SMD Questions

My name is Penni Hernandez and I am investigating the implementation of the Document Ontology codes in our CDW at Stanford. I have many questions and wanted to start with a few around SMD and see if this forum would be the appropriate place. I am new to the Document Ontology so I apologize up front if these questions are off-target.

  1. I can see that the medical SMD’s are generally aligned with ABMS list of Specialties and Sub-Specialties. But a few that I would need are not there (e.g. Advanced Heart Failure and Transplant Cardiology) which is new. Since I have compared the complete ABMS list to the LOINC proposed SMD list I wondered if you would be interested in getting all of the additions. And if so where is the appropriate place to submit these?

  2. A few SMD’s exist under several ABMS categories (e.g. Adolescent Medicine is under Internal Med, Pediatrics, Family Med) Is it necessary to indicate which one, or is Adolescent Medicine its own concept and the hierarchy is indicated somewhere else? Is that other place: MULTI-AXIAL_HIERARCHY?

  3. There are a couple of places where I am not clear on the differences between SMDs (e.g. Clinical Genetics and Medical Genetics). There is a ABMS specialty of “Clinical Genetics (MD)” from the definitions this would seem to be “Clinical Genetics” is that correct?

    Thank you in advance and please let me know if I am missing something fundamental that makes all of this nonsensical.

    Penni Hernandez

Penni -

Very glad to hear of your efforts and that you also got a hold of us by email. Let me see if I can take a stab at your questions.

  1. We would be happy to consider some additions to the SMD axis and think it would be good to discuss at the next Clinical LOINC Meeting. Emailing these to Stan Huff and me in advance of the meeting would be great. [/*:8kpxhhjd]
  2. As you see in the LOINC manual we do list several SMDs in multiple places (if able to sub-specialize from multiple primary specialties), but they are intended to be represent the same SMD (one concept). We have not fully represented the items in these ontology axes in the main LOINC hierarchies. We make a first pass organization of the existing LOINC terms in the Multi-axial hierarchy, but that organization takes place at the level of the LOINC Component ( ) and does not yet address the SMD axis.[/*:8kpxhhjd]
  3. We are still working on getting crisp definitions for all of these nodes, so I'm not sure I am totally correct about this, but I believe the Medical Genetics node was meant to be the broad category that would encompass the ABMS specialty of Clinical Genetics and the other related domains.[/*:8kpxhhjd]