The terms required by users of a clinical terminology vary according to the local languages and dialects.
Some terms differ only in spelling conventions (e.g. color, colour). The same spelling variants may recur in many different terms.
An individual instantiation of an application may only require access to a single language or dialect. It is inappropriate to install and maintain all language and dialect variants.
An application may need to support several languages with the ability to switch between languages and dialects in real-time to meet the needs of users.
Some specialties or disciplines prefer to use different terms to describe the same meaning. A particular specialist may use a precise term, while a generalist may use a different term to describe the same condition.
The following table lists factors affecting term use and examples of each.
|Factors affecting term use|
|Geographic and seasonal differences|
Malaria is more common in certain regions
Hay fever is more common in spring, summer, and fall
|Cultural perceptions of health||Acceptance of alternative therapies|
|Discipline or specialty|
Obstetricians use fundus to mean fundus of the uterus; gastroenterologists use the same term to mean fundus of the stomach
Surgeons record operative procedures relevant to their specialties
|Professional criteria||The definition of hypertension may vary based on professional guidelines|
|National or organizational requirements, including those for administrative or funding purposes||Performance measure results affecting reimbursement|
Topics of special interest to individual clinicians
|Infectious disease specialist with an interest in tropical diseases|
Particular terms may be specific to an organization. They may not be included in the International Release of SNOMED CT. Organizations and users must be able to add terms or codes to SNOMED CT, without devaluing the main body of SNOMED CT.
It may be necessary to combine several subsets and extensions to meet the needs of a country, an organization, or a specialty. There must be consistent rules for combining subsets and extensions.
The requirements of a particular user may change according to the role they are performing. A single instance of an application may need to support different requirements of several users.