Management of the concept Single live birth (finding)
A request has been received regarding the terming of the concept 169826009 |Single live birth (finding)| as it could be interpreted to mean a single live birth from a singleton pregnancy or alternatively a single live birth from a multiple pregnancy. The requester suggested it be re-termed to make it clear it was from a singleton pregnancy.
This concept has high usage when looking at UK usage data.
The concept looks to be derived from ICD 10. In ICD Z37 Outcome of delivery has the exact wording: Z37.0 Single live birth. The category then goes on to have separate ICD-10 codes for other birth outcomes.
The meaning of this concept needs to be clarified. This could be undertaken through inactivation and replacement (but it is a high usage concept) or alternatively, description changes.
Possible new concepts would be:
Live birth from singleton pregnancy
Live birth from multiple pregnancy.
Input from the CMAG is being sought on:
- the meaning of that concept in your country
- usage in your country
- the preferred solution for your country
Please provide your responses by the end of July. If additional time is needed please let us know.
Response due date extended until 6th September.
Thank you.
Comments
Thanks for your input John.
We can't find any usage of this concept. The concept is translated in Dutch as 'Single live birth from singleton pregnancy', so that is our interpretation of the concept. Depending on how the concept is changed, it could have impact on our translation and meaning of the concept. Changing the concept as source 1 of John proposed would have no impact for us (keep the “Single live birth” description and add “Single live birth from singleton pregnancy” as the FSN). The most clean way would be to deactivate the concept and create 2 replacements.
Hi all,
In Belgium we refer in our translations (French & Dutch) of this concept to a single pregnancy. So no confusion from our site with multiple pregnancies or ambiguity of the concopt/fsn. I agree with John his suggestion about keeping the FSN and adding a synonym.
fyi, we included this concept in our GP reference sets (721000172106)
Hi Cathy,
I have requested feedback from several clinical subject matter experts and to-date have received only one response as follows:
Source 1:
As a physician, “single live birth” would not be confused with multiple pregnancies. If I just saw or heard “single live birth” alone I would not think about multiple pregnancies. Can you not just keep the “Single live birth” description and add “Single live birth from singleton pregnancy” as the FSN?
Source 2:
We do not have usage statistics for this concept
We support the proposal to inactivate the existing concept and create the two new concepts. However, we noted that the proposed FSNs for the new concepts do not capture the “single-ness” of the original concept 169826009 |Single live birth (finding). In other words, for clarity, it may be desirable to add “Single” to the FSNs of the new concepts.
Source 3:
The following value sets from the Value Set Authority Center (VSAC) contain the concept, 169826009 |Single live birth (finding)| , with the following metadata:
Value Set Name: Delivery of Singleton
Steward: The Joint Commission
Definition Version: 20210611
OID: 2.16.840.1.113762.1.4.1045.173
FHIR URI: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.173
Clinical Focus: The purpose of this value set is to group diagnoses of a fetus in an abnormal position in the uterus at the time of delivery.
Value Set Name: Problem
Steward: HL7 US Realm Program Management
Definition version: 20240607
OID: 2.16.840.1.113883.3.88.12.3221.7.4
FHIR URI: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.7.4
Clinical Focus: A pathology or disorder identified in a patient
Value Set Name: Complications of Pregnancy, Childbirth and the Puerperium
Steward: National Committee for Quality Assurance
Definition Version: 20230209
OID: 2.16.840.1.113883.3.464.1003.111.11.1023
FHIR URI: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.11.1023
Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of complications related to pregnancy or childbirth.
I will append any additional comments I receive before the deadline to this post.