Stream: snomed
Topic: Immunization Route
Richard Kavanagh (Nov 04 2019 at 23:22):
If using SNOMED to describe the immunization route as being an injection. Would it be appropriate to use a qualifier value such as:
78421000 | Intramuscular route (qualifier value) |
Michael Padula (Feb 18 2021 at 18:38):
Yes. For immunizations, you'd typically want to differentiate between intramuscular (IM) route versus Subcutaneous route (qualifier value) | SCTID: 34206005.
Lin Zhang (Feb 19 2021 at 00:27):
+1
Jeremy Rogers (Mar 23 2021 at 12:05):
Michael Padula said:
Yes. For immunizations, you'd typically want to differentiate between intramuscular (IM) route versus Subcutaneous route (qualifier value) | SCTID: 34206005.
Oral, intranasal and intradermal are also common routes of vaccine delivery.
Not sure about the wisdom of permitting the use of qualifiers rather than procedures; we would need to establish that the use of qualifiers will interoperate with other data that has explicitly used the procedures implied by the qualifiers instead and which, within the SNOMED reference data, are already explicitly modelled in terms of those same qualifiers:
386356001 Administration of drug or medicament via intramuscular route (procedure)
386362006 Administration of drug or medicament via subcutaneous route (procedure)
386355002 Administration of drug or medicament via intradermal route (procedure)
386359008 Administration of drug or medicament via oral route (procedure)
406172003 Administration of drug or medicament via nasal route (procedure)
Main challenge I foresee is that the formal definitions of the procedure codes above also entail an explicit representation of the anatomical site of the administration procedure. This anatomical site value is not trivially implied by the qualifier alone but is required to compute the equivalence between, for example:
34206005 Subcutaneous route (qualifier value)
386362006 Administration of drug or medicament via subcutaneous route (procedure)
Although other parts of the same FHIR message may represent the anatomical site of the injection, if this is captured more generally as e.g.
362677002 Entire buttock (body structure)
...then this still won't allow you to detect the equivalence between a pair of [route + site] codes carried by more than one FHIR element and the alternative of carrying one of the procedure codes above, unless the site was more specifically captured as:
52435007 Subcutaneous tissue structure of buttock (body structure)
Michael Lawley (Mar 24 2021 at 05:22):
Or you bind the administration site to something like:
<< ((386356001 |Administration of drug or medicament via intramuscular route (procedure)| OR
386362006 |Administration of drug or medicament via subcutaneous route (procedure)| OR
386355002 |Administration of drug or medicament via intradermal route (procedure)| OR
386359008 |Administration of drug or medicament via oral route (procedure)| OR
406172003 |Administration of drug or medicament via nasal route (procedure)|) . 405814001 |Procedure site - Indirect|)
Last updated: Apr 12 2022 at 19:14 UTC
