There should be a syntactic distinction between refinement and constructive addition (ie adding a new role group). That is:

    1. 83152002 |Oophorectomy| :  405815000 |Procedure device|  =  122456005 |Laser device|

       • is classified as (i.e. the refinement is added to the role groups in the definition of the focus concept(s)):

         • 83152002 |Oophorectomy| :  
           { 260686004 |Method| = 129304002 |Excision - action|,
              405813007 |Procedure site - Direct| = 15497006 |Ovarian structure|,
              405815000 |Procedure device|  =  122456005 |Laser device| }

    2. 83152002 |Oophorectomy| :  { 405815000 |Procedure device|  =  122456005 |Laser device| }

       • is classified as:

         • 83152002 |Oophorectomy| :  
           { 260686004 |Method| = 129304002 |Excision - action|,
              405813007 |Procedure site - Direct| = 15497006 |Ovarian structure|},
           {  405815000 |Procedure device|  =  122456005 |Laser device| }

  • However, for attributes which are always self-grouped - i.e. Priority, Due to, After, Before, During, Clinical course, Temporally related to, and all Observable entity attributes (see Relationship Group), these must always be put into their own role group:

    1. 125605004 | Fracture of bone |: 42752001 | Due to (attribute) | = 1912002 | Fall |

       •  is classified as:

         • 125605004 | Fracture of bone |: { 42752001 | Due to (attribute) | = 1912002 | Fall | }

         • or

         • 125605004 | Fracture of bone |: 
           { 363698007 |Finding site| = 272673000 |Bone structure|,
             116676008 |Associated morphology | = 72704001 |Fracture| }
           { 42752001 | Due to (attribute) | = 1912002 | Fall | }

• Proposal: Expression forms needed for this (see 3.4 Transforming Expressions)

  • Close to user form - e.g. 83152002 |Oophorectomy| :  405815000 |Procedure device|  =  122456005 |Laser device|

  • Canonical close to user form - e.g. 83152002:405815000=122456005

  • Classifiable form (SCG) - e.g. 83152002:{260686004=129304002,405813007=15497006,405815000=122456005}

    • PLUS Classifiable form (OWL) - e.g.  

      • EquivalentClasses(:123063
           ObjectIntersectionOf (:71388002
               ObjectSomeValuesFrom(:609096000 ObjectIntersectionOf( ObjectSomeValuesFrom(:260686004 :129304002)
               ObjectSomeValuesFrom(:405813007 :15497006))))

  • Necessary normal form - e.g. 83152002+416376001:{260686004=129304002,405813007=15497006,405815000=122456005}

    • PLUS Necessary normal form (tables)

      • Relationships:

        • (123063 116680003 83152002) - 0

        • (123063 260686004 129304002) - 0 

        • (123063 405813007 15497006) - 1

        • (123063 405815000 122456005) - 1

  • Primitive expressions - "<<<" (only useful in a mapping context) → .... relies on the assigned identifier (which are necessarily semantically unique).

• Proposed Transformation Rules - Refinements (in valid domain of focus concepts)
  Close-to-user-form - IF the grouping of the refinement is not concept model valid THEN
            If there is a single (non-self-grouped) role group in the definition of the focus concept, then any ungrouped (but groupable) refinements are merged with this role group
            If there is more than one (non-self-grouped) role group in the definition then flag as ambiguous and require refinement
                         NEED TO FIND a realistic clinical example where this may occur // Prevent failing cases from coming up // use template
                         ALTERNATIVE: Refinement is applied to all (non-self-grouped) role groups in the definition
            Self-grouped attributes in the refinement are grouped on their own - i.e. Priority, Due to, After, Before, During, Clinical course, Temporally related to, and all Observable entity attributes (see Relationship Group)
           Self-grouped attributes in the definition of the focus concept(s) are left unchanged

  1. Single refinement
     83152002 |Oophorectomy| :  405815000 |Procedure device|  =  122456005 |Laser device|

     • →  83152002 |Oophorectomy| :
              { 260686004 |Method|  =  129304002 |Excision - action| ,
                405813007 |Procedure site - direct|  =  15497006 |Ovarian structure|,
                405815000 |Procedure device|  =  122456005 |Laser device|  }

  2. Two groupable refinements
     83152002 |Oophorectomy| :  405815000 |Procedure device|  =  122456005 |Laser device|, 363700003 |Direct morphology| = 367643001 |Cyst |

     • →  83152002 |Oophorectomy| :

     •        { 260686004 |Method|  =  129304002 |Excision - action| ,
                405813007 |Procedure site - direct|  =  15497006 |Ovarian structure|,
                405815000 |Procedure device|  =  122456005 |Laser device| ,
                363700003 |Direct morphology| = 367643001 |Cyst | }

  3. One groupable refinement with one self-grouped refinement
     83152002 |Oophorectomy| :  405815000 |Procedure device|  =  122456005 |Laser device|, 260870009 |Priority| = 394849002 |High priority|

     • →  83152002 |Oophorectomy| :

     •        { 260686004 |Method|  =  129304002 |Excision - action| ,
                405813007 |Procedure site - direct|  =  15497006 |Ovarian structure|,
                405815000 |Procedure device|  =  122456005 |Laser device| }
              { 260870009 |Priority (attribute)| = 394849002 |High priority| }

  4. Refinement attribute matches (or subsumed by) attribute in focus concept's definition
     83152002 |Oophorectomy| : 260686004 |Method|  = 277261002 |Excision biopsy (qualifier value)|

     • → 83152002 |Oophorectomy| :

     •        { 260686004 |Method|  =  129304002 |Excision - action| ,

     •          260686004 |Method|  =  277261002 |Excision biopsy (qualifier value)| ,

     •          405813007 |Procedure site - direct|  =  15497006 |Ovarian structure| }

  5. Refinement explicitly in role group
     83152002 |Oophorectomy| :  { 260686004 |Method|  =  281615006 | Exploration - action | , 405813007 |Procedure site - direct|  =  367643001 |Cyst | }

     • →  83152002 |Oophorectomy| :

     •        { 260686004 |Method|  =  129304002 |Excision - action| ,
                405813007 |Procedure site - direct|  =  15497006 |Ovarian structure| },
              {  260686004 |Method|  =  281615006 | Exploration - action | , 
                405813007 |Procedure site - direct|  =  367643001 |Cyst |}