Terminology Talk

Terminology Talk

By Dr. Linda Vidone, Delta Dental MA

Chairperson Diagnostic Terminology SWG

November 1, 2023

Highlights from SNOMED CT Business Meeting and EXPO October 2023

Dentistry Clinical Reference Group (CRG)

The Dentistry Clinical Reference Group (CRG), chaired by Dr. Mark Jurkovich, met during the Bi-Annual SNOMED business meeting on Oct. 23-27 in Atlanta, GA. NADP attendees included Drs. Roger Adams, Avesis, Mark Jurkovich, Health Partners, and Linda Vidone, Delta Dental Massachusetts, along with NADP Deputy Executive Director Timothy L. Brown.

Editor Updates included:

• Odontogram and General Dentistry Refsets are ready for release – the end of October.
• Subtypes of 245643006 |Structure of tooth surface (body structure) | which relate to multiple surfaces have been remodeled to include the top-level single surface concepts as parents e.g. 245655000 |Structure of buccal occlusal tooth surfaces (body structure).
• Updates to dental x-ray procedure concepts – descriptions and modeling.
• SNOMED received permission to use P.D. Millers soft tissue recession classification for use in the Periodontal Concepts. Note Stage and Grading are already in and good to go.
• Dental EXPO presentations: Oral Health Programme, Malaysia (Thursday AM), Statistical analysis with R of a large dataset of SNOMED CT (Friday PM)

Meeting discussions:

Dr. Joel White, University of California San Franciso, gave an update on his work group on the General Dentistry ref set. They started with 1500 concepts and got it down to 800, which are the ones used in the US. They believe they can get it down to 250 unique concepts. (eliminating duplications). Dr. Jurkovich recommended a comment period from other countries prior to the release next year and noted this may be additional to the current general dentistry ref set.

Ms. Afton Dunsmoor from the American Dental Association gave a presentation on work the ADA initiated for CDT 2.0 with modifiers. Although the dental community is not yet ready for this change for CDT, it does have a place in SNOMED as modifiers are really attributes, which can be utilized for electronic dental records (EDRs). Once the dental community embraces standardized terminology with EDRs, this design of CDT may be used as background information used for improved understanding of the procedures regularly performed.

The committee is in the process of reviewing all endodontic concepts to be sure the current concepts are still relevant and will engage with endodontists.

Over the past 18-24 months, 100 Orthodontic concepts were developed to assist in Dicom for exchange of images, etc.

Overall SNOMED Updates

SNOMED has grown to 48 members with Andorra, Croatia, France, Jamaica and Poland joining in 2023 and anticipates adding Hungary and Qatar soon, with ongoing discussions with Italy on membership. SNOMED is progressing collaborations with LOINC and the production of LOINC ontology preview, Nomenclature for Properties and Units (NPU), Unified Nomenclature for vaccines (NUVA) and American Network of Cooperation on Electronic Health (RACSEL). LOINC is a common language (set of identifiers, names, and codes) for identifying health measurements, observations, and documents.

They have also been working on emerging technologies including a public machine learning challenge involving the use of SNOMED CT to extract structured data from clinical text and developing artificial intelligence (AI) strategies. SNOMED has also recently completed a design and prototype with Apple for consumer-facing usage.

Clinical Engagement has eight (8) CRGS (clinical reference groups) with discussions underway to create such for Neurology, Public Health, and Social Care while continuing to pursue clinically focused implementation guides with target audiences of clinicians and clinical system developers. The allergy guide is out for review with the cancer synoptic reporting scheduled to go for review and the nutrition care pathways guide planned.

With regards to product releases, the monthly International Releases were moved to the first of the month, previously on the last day of the month, due to the variance of the last of the month release dates. More details on this change can be found on the SNOMED Blog.

Refresher: What is SNOMED CT?

SNOMED CT:

• Is the most comprehensive, multilingual clinical healthcare terminology in the world.
• Is a resource with comprehensive, scientifically validated clinical content.
• Enables consistent representation of clinical content in electronic health records.
• Is mapped to other international standards.
• Is in use in more than eighty countries.

The Diagnostic Terminology SubWorkGroup are active participants during the SNOMED meetings. In addition to these meetings our group is also actively involved in the SNOMED International Dentistry Clinical Reference Group (CRG), which provides advice and guidance to ensure that SNOMED CT dentistry content and design meet the needs of users globally, is in line with clinical practice and is implementable in dentistry information systems. This group meets bimonthly and is led by Dr. Mark Jurkovich.

For additional information https://www.snomed.org/

We welcome your feedback and suggestions for future newsletters. You can contact our staff liaison Timothy L. Brown or myself.