Inconclusive lab results coding

Technical (archive)
1

Hi all, lately I’ve been modeling different types of lab results.

Now I’m modeling cervical cytology, and there is a kind of result that is “inconclusive or not clear”, for other results I’ve found SNOMED CT codes but not for this one. That is the only one that I can’t code right now, maybe others with more experience on this area can help me find a code.

This is what I have right now, sorry rubrics are in spanish (but is easy to just put the codes in the SNOMED browser to see the concept in english http://browser.ihtsdotools.org/?perspective=full&conceptId1=404684003&edition=en-edition&release=v20180731&server=http://browser.ihtsdotools.org/api/v1/snomed&langRefset=900000000000509007):

  • Normal (negativo): SNOMED-CT::5559008
  • Poco claro (no concluyente)
  • Anormal (positivo)
  • CEASI o ASCUS (células escamosas atípicas de signigicado indeterminado): SNOMED-CT::39035006
  • CGA (células grandulares atípicas): SNOMED-CT::4476003
  • LIEBG (lesiones intraepiteliales escamosas de grado bajo): SNOMED-CT::112662005
  • LIEAG (lesiones intraepiteliales escamosas de grado alto): SNOMED-CT::22725004
  • CEA (células escamosas atípicas, no se pueden excluir las LIEAG): SNOMED-CT::373878001
  • AIS (adenocarcinoma in situ): SNOMED-CT::51642000
  • Células de cáncer cervical (carcinoma de células escamosas o adenocarcinoma): SNOMED-CT::285432005

Thanks!

2

Hi Pablo,

There is a hierarchy specifically for cervical cytology findings – see Cervical smear result (finding)

SCTID: 269957009 and below.

So for CEASI o ASCUS the code from that hierarchy would likely be 441087007

I haven’t had time to look at all, but I suspect this is a better hierarchy and there may not be all options available for you. There are lots of gaps in SNOMED!

Hope this helps

Heather

3

Hi Pablo Pazos

I searched “inconclusive or not clear” (with/without cervical cytology) in my mapping tool (http://term.infoclinic.co/map.html)

There may be not terms of “inconclusive or not clear” confined to “Cervical Cytology”.

Some general terms were searched.

In qualifier value, related terms are below

419984006 |Inconclusive (qualifier value)|

373068000 |Undetermined (qualifier value)|

82334004 |Indeterminate (qualifier value)|

In finding, I think below is proper

442754001 |Inconclusive evaluation finding (finding)|

I hope this will help you.

Best regards

From Seung-Jong Yu

2018년 9월 11일 (화) 오후 1:27, Pablo Pazos <pablo.pazos@cabolabs.com>님이 작성:

4

Thanks Heather, I got those codes in the cervical cytology findings, found the “normal” and the “abnormal” concepts, but not a code for the grey area in the middle of those, that, from my research, seems to be a valid outcome from a PAP test with something like “Not clear (not conclusive)”.

5

That makes me think that I can create a post coordinated expression with the inconclusive and the cervical cytology (procedure) or (findings) concepts :slight_smile:

6

Terrific, Pablo. Didn’t want to run the risk of you missing the cervical cytology codes that are present.

A post coordinated solution is a good work around, but wonder if it is worth requesting SNOMED for the addition of new codes for the ones that you’ve identified as missing. If you need them, then there is a very good chance that others might as well.

And if there is a better solution then SNOMED Intl might be able to point us to them.

Regards

Heather

7

Need to check how to contact HITSDO, I already contacted LOINC about missing codes related to this topic :slight_smile:

8

You should contact your national representative, since Uruguay is a member country. It is AGESIC (snomed@salud.uy)

9

You are awesome :slight_smile: