At symposium, the issue of left eye vs right eye and a condition was discussed. (after a keynote by Cindy Cai) @cindyxcai (Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION))
If our standard terminology (=terminology that we map to; eg. SNOMED CT, or target terminology) is lacking separate terms for disease X in left and right organs. It is a problem ! Currently SNOMED CT does not have separate terms that are eye specific. Just generic term for wet AMD.
Best is to rely on perfect target terminologies rather than creating OMOP extension terminology.
The problem is hard especially if our source [data] terminology (non standard) (e.g., ICD (ICD10CM, ICD9CM, ICD10,ICDxxxx,etc) has those. (DiseaseConceptWithLaterality). Eg. Wet AMD left eye. Dry AMD right eye. We end up in situation where we lack “perfect” target concept and our mapping is dropping laterality information from source data concept.
Here is reply from SNOMED Chief terminologist (Jim Case; thank you!) on my question about that:
(from Oct 2025)
(no login required to read SNOMED CT forum)
The answer: We don’t need to do US extension. We can target SNOMED CT international edition.
We can query all cases where source terminology (icd10cm) has left and right terms mapped to single DiseaseConceptWithoutLaterality.
e.g., here left wet AMD mapped to disease concept lacking laterality “DiseaseConceptWithoutLaterality”
https://athena.ohdsi.org/search-terms/terms/37200408
See pictureA below
This is possibly a lot of terms. (like 200 or more).
But this solves our dilema around extending SNOMED CT. (snomed extension) with regard to DiseaseConceptsWithLaterality. (and lack of them in target terminology)
Snomed has monthly releases now.
I made a submission for 2 new terms. (wet AMD, left and right eye variants). They have a batch system. (and I used it).
That means we can work in Excel and submit all 200 terms in batch (and do it in a non tedious way). By the way the US submission history allows seeing the volume of requests over last 3 years. It is interesting to see the dynamics of how many users indeed evolve the terminology for the better.)
The submission was made Nov 11 and as of Nov12 it was passed further to processing. (status of ‘forwarded’ as opposed to status of ‘new’ when submission was made).
I may post update on how it further progresses.
Creating of US submission system to SNOMED CT was not very hard. (took 2 business days to get login, see picture B). (I may do a follow up post on that).
Tagging some folks: @schuemie @aostropolets @Patrick_Ryan @TatianaSkugarevskaya
pictureA
picture(s) B
fill this form (in link in the middle)
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btw. I also asked about LLMs here SNOMED CT license and LLMs - General - SNOMED Forums
