Non-Standard Concepts mapped to Standard Concepts to be replaced by Standard Concepts by the "Optimize" functionality of a Concept Set

[alex-odysseus]

Business Requirements

If a Concept Set contains all non-Standard Concepts that are comprised of a Standard Concept they should be replaced with the Standard Concept as the result of Concept Set optimization routine

Design Ideas and Functional Requirements

An initial idea is:

An additional flag to be added on the "Concept Set Optimization" screen which will extend the existing optimization business logic with a possibility to replace non-Standard Concepts being mapped to the Standard Concepts by the appropriate Standard Concepts

Based on Anthony's comment the following solution design is proposed:

• a new button "Resolve mappings" to be added in between the "Optimize" and the Delete buttons, it is enabled only if at least one non-standard Concept is present as a Concept Set Item
• after clicking on the button there will be a popup window displayed with the title "Non-standard Concepts Mapping Resolution" which will contain three visually distinguished blocks
• 'Concept Set with resolved mappings' will contain all Standard and Classification Concepts which were present before clicking on the 'Resolve mappings' button -- additionally it will contain Standard Concepts counterparts (without duplicates) for those non-Standard Concepts where the mapping is straightforward -- 'Remove Selected' will allow to remove some of the items which may not be needed
• 'Non-standard Concepts with multiple Standard Concepts mappings' will be grouped in a way that Standard Concepts with 'Non-standard to Standard map (OMOP)' will be followed by non-standard Concepts for which the ambiguity is present -- a User will be able to select both Standard and non-Standard Concepts and add them to the 'Concept Set with resolved mappings' block after selecting the appropriate ones and clicking on "Add to Concept Set" button -- by means of the 'Preview...' button it will be possible to preview a Concept Set and how it will look like after adding the selected Concepts to 'Concept Set with resolved mappings' (additionally displaying 'Included Concepts' and 'Included Source Codes' listings)
• 'Original Concept Set' displays the version of Concept Set Items before any mapping resolution and User's manipulations after
• a button to be placed in the popup dialogue so that a User will be able to choose what to do with the 'Concept Set with resolved mappings' block after a task on the dialogue is finished
• it is possible that 'Non-standard Concepts with multiple Standard Concepts mappings' is empty as all non-Standard Concepts can be mapped to one Standard Concept and there is no ambiguity (we may think about leaving a possibility to display such resolved mappings as well so that a User will be able to add non-Standard Concepts to the 'Concept Set with resolved mappings')

Open Questions

N/A

@mrechkem @Sathyaraos

[anthonysena]

This is a good use-case but I think the proposed approach requires discussion.

The "optimize" function is designed to work with standard concepts and eliminate redundant concepts (i.e. descendant concepts that are captured because a parent concept + descendants is included). This use-case is a bit more complex and to illustrate this, I'll use an example.

Take ICD10CM code O24.4 - Gestational diabetes mellitus (ref):

This maps to multiple standard concepts. Someone designing a concept set will need to think about the implications of selecting a standard concept at this point. Doing a wholesale replacement of non-standard to standard concepts will likely yield a concept set that is too broad for use. This particular task may be better oriented to allow the user to go from non-standard to standard with the mappings between them clearly defined. From there they may opt to select a subset of standard concepts. Once that is completed, another step would be to then go back down from standard to non-standard as this may include new non-standard codes that require consideration.

So from the example above, if I selected Gestational diabetes mellitus from SNOMED (ref) and navigate to the non-standard codes, for ICD10CM, I am now using some new codes that require attention:

So the design of this feature is important and requires further elaboration before an implementation should begin.