Similarly to blindness in certain eye, it is crucial to record which eye has wet AMD.
Similarly for 230509007 |Non-arteritic ischemic optic neuropathy (disorder)|
For production use of SNOMED CT, we can’t live without having a precoordinated term for lateral specific eye conditions where ICD1x (10 or 11) has left and right eye specific codes.
For conditions that progress from one eye to the other (or may worsen in the same eye) (ischemia to the same eye as before) - my submission will bring SNOMED to level where we need it to be.
Is there any high level policy on laterality and diseases. I prefer to be inline with the overall strategy.
HI, I’m an ophthalmologist and interop enthusiast, my focus is mostly on openEHR and FHIR but I want any eye care data point to potentially be useable across openEHR, FHIR and OMOP. So just a disclaimer that I’m writing this because I want all of these standards (and and SNOMED of course) to succeed and harmonize in my domain.
@icacciottolo I’m sure the larger implications for this for a domain like eye care have been considerered, is there a documentation of this decision or rule?
@vhuser I absolutely appreciate the effort to push for better representation of eye care concepts in OMOP. Nontheless, this is squarely on the slippery slope to having nearly all concepts in eye care that can relate to one eye be represented with precoordinated laterality, codes, it does not stop at conditions.
I know these terms can be resolved to the same parent, but this pattern contributes to ambiguity of how snomed is to be used across production systems that handle primary data and multiplies the codes needed for further precoordination with concepts where there is truly no other option.
Many of the codes you are suggesting could be taken from the ICD10CM in this post are so general that they will grow to have more children with more precoordinated concepts in the future.
Also, if you want to batch request based on ICD10CM and precoordinate laterality, what is the plan for “laterality unknown” or “bilateral”? It might not be relevant for the purposes of OMOP, but in routine care where patients may simply not recall which of the eyes had a certain diagnosis it certainly can be.
For glaucoma there are already bilateral codes in use:
347381000119106 | Bilateral acute angle-closure glaucoma (disorder)
I’m not saying please request everything with bilateral as well, I just want to point at what is right below us on the slippery slope.
I hope you are not offended but not being able to live does strike me as a bit of a dramatization.
Honest question because I’m not an OMOP expert:
FHIR and openEHR can represent the laterality of a condition as a seperate attributes/data elements - I know the OMOP CDM does not - but do you know if this is a can’t or a won’t?
Here is follow up on this topic. Above in the thread, we indicated ideally targeting international edition.
As of today, the request was processed. (made in US content request system using batch mode). Thank you !
There is no field/column in CRS for the submitter to indicate edition (international or national).
Q1 Is there a way to submit content in a national CRS and specify international edition as target edition? How exactly? If it was decided to go to national extension during processing of the request (in absence of desired edition field) - is there a way to appeal that decision before the submission is processed? (once done in national extension, it is more difficult to post-hoc correct it)
Q2 What is the process exactly of submitting a promotion of concept from national extension to international edition?
Q3: Given instructions of (see link below): “Requests that meet inclusion criteria for the International Release are addressed by ….”. We think our request met those criteria. (needed by more than 1 country) (represented by OHDSI vocabulary WG with international representatives)
SNOMED International coordinates requests for additions or changes to SNOMED CT through its Members’ National Release Centers (NRCs). For more information about the processes in each country/territory, please access the relevant Member page.
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Members’ NRCs and other authorized users submit requests for additions or changes via the SNOMED CT Content Request Service (CRS). Requests that meet inclusion criteria for the International Release are addressed by SNOMED International staff. If a request is declined, a reason and explanation is provided to the requester, who may choose to appeal the decision to the Head of Terminology.
When submitting a request to the US NRC, you can add a comment in the summary field recommending that the concept be forwarded to the International CRS system. After submitting the request, you can follow the progress through the USCRS system and communicate your desire to have the request handled by the International release. It is the decision of the US extension manager to decide whether the request is suitable for forwarding. If the concept does end up in the extension, then you can request promotion by submitting another request (using the “other” category) along with evidence that the concept is required by another member.
I would think that your use case would support inclusion in the international release and if the request is documented sufficiently, there should be no problem.
