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The proximal primitive concept is the nearest primitive supertype concept to the concept in question. In some cases this will be a top level concept e.g. | Procedure |, however this is not always the case and the PP parent may be an intermediate primitive concept located beneath the top level concept and the concept in question. There may also be more than one proximal primitive supertype for a concept. Proximal primitive (PP) parent modeling approach: 

  • The SNOMED International preferred modelling approach that is followed when creating or changing the logical definition of a concept. 
    • The author states 
      • the proximal primitive supertype(s) 
      • all the defining attribute-value pairs required to express the meaning of the concept.  
        •  An attribute-value pair is explicitly stated on the concept being modeled even if it is already present on a supertype concept.
        • The attribute-value pairs are grouped as required.  
    • The classifier is used to infer all appropriate proximal supertype(s).
      • With fully defined concepts the subtypes will also be inferred. 
  • In all cases it is necessary to review the concept after classification to examine the inferences and confirm that they are appropriate.

Example: 713026007|Plain x-ray of humerus (procedure)

Stated view 

The PP parent for this concept is 71388002| Procedure (procedure) |. It has been modeled with one stated supertype and two attribute value pairs grouped together in a relationship group.

Inferred View

The inferred view shows the logical definition of the concept. By using the stated relationships (for this concept and other concepts currently in the terminology) the classifier has inferred three defined proximal supertypes:

  • | Radiography of humerus (procedure) |,
  • | X-ray of bone (procedure) | and
  • | Plain x-ray of upper limb (procedure) |.

Given this is a defined concept, subtypes would also be inferred. Multiple potential proximal primitive parent concepts

Where more than one potential proximal primitive supertype is identified for a concept being modeled, there is a need to check that if any of the primitive supertype(s) subsume one or more of the other primitive supertype(s). Where subsumption exists, the subsuming concept is not a proximal primitive supertype. 

Example: 421095001 | Allergic disorder by body site affected (disorder) |

In this example there is more than one potential proximal primitive supertype. Through analysis it can be seen that | Disease (disorder) | is subsumed by | Clinical finding (finding) | therefore | Disease (disorder) | is the PP parent concept.

Example: 424643009 | Immunoglobulin E-mediated allergic asthma (disorder) | 

In this example there are three primitive supertypes of the concept | Immunoglobulin E-mediated allergic asthma (disorder) |. Through analysis it can be seen that | Disease (disorder) | subsumes |Allergic asthma (disorder) | and | Immune hypersensitivity disorder by mechanism (disorder) | so it is not a PP parent of the concept in question. Looking further neither |Allergic asthma (disorder) | nor | Immune hypersensitivity disorder by mechanism (disorder) | are subtypes of each other, so both are the PP parents for this concept.