Discuss ICD-O-3 utilization in IMO as it pertains to IMO's primary vs. metastatic pre-coordinated concepts

[odikia]

Discussion in Teams

Some of Andy's text:

Ok. Here are a couple of examples of how IMO handles pre-coordinated mappings. These diagnoses would appear in the Epic EDG master file and the SNOMEDs come across in Clarity/Kaboodle. I don't know if the ICD-O maps do without additional licensing: infiltrating duct carcinoma metastatic to pancreas:

[odikia]

@golozara , Assigning you only because of this statement in Teams, though I'm happy to update this issue as needed (so am assigning the ICDO3 team too!):

Thanks Kanter, Andrew S. (Guest). Will put this on the list of items to discuss along with other metastasis related topic. That is a big item and will plan for it once all the proposals come in.

[cgreich]

@odikia:

There are about 100 or so metastatic sites, and 6000ish cancer condition. If we pre-coordinate those we end up with some 600k new concepts. We decided to not pre-coordinate anything except morphology and topography for that reason. Everything else (metastases, lymph nodes, grades, stages etc.) will live post-coordinated as a Cancer Modifier in Measurement. Because the disease is still the same (primary), but has progressed.

[askanter]

I don't see why we need to pre coordinate as that is handled by the interface terminology and only relevant combinations are included. My question was more about how to handle when the EHR has pre coordinated concepts and where those have ICD-O codes for both primary and secondary in one mapped term.

[odikia]

@cgreich and @askanter , thank you for your feedback! Notifying @peterprinsen-iknl of your notes.

@cgreich , our plan is to use a data driven approach by assessing used combinations in our registries. In addition, we’re having a look at IARC’s indications of plausible and implausible combinations, as well as Cancer PathCHART from SEER.