Well in our case (cancer research drug development) we confirm both Topography and Histology and check that they agree. Either way we gather both data points. Topography is generally confirmed by a clinician and the Histology is a pathological confirmation. SNOMED is often inadequate for this vs the ICD coding.
Agree? Like the histology can happen in the topology? We did that with the ICDO Condition. So, a melanoma of the skin cannot have adenomcarcinoma as the histology.
Both data points are present in the Condition. Pick the ICDO3 histology code, the ICDO3 topology code, combine them with a dash and look up the chimera. For example, you got ICDO3 9700/3 “Mucosis fungoides” and C42.0 “Blood”. Look up 9700/3-C42.0 and you will find Condition Concept 36402813 “Mucosis fungoides of blood”.
I use Athena but it does not always seem to find things. Again I don’t write the questions. So “we” don’t ask anything more specific about the site in this case. Part of the issue faced is some of this is legacy data we are trying to analyze/mine. I’m faced with trying to doing this exercise with folks that don’t have a clear idea about the use cases.
It’s not an algorithm flaw, right. We decided that ICDO3 attributes (Topography and histology) are always non-standard regerdless of presense of mapping to SNOMED.
While ICDO3 condition concepts are not standard if only the have SNOMED equivalent.
Now I think that the rule for ICDO3 conditions should be applied to Topography and histology as well.
9086/3-C73.9 is new, 8343/3-C73.9 already exists.
Then we need to use new names, because “bronchioloalveolar carcinoma” is no longer used (the codes contained this name).
Note, the clinical meaning stays the same. Don’t worry, they don’t make “concept changing their meaning over time” problem.