Expert Comments: Structure and Content

[BorisDelange]

Summary

This discussion focuses on the structure and content of expert comments that accompany each general concept in the INDICATE dictionary. These comments help data scientists and clinicians make correct mapping decisions.

To do:

• Finalize the standard structure for expert comments
• Establish consistency rules for formatting (bold, italics, concept names)

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Current Proposal: Expert Comment Structure

This section will be updated based on discussion feedback.

Definition

Clinical definition in 1-2 sentences + standard units. Optional: normal values if clinically relevant.

Mapping Strategy

Default concept:

• Concept Name (Concept Code): Use when [default condition]

By [primary grouping dimension]:

• Concept Name (Concept Code): [When to use]
• Concept Name (Concept Code): [When to use]

Important Notes

Optional - only for clinical warnings or common pitfalls.

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Example: Heart Rate

Definition

Heart rate represents the number of heartbeats per unit of time, expressed in beats per minute (bpm). Normal resting heart rate in adults typically ranges from approximately 60-100 bpm.

Mapping Strategy

Default concept:

• Heart rate (LOINC 8867-4): Use when measurement method is unspecified

By measurement method:

• Heart rate by Pulse oximetry (LOINC 8889-8): Heart rate derived from photoplethysmography via pulse oximeter sensor
• Heart rate.beat-to-beat by EKG (LOINC 76282-3): Heart rate captured via electrocardiography (ECG or continuous cardiac monitoring)
• Heart rate Intra arterial line by Invasive (LOINC 60978-4): Heart rate measured via intra-arterial catheter
• Heart rate Peripheral artery by palpation (LOINC 8893-0): Manual pulse palpation at peripheral artery
• Heart rate by Transthoracic impedance (LOINC 76476-1): Impedance cardiography measurement
• Heart rate Peripheral artery by US.doppler (LOINC 8892-2): Doppler ultrasound measurement at peripheral artery
• Heart rate by Noninvasive (LOINC 76477-9): Generic non-invasive measurement when specific method is unknown

By patient position/activity:

• Heart rate --resting (LOINC 40443-4): Measured at rest (position not specified)
• Heart rate --supine (LOINC 68999-2): Measured while patient is lying flat
• Heart rate --sitting (LOINC 69000-8): Measured while patient is seated
• Heart rate --standing (LOINC 69001-6): Measured while patient is upright/standing
• Heart rate --W exercise (LOINC 89273-7): Measured during exercise
• Heart rate --post exercise (LOINC 40442-6): Measured immediately after exercise cessation

By clinical context:

• Heart rate --during anesthesia (LOINC 89278-6): Measured intraoperatively under anesthesia
• Heart rate --post bronchodilation (LOINC 89282-8): Measured after bronchodilator administration (pulmonary function testing)
• Heart rate Peripheral artery by palpation --resting (LOINC 67129-7): Manual pulse at rest

Neonatal/obstetric:

• Fetal Heart rate (LOINC 55283-6): Heart rate measured in utero via fetal monitoring

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Methodology: Writing Expert Comments

To reduce manual effort while maintaining quality, expert comments are created using the following workflow:

1. Source terminology descriptions: Concept definitions are extracted from LOINC and SNOMED CT source files. This provides official descriptions, synonyms, and component information.

2. LLM-generated initial draft: An initial comment template is generated by a large language model based on the source terminology data and the standard structure.

3. Expert review and validation: Clinical experts review and validate the generated content, correcting any inaccuracies and adding domain-specific guidance.

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Formatting Conventions

• Use bold for emphasis, key terms, and units
• Use italics for concept names
• Section headers with # and ##
• Bullet points for concept lists

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How to Contribute

Please share your thoughts on the open questions above by replying to this discussion. Based on your feedback, the "Current Proposal" section will be updated to reflect the agreed-upon structure.