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ICD 11 FC and SNOMED CT – finding as Ontologies of Clinical Situations

ICD 11 FC and SNOMED CT – finding as Ontologies of Clinical Situations. Stefan Schulz. Model according to SemanticHealthNet. includes Condition. isAbout Situation. Clinical Diagnosis. Clinical Situation. Clinical Condition. not includes Condition. isA. Clinical Disposition.

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ICD 11 FC and SNOMED CT – finding as Ontologies of Clinical Situations

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  1. ICD 11 FC and SNOMED CT – finding asOntologies of Clinical Situations Stefan Schulz

  2. Model according to SemanticHealthNet includesCondition isAboutSituation Clinical Diagnosis Clinical Situation Clinical Condition not includesCondition isA Clinical Disposition ClinicalStructure ClinicalProcess EHR Patient A clinical situation with X is a phase of a patient's life in which a condition of the type X is wholly present A clinical situation without X is a phase of a patient's life that does not include any condition of the type X at any time

  3. Conjunction Example (ICD11 draft) Situation Situation isA isA Situation

  4. Example (ICD11 draft) clinical disposition ? clinical process? clinical structure? clinical structure? Situation isA Situation isA Situation isA Situation

  5. Situations in SNOMED CT • Many Is-a links in the SNOMED finding hierarchy only plausible for situations (Tetralogy of Fallot example), cf. eHealth 2012 paper • Very difficult to draw a line between conditions and situations, cf. AMIA 2012 paper • Caveat: Bipartition in existing SNOMED situation hierarchy (context model): • Situations proper (e.g. Has a red eye) • Information entities (e.g. Suspected sarcoma) • See MEDINFO 2012 submission on the SNOMED CT context model

  6. Open issues (II) • Consensus in both communities • Action to "officially" declare SNOMED CT findings/disorders as Clinical situations • "Situation" in FSNs and text definitions • What about disjointness of ICD categories? • Tricuspid stenosis and Mitral stenosis are disjoint conditions • Situation with Tricuspid stenosis and Situation with Mitral stenosis are not disjoint (only very few situations are really disjoint, e.g. pregnancy and prostate cancer) • Axiomatization of "Clinical Situation": JAMIA paper under review

  7. Open issues (II) • Exclusions: • Many ICD class that carry (or inherit) exclusions • Classes with exclusions are managed in the foundational component • Classes with exclusions do normally not exactly map to SNOMED CT concepts • e.g. icd:Acutepericarditis excludes rheumatic p. • icd:Acutepericarditis equivalentTosct:AcutePericarditis and not RheumaticPericarditis

  8. Exclusions and common ontology e e e e e e e e e e e e e e e e ICD linearizations and FC only FC (common parents of "e") ICD "heading" common ontology concepts only ICD linearizations (residuals) ICD classes that carry exclusions SNOMED CT e

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