Two standard concepts for 'Exacerbation of asthma'

Vocabulary Users
1

It looks like there may be two standard concept_ids for the concept ‘exerbation of asthma’.

I do see that the concept name in the omop concept table for (the active) SNOMED concept is ‘acute asthma’, however this is just the SNOMED preferred term for ‘exacerbation of asthma’.in the US edition.

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Here’s the concept and synonyms from the SNOMED browser:
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Was the omop extension concept added because there are concerns that ‘exacerbation of asthma’ and ‘acute asthma’ may not be semantically equivalent?

Any insight greatly appreciated.

Piper

2

It seems that Exacerbation of asthma was created to replace invalidated Exacerbation concept in SNOMED (not sure though, tagging @zhuk).

Now, SNOMED hierarchy itself is not that intuitive - they have Acute asthma (which has exacerbation as a synonym) and Acute exacerbation of asthma as a descendant, which to me sounds like two equivalent concepts. Altogether, it seems that we have three standard terms for the same concept :slight_smile: Aside from creating confusion, does it have an impact on your activities?

3

Thank you @aostropolets for the quick response.

Hmmm… it looks like the ‘acute exacerbation of asthma’ concept all refer to more specific subtypes of asthma. Well… at least in the US edition. :face_with_monocle:

If you don’t think arbitrarily selecting one of the two concepts will impact downstream analytics, I’ll just select one of the two.

Thanks again,
Piper

4

Do you mean selecting for ETL (mapping) or for concept sets? For latter you’d select both, for former - I’d go with SNOMED Acute asthma.

it looks like the ‘acute exacerbation of asthma’ concept all refer to more specific subtypes of asthma. Well… at least in the US edition

Its descendants are more specific, but the concept itself is non-specific. Or am I missing something?

5

Friends:

Acute asthma = asthma attack (airway constriction).
Acute exacerbation of asthma = worsening of an asthma attack (airway swelling and inflammation).

1 Like
6

Years ago they were constructed to cover exacerbations in MedDRA.

7

Thank you @zhuk.

Piper

8

And there can be airway construction in asthma wo baseline inflammation? That contradicts my training but I’m open to learning new things.

9

@Christian_Reich
Is the following also true:
Asthma exacerbation = acute asthma = asthma attack (airway constriction)?

per SNOMED concept definition 281239006 | Exacerbation of asthma (disorder) | with SYN asthma attack, and SYN acute asthma

Thank you.
Piper

10

Sure. Allergic ones.

Yes, but not necessarily the other way around.

I understand the acute asthma is both a synonym and a parent concept. Complain to SNOMED.

11

Its descendants are more specific, but the concept itself is non-specific. Or am I missing something?

@aostropolets - I see what you’re saying.
SNOMED is using the expressions ‘Exacerbation of asthma’ and ‘Acute exacerbation of asthma’ in the FSN to describe the same idea (an asthma attack). it’s inconsistent and non-intuitive as you say.

Piper

12

I wonder if I’m missing something now?
Acute asthma (aka exacerbation of asthma) is a parent concept of child concepts that are all more specific subtypes of acute asthma (e.g., acute exacerbation of chronic asthmatic bronchitis). That looks accurate to me.

Where do you see the problem @Christian_Reich ?

13

Well, the whole name space is not clean:

  • “Acute asthma” (Concept ID 257581) has the synonyms “Exacerbation of asthma”,
    “Asthma attack” and “Exacerbation of asthma (disorder)”.
  • It’s child “Acute exacerbation of asthma” (Concept ID 45771045) has the synonyms “Acute exacerbation of asthma (disorder)” and “Asthma attack”.

What exactly is the additional attribute that the child adds to what’s inherited from the parent? It’s not the acuteness (both of them have it), and it’s not the attack (both have it), and it’s not the exacerbation (both have it). Now what? Time to complain to SNOMED.

(Except the new version has it fixed. Can you see, @aostropolets?)

14

Looks like someone beat us to the punch on this one. :slight_smile:
The concept was inactivated.

15

In new version that is not yet in the OHDSI Vocabs? Haven’t checked it. Otherwise yes, I also saw the child and the parent as being totally same terms.