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Multiple Birth concept - delineating between live and still birth

General
#1

Hello,

I am trying to design some concept sets for stillbirth diagnoses. In ICD10CM, there are many codes in which a combination of live and still births occur. These tend to map to a “Multiple birth” standard concept, 4163851.

The problem is, this standard concept will include ICD10CM codes for things like:

1576070 Z37.5 Other multiple births, all liveborn
45600324 Z37.50 Multiple births, unspecified, all liveborn
45595504 Z37.59 Other multiple births, all liveborn
1576075 Z38.6 Other multiple liveborn infant, born in hospital

These codes are specifically liveborn outcomes only, so it becomes difficult to cleanly delineate multiple births with all liveborn events from multiple births with a mix of still and live born.

I’m wondering if we can create some synthetic SNOMED terms here, see this “tree” with the 2 new terms to add:

Multiple Birth → Multiple Birth - all liveborn | Multiple Birth - some liveborn

Git issue: https://github.com/OHDSI/Vocabulary-v5.0/issues/484

@Christian_Reich @mik

#2

If you need such terms, why not request new SNOMED CT term formally.
The problem is that SNOMED international will probably reject such a proposal.

And that is the problem with real world terminologies and purist terminology like SNOMED CT. In some instances, you are left with a situation where the fancy terminology can not support all situations that you need to have covered.

https://us-request.ihtsdotools.org/

#3

That may need to be the next step, raising it with SNOMED. Before going down that rabbit hole, though, @mik and @Christian_Reich , I see that the Git issue is tagged with “OMOP Extension.” Is there a SNOMED extension vocabulary approach, like we have with RxNorm?

t