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This section demonstrates how an 5.2.20 Ordered Reference Set is used to specify and display a customized navigation hierarchy. A navigation hierarchy is a hierarchical view of SNOMED CT concepts which may differ from the strict subtype hierarchy (represented by 116680003 |is a| relationships ).

Navigation Hierarchy Example

To illustrate the way a navigation hierarchy is represent this section uses an example containing a set of concepts used to describe x-ray examinations of the upper and lower limbs. The resulting navigation hierarchy might usefully be extended to include other x-ray procedures but has been kept small for the purposes of the example.

Reference sets are created as explained in how to create a new Reference Set using an existing pattern and their Identifier, name and type are specified by a concept. The example reference set would be specified by a concept with the characteristics shown in .

Table 43. Concept specifying the Example Navigation Reference Set

 

 

Characteristic

Value

Comment

id

<RefsetId-A>

These symbolic values are used to avoid any potential confusion with released reference sets. The moduleId represents the module in which the reference set was developed.

moduleId

<ModuleId-A>

 

preferredTerm

Example Navigation Reference Set

 

116680003 |is a|

447258008 |Ordered type reference set|

 

The concepts included in the reference set are shown with their preferred terms in .

Table 44. Concepts used in the Example Navigation Reference Set

 

Id

Preferred Term

1225002 |Radiography of humerus (procedure)|

1225002 |radiography of humerus|

1597004 |Skeletal X-ray of ankle and foot (procedure)|

1597004 |skeletal X-ray of ankle and foot|

168594001 |Clavicle X-ray (procedure)|

168594001 |clavicle X-ray|

168619004 |Plain X-ray head of humerus (procedure)|

168619004 |plain X-ray head of humerus|

168620005 |Plain X-ray shaft of humerus (procedure)|

168620005 |plain X-ray shaft of humerus|

168623007 |X-ray shaft of radius/ulna (procedure)|

168623007 |X-ray shaft of radius/ulna|

168637003 |Plain X-ray radius (procedure)|

168637003 |plain X-ray radius|

168655007 |Instability views carpus (procedure)|

168655007 |instability views carpus|

168663008 |Plain X-ray head of femur (procedure)|

168663008 |plain X-ray head of femur|

168664002 |Femoral neck X-ray (procedure)|

168664002 |femoral neck X-ray|

168665001 |Plain X-ray shaft of femur (procedure)|

168665001 |plain X-ray shaft of femur|

168669007 |Patella X-ray (procedure)|

168669007 |patella X-ray|

205115004 |Radiologic examination of femur, anteroposterior and lateral views (procedure)|

205115004 |radiologic examination of femur, anteroposterior and lateral views|

241063007 |Bicipital groove X-ray (procedure)|

241063007 |bicipital groove X-ray|

241066004 |Ulna groove X-ray (procedure)|

241066004 |ulna groove X-ray|

241069006 |Ulna X-ray (procedure)|

241069006 |ulna X-ray|

241071006 |Scaphoid X-ray (procedure)|

241071006 |scaphoid X-ray|

241073009 |Metacarpal X-ray (procedure)|

241073009 |metacarpal X-ray|

241075002 |Femur X-ray (procedure)|

241075002 |femur X-ray|

241076001 |Tibia and/or fibula X-ray (procedure)|

241076001 |tibia and/or fibula X-ray|

241077005 |Tibia X-ray (procedure)|

241077005 |tibia X-ray|

241078000 |Fibula X-ray (procedure)|

241078000 |fibula X-ray|

241079008 |Metatarsal X-ray (procedure)|

241079008 |metatarsal X-ray|

241080006 |Tarsus X-ray (procedure)|

241080006 |tarsus X-ray|

268427003 |X-ray shaft of tibia/fibula (procedure)|

268427003 |X-ray shaft of tibia/fibula|

271311001 |Carpal bones X-ray (procedure)|

271311001 |carpal bones X-ray|

302402006 |Radius and/or ulna X-ray (procedure)|

302402006 |radius and/or ulna X-ray|

37815002 |Diagnostic radiography of calcaneus (procedure)|

37815002 |diagnostic radiography of calcaneus|

40348008 |Skeletal X-ray of pelvis and hip (procedure)|

40348008 |skeletal X-ray of pelvis and hip|

418687005 |Fluoroscopy of humerus (procedure)|

418687005 |fluoroscopy of humerus|

427961005 |Radiographic imaging of acetabulum (procedure)|

427961005 |x-ray of acetabulum|

432552002 |Computed tomography of clavicle (procedure)|

432552002 |computed tomography of clavicle|

48966008 |Skeletal X-ray of shoulder and upper limb (procedure)|

48966008 |skeletal X-ray of shoulder and upper limb|

5433008 |Skeletal X-ray of lower limb (procedure)|

5433008 |skeletal X-ray of lower limb|

70780000 |Skeletal X-ray of elbow and forearm (procedure)|

70780000 |skeletal X-ray of elbow and forearm|

72872009 |Skeletal X-ray of upper limb (procedure)|

72872009 |skeletal X-ray of upper limb|

79082005 |Diagnostic radiography of fibula, combined anteroposterior and lateral (procedure)|

79082005 |diagnostic radiography of fibula, combined AP and lateral|

82420003 |Radiologic examination of forearm, anteroposterior and lateral views (procedure)|

82420003 |radiologic examination of forearm, anteroposterior and lateral views|

The members of the example reference set would be distributed in a file with a name like:

  • xder2_ciRefset_NavigationRefsetExampleFull_XX_20100731.txt.

The content of this file is shown in and the resulting hierarchical display is shown in .

Table 45. Example Navigation Reference Set File

 

 

 

 

 

 

 

id

effectiveTime

active

moduleId

refsetId

referencedComponentId

order

linkedId

<uuid-0211>

20100731

1

<ModuleId-A>

<RefsetId-A>

<RefsetId-A>

1

5433008

<uuid-0212>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

1

241080006

<uuid-0213>

20100731

1

<ModuleId-A>

<RefsetId-A>

241080006

1

37815002

<uuid-0214>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

2

241079008

<uuid-0215>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

3

241076001

<uuid-0216>

20100731

1

<ModuleId-A>

<RefsetId-A>

241076001

1

241078000

<uuid-0217>

20100731

1

<ModuleId-A>

<RefsetId-A>

241078000

1

268427003

<uuid-0218>

20100731

1

<ModuleId-A>

<RefsetId-A>

241078000

2

79082005

<uuid-0219>

20100731

1

<ModuleId-A>

<RefsetId-A>

241078000

3

241077005

<uuid-0220>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

4

241075002

<uuid-0221>

20100731

1

<ModuleId-A>

<RefsetId-A>

241075002

1

205115004

<uuid-0222>

20100731

1

<ModuleId-A>

<RefsetId-A>

241075002

2

168665001

<uuid-0223>

20100731

1

<ModuleId-A>

<RefsetId-A>

241075002

3

168664002

<uuid-0224>

20100731

1

<ModuleId-A>

<RefsetId-A>

241075002

4

168663008

<uuid-0225>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

5

168669007

<uuid-0226>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

6

1597004

<uuid-0227>

20100731

1

<ModuleId-A>

<RefsetId-A>

5433008

7

40348008

<uuid-0228>

20100731

1

<ModuleId-A>

<RefsetId-A>

40348008

1

427961005

<uuid-0229>

20100731

1

<ModuleId-A>

<RefsetId-A>

<RefsetId-A>

2

72872009

<uuid-0230>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

1

302402006

<uuid-0231>

20100731

1

<ModuleId-A>

<RefsetId-A>

302402006

1

241069006

<uuid-0232>

20100731

1

<ModuleId-A>

<RefsetId-A>

241069006

1

168623007

<uuid-0233>

20100731

1

<ModuleId-A>

<RefsetId-A>

302402006

2

168637003

<uuid-0234>

20100731

1

<ModuleId-A>

<RefsetId-A>

302402006

3

70780000

<uuid-0235>

20100731

1

<ModuleId-A>

<RefsetId-A>

70780000

1

241066004

<uuid-0236>

20100731

1

<ModuleId-A>

<RefsetId-A>

302402006

4

82420003

<uuid-0237>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

2

168594001

<uuid-0238>

20100731

1

<ModuleId-A>

<RefsetId-A>

168594001

1

432552002

<uuid-0239>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

3

1225002

<uuid-0240>

20100731

1

<ModuleId-A>

<RefsetId-A>

1225002

1

241063007

<uuid-0241>

20100731

1

<ModuleId-A>

<RefsetId-A>

1225002

2

168620005

<uuid-0242>

20100731

1

<ModuleId-A>

<RefsetId-A>

1225002

3

168619004

<uuid-0243>

20100731

1

<ModuleId-A>

<RefsetId-A>

1225002

4

418687005

<uuid-0244>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

4

168655007

<uuid-0245>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

5

271311001

<uuid-0246>

20100731

1

<ModuleId-A>

<RefsetId-A>

271311001

1

241071006

<uuid-0247>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

6

241073009

<uuid-0248>

20100731

1

<ModuleId-A>

<RefsetId-A>

72872009

7

48966008

Note: Each of the symbolic names '<uuid-0211>' to '<uuid-0248>' in represents a unique 128-bit UUID generated by a standard algorithm. Use of the same symbolic names elsewhere in this example indicates a revised version of the same component with the same Identifier. Use of the same symbolic name in another example does not imply the same Identifier .

Figure 46. Example Navigation Reference Set - Hierarchy View

This reference set could be updated by addition of the rows in a subsequent release. If the three rows shown in are added in the next version, the results are as follows:

The changed part of the hierarchy is shown in .

Table 46. Example Navigation Reference Set File - Updated Rows

 

 

 

 

 

 

 

id

effectiveTime

active

moduleId

refsetId

referencedComponentId

order

linkedId

<uuid-0245>

20110731

1

<ModuleId-A>

<RefsetId-A>

72872009

6

271311001

<uuid-0247>

20110131

1

<ModuleId-A>

<RefsetId-A>

72872009

5

241073009

<uuid-0248>

20110131

0

<ModuleId-A>

<RefsetId-A>

72872009

7

48966008

Figure 47. Example Navigation Reference Set - Updated Hierarchy View

Navigation Hierarchy Inheritance

A Navigation Reference Set may organize some concepts while allowing the subtype hierarchy (or another navigation hierarchy) to provide additional hierarchical links. In this case, a concept that has no children in the navigation hierarchy inherits the children specified in the subtype hierarchy or a specified default navigation hierarchy .


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