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Some icd9proc 'maps to' relationships seem to be removed

Hi everyone,

I have a problem for mapping some ICD9Proc concepts that were mapped to standard concepts in previous vocabulary versions but It seems these mappings are not included in the concept_relationship table anymore.

The query:

select c.concept_code ,c.concept_name , cr.* from concept c inner join concept_relationship cr on c.concept_id =cr.concept_id_1 where c.concept_code in (‘55.52’, ‘69.91’, ‘99.52’, ‘99.48’, ‘99.13’, ‘15.3’) and cr.relationship_id like ‘Maps to’

yielded these results when using v5.0 16-DEC-21 ATHENA vocabulary:

concept_code concept_name concept_id_1 concept_id_2 relationship_id valid_start_date valid_end_date invalid_reason
15.3 Operations on two or more extraocular muscles involving temporary detachment from globe, one or both eyes 2,000,690 4,324,837 Maps to 25/06/2018 31/12/2099 [NULL]
55.52 Nephrectomy of remaining kidney 2,003,611 4,158,858 Maps to 25/06/2018 31/12/2099 [NULL]
69.91 Insertion of therapeutic device into uterus 2,004,531 4,322,048 Maps to 25/06/2018 31/12/2099 [NULL]
99.13 Immunization for autoimmune disease 2,008,248 4,119,105 Maps to 25/06/2018 31/12/2099 [NULL]
99.48 Administration of measles-mumps-rubella vaccine 2,008,334 4,296,954 Maps to 25/06/2018 31/12/2099 [NULL]
99.52 Prophylactic vaccination against influenza 2,008,337 4,313,306 Maps to 25/06/2018 31/12/2099 [NULL]

whereas no result was yielded in when using vocabulary version equal or more recent than v5.0 31-OCT-22.

If this ‘Maps to’ relationship has been removed for a set of ICD9PROC concepts, how do I map them? I mean, should I create the mapping manually via ATHENA or Usagi? Is it ok if I use the mapping in the previous version of the vocabulary?

Thank you in advance for your help.

Best regards,
Juan Manuel Ramírez Anguita

Yeah. These are victims of SNOMED regression. They used to be mapped to SNOMED concepts, which were deprecated without a successor. For example, ICD9Proc 2003611 (55.52) “Nephrectomy of remaining kidney” was mapped to SNOMED 4158858 “Nephrectomy of remaining kidney”. This mapping died when Snomed.org deprecated it, replacing it with four new concepts: 35623140 “Excision of left kidney”, 35623141 “Excision of right kidney”, 40484990 “Total excision of left kidney” and 40483688 “Total excision of right kidney”. There is some logic to that, because “remaining” is not a definition that works standalone, it needs another record indicating which kidney was removed or damaged before.

But that’s what you have in your data. Now what do we do? Short of having a proper procedure hierarchy we might just give these guys another life as a standard concept, and then it is the problem of the analyst when picking conceptsets for a cohort.

Thank you Christian. Really helpful!!