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SNOMED Extension proposal #185
original forum post along with comments
But sometimes we meet a bunch of problems related to inequality of the ontologies.
Here are the examples of mappings where we can't find exact match.
Case 1. Mapping to a more general concept
M99.03 "Segmental and somatic dysfunction of lumbar region" Maps to 203708004 "Segmental and somatic dysfunction"
Case 2. Mapping to a several concepts describing condition and co-occurring condition
E10.321 "Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema Maps to 138881000119106 "Mild nonproliferative retinopathy due to type 1 diabetes mellitus"
G43.001 "Migraine without aura, not intractable, with status migrainosus" Maps to 230467008 "Status migrainosus"
Advantage: although we don't have corresponding concept, we can fully represent the patient condition in CDM, both conditions will have the same visit_occurrence_id (if given) and the same visit_start_date, visit_end_date.
Case 3. Mapping to a same-meaning concept but with different hierarchy (ICD10CM and SNOMED uses different principles for hierarchy sometimes)
E10.21 "Type 1 diabetes mellitus with diabetic nephropathy" Maps to 421893009 "Renal disorder associated with type 1 diabetes mellitus"
F11.1 "Opioid abuse" Maps to 5602001 "Opioid abuse" 438130
As you can see ontologies mismatch can lead to a wrong cohort definition.
Obviously, some decision need to be done.
From the vocabulary user perspective the best decision is to add to the vocabulary SNOMED-like concepts (SNOMED Extension) that have exact match to a given source vocabulary.
These SNOMED-like concepts will have hierarchical relationships as SNOMED concepts have. Thus using concept_ancestor the user will get the accurate cohort definition.
Issue: Mismatched ICD-9/10-CM to standard concept mappings
C34 Malignant neoplasm of bronchus and lung now is mapped to Malignant neoplasm of respiratory system (not specific)
This approach looks quite time consuming, but it will solve all the condition mapping related problems.
Please let me know you thoughts and suggestions