Please review the breifing note: Proposal to move 129453003 |Deficiency of (attribute)| from unapproved to approved. Comments are due by November 30. We will also be discussing this on a future EAG call.
Hi Jim and fellow EAG members,
We recognise this branch as one that requires some quality improvement. When translating, we often struggled with semi-duplicates or triplicates: the deficiency of, which is sometimes defined as a finding and sometimes as a disorder; and the clinical manifestation that in practice often gets called ‘deficiency of’.
I think it would be great to have an attribute that allows us to model the deficient substance. However, the current proposal does not seem to solve the confusion between a clinical manifestation and the unmanifested deficiency.
Have you considered the following alternative?
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Model deficiencies (e.g. lab results) as a finding: deficiency of = substance
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Model deficiencies with a clinical manifestation as a disorder: deficiency = substance
That makes the difference between the deficiency itself and its manifestation clear but also shows there is a link.
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The proposal would be to model findings using the INTERPRETS/HAS INTERPRETATION relationship group to define the observation as a level of the substance as being below or above the reference range. It would be assumed that these would indicate a single observation, whereas multiple observations of the same type would indicate a disorder. Disorder concepts would use the proposed “deficiency of” attribute to identify the substance associated with the deficiency. On the general Briefing note forum, there has been a more extensive discussion around the impact of this proposal. I would encourage you to add your thoughts to that thread.