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  2. CQM-873

Missing SNOMED codes based on IS A relationships

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    • Icon: Value Sets Value Sets
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      Thank you for your inquiry regarding the SNOMED concepts that are not included in certain value sets, based on the Is A relationships. The question raised here is quite broad, and most likely affects multiple value sets across multiple value set stewards beyond the example of the Glaucoma Value set. We agree that in certain cases, it may be appropriate to include all SNOMED concepts that are defined as the concept of interest, based on Is A relationships. In some cases, however, depending on the context of the value set, including all the children of a given SNOMED concept may not be appropriate, as it may pull in specific concepts which the measure is not intended to include. As the value sets are updated, we can review the AMA-PCPI stewarded value sets to identify where the value set intent lends itself to including all children of a given clinical concept, and incorporate into future versions of the value set. We appreciate the analysis of the Glaucoma value set that was provided and will be sure to review the list of concepts as we update our value set.
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      Thank you for your inquiry regarding the SNOMED concepts that are not included in certain value sets, based on the Is A relationships. The question raised here is quite broad, and most likely affects multiple value sets across multiple value set stewards beyond the example of the Glaucoma Value set. We agree that in certain cases, it may be appropriate to include all SNOMED concepts that are defined as the concept of interest, based on Is A relationships. In some cases, however, depending on the context of the value set, including all the children of a given SNOMED concept may not be appropriate, as it may pull in specific concepts which the measure is not intended to include. As the value sets are updated, we can review the AMA-PCPI stewarded value sets to identify where the value set intent lends itself to including all children of a given clinical concept, and incorporate into future versions of the value set. We appreciate the analysis of the Glaucoma value set that was provided and will be sure to review the list of concepts as we update our value set.

      In looking at SNOMED codes included in Value Sets, the listed SNOMED codes do not seem to pull in all more granular codes that have a IS A relationship to those included. While there will certainly be exceptions (depression value set excluding "in remission" codes may be intended, etc) and errors in the SNOMED hierarchy, every value set I've looked at seems to be missing codes that would work.

      Attached is one example set based on the glaucoma value set. The SNOMED codes in column D & E have a IS A relationship to SNOMED codes used in the value set (columns B & C).

      Unfortunately, I'm not currently familiar with the value set editors, but is there a planned improvement to the SNOMED explosion logic?

        1. mu2_vs_glaucoma_missing_child_snomed.xlsx
          10 kB

            rob.mcclure Rob McClure (Inactive)
            galdin Greg Aldin (Inactive)
            Cindy Cullen, Julia Skapik (Inactive), Maureen Madden (Inactive), Rob McClure (Inactive), Steve Emrick (Inactive)
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