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The   | Member Annotation Type Reference Set|  provides the ability to supplement SNOMED CT reference set members with additional informative details. This reference set type enables the association of non-defining annotations with reference set members, providing valuable contextual information about each member's significance or usage.

The objective of Member Annotation Type Reference Sets is to enhance comprehension and implementation by offering supplementary information that aids in the interpretation and utilization of reference set members. These annotations are optional but highly beneficial, offering insights into the purpose, relevance, or specific usage scenarios of individual reference set members. For instance, these annotations might include notes about how a particular member should be used, clarifications on its scope, or any other pertinent details that facilitate effective utilization within diverse healthcare settings.

Example Use Cases

One significant use case for the | Member Annotation Type Reference Set| pertains to the representation and management of change notes related to content changes. 

In SNOMED CT, a single concept might possess multiple axioms, which represent logical statements defining relationships between concepts. These axioms are represented as members of the OWL Axiom reference set.

By using change notes, content authors can add comments or explanations to each axiom, helping to explain why changes were made or providing additional context about the relationships defined by these axioms. This annotation method assists in keeping track of modifications, offering insights into the reasons behind changes, and aiding in understanding the logical structure of SNOMED CT concepts.








1292995002 | Member annotation with string value reference set (foundation metadata concept) |

91302008 |Sepsis (disorder)|



In the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) published in 2016, the new definition eliminated the requirement for the presence of systemic inflammatory response syndrome (SIRS) to define sepsis. The sepsis is now logically defined as Organ dysfunction syndrome (disorder) with pathological process of disregulated host response due to infectious disease.

900000000000516008 | Annotation type reference set|

Reference Specific Attributes

Besides from the identification and versioning attributes, the annotation reference set type has following attributes.


Data type


A reference to the SNOMED CT component to be included in the reference set.

The concept to which the Annotation applies. 

The UUID of the relevant member of the reference set in SNOMED CT.


Specifies the language of the Annotation text using the two character ISO-639-1 code. Note that this specifies a language level only, not a dialect or country code.

NOTE:  This field should be blank wherever a language code is not applicable, but never NULL.

The Annotation text itself, with a maximum size of 32Kb, represented in UTF-8 encoding.

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