Nathan

The scope of ICD* includes items such as "injury from motor vehicle accident" 
(E codes), "past history of diabetes"(V codes), "family history of rheumatic 
fever"(V codes) which are not diagnostic events in the SNOMED concept model.  
For all "Diagnoses" retrieved from out Clarity problem lists and billing 
diagnoses, these items will have a slightly different access path in the SNOMED 
concept dimension.  We should probably discuss with the group what would 
provide most pragmatic access for our research community.



We agreed at Hackathon to prioritize SNOMED work to a later step and so there 
is no hurry to come to a conclusion on this issue

Jim

________________________________
From: Wilson Nathan [[email protected]]
Sent: Friday, March 14, 2014 10:19 AM
To: Campbell, James R
Subject: RE: Top level ontyology for i2b2

Hi Jim,

Thanks for sharing, some comments below..

ICD9CM: OK

SNOMED-CT Clinical Findings: OK

SNOMED-CT Events: This has not been discussed or mentioned until now (to the 
best of my recollection), how are you thinking that the GPC sites would 
implement this information?  From UW-Madison’s perspective we would need to 
create a mapping of our EPIC diagnosis IDs to SNOMED Event IDs and I do not 
believe that we can undertake such an effort at this time.

SNOMED-CT Past History: The group had talked about using a modifier on the 
diagnosis codes to indicate Past Medical History.

SNOMED-CT Family History: This has not been discussed or mentioned until now 
(to the best of my recollection), how are you thinking that the GPC sites would 
implement this information?  My concern is again for similar reasons as 
SNOMED-CT Events, although the set of information is small so it would be more 
possible.

Lab Tests look fine

Clinical Measurements are fine

Procedures, Orders, and Medications:  I known that we haven’t talked discussed 
this much as a group, but it may also be possible to use Modifiers to 
distinguish amongst the ordered and performed procedure as well as the ordered 
and administered medication.  When we talk about medications we may also want 
to include dispensed medications as well (again possibly as a modifier to 
medications).


Nathan

From: Campbell, James R [mailto:[email protected]]
Sent: Thursday, March 13, 2014 6:05 PM
To: Wilson Nathan
Subject: Top level ontyology for i2b2

Nathan
The top level ontology I was trying to discuss is below.  Otherwise the 
spreadsheet that I emailed had only the files that you and Dan had prepared.
Jim


Diagnoses

\ICD9CM


\SNOMEDCT\Clinical_Findings


\SNOMEDCT\Events


\SNOMEDCT\Past_History


\SNOMEDCT\Family_History

Laboratory Tests

\LOINC_Multiaxial


Clinical_Measurements

\Body_Measurements;VS

(Height;Length;Weight;BMI;BMI%;BP;Temp;Resp;)


\Historical_Characteristics

(Race;Gender;Ethnicity;Address(location);nationality;)


Procedures

Orders

\Procedures


\Medications

Medications administered



James R. Campbell MD
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