Disjunctive components
An open discussion on the Use of “+” and “&” in LOINC Components and their representation in SNOMED CT as part of the LOINC/IHTSDO alignment
Comments
In my opinion, I think given the limited expressivity of SNOMED’s DL at this time, the current approach of creating disjunctive primitives and manually asserting the individual components underneath although resulting in some degree of inconsistency seems most reasonable. Another suggestion alluded to in Daniel’s presentation was to model a subset in Protégé using OWL and export the classified results back to SNOMED as a primitive hierarchy. This should be investigated further.
Thanks Bruce,
there's still a decision to be made if the primitives are to be added at the level of the substances/organisms/etc. or the observables.
/Daniel
Adding disjunctive substances will help with the issue we are seeing with allergy/adverse reactions to drug combinations such as amoxicillin+clavulanate - so I would favor that approach.
Bruce
And that is a bit special, while in most cases, e.g. concentration of Alanine+Beta Alanine+Sarcosine, it means any or all of the alternatives, i.e. concentration of (Alanine OR Beta Alanine OR Sarcosine), while in the case of susceptibility towards amoxicillin+clavulanate case and other cases where there is a synergistic effect all constituents must be present, i.e. SOME Amoxicillin AND SOME Clavulanate. I guess there are (at least) two distinct meanings of the +.
/Daniel
Daniel Karlsson asked that the Editorial Advisory Group review and comment on the issue surround the use of disjunctive component in LOINC and how they might be addressed as part of the LOINC project. An issue brief is available from
https://snomed.atlassian.net/wiki/download/attachments/131537657/LOINC%20-%20SNOMED%20CT%20cooperation%20project%20-%20Union-Disjunction.pptx?api=v2
Please post your comments here and we will add this to our next conference call