Representing Patient Allergies and Intolerances; Food Substances

Printer Friendly, PDF & Email
Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard
Final
Production
Rating 4
No
Free
N/A
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • Feedback is requested as to the extent the suggested value sets using SNOMED CT parent and child codes for food allergens are sufficient to meet the needs for starter value set.

Comment

Food substances too broad

There are over 4000 of these codes in SNOMED CT. It is still way to broad to be useful. Would suggest that a value set that would be useful would cover top 100 food items.  Avoid repetition like

256349002 Peanut - dietary (substance)      
229889003 Peanut brittle (substance)      
102260001 Peanut butter (substance)      
412047006 Peanut containing products (substance)

 

How many different ways do we need to say an interpret Peanut containing products?  Would you feed peanuts to someone with a peanut butter allergy?  That kind of clinical decision making needs to go into the making of these value sets.

 

UNII code system and value set is specific to FDA Product labeling and is not all that helpful for clinical use.  SNOMED CT is much better suited for this purpose.

What is the state of UNII, its not listed

What is the state of UNII, its not listed? UNII has been problematic when implementing related to the volume of choices.  SNOMED has a similar issue.  Establish a top used list for Food Substances as core implementation list. Allow outliers where needed, this will improve implementation and interoperability.  

UNII has broad coverage and…

UNII has broad coverage and connections to many other code systems and to chemical structures. Also includes what food and/or allergens. Would not dismiss it out of hand.

Should use the American Allergy and Immunology list

It is short (but longer than the one below), uncluttered by special forms of food and is authoritative. While any food can cause an adverse reaction, eight types of food account for about 90% of all reactions:

http://acaai.org/allergies/types/food-allergy

Eggs, Milk, Peanuts, Tree nuts, Fish, Shellfish, Wheat, Soy