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Shane Byrnes

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Hi All,

As a follow up to our DEUSG meeting last week please use this discussion thread for any feedback on additional attributes being added to the MRCM for use in national drug extensions.

Presentation here: https://drive.google.com/file/d/1mA4JuuPY7-QEHDOUXjeA7zlvJmnBJybW/view and link to meeting recording here: 2025-02-20: Virtual - User Support Reference Group - SNOMED Confluence 

Thanks to Canada for proposing.

Regards,
Shane

Contributors (2)

3 Comments

  1. Dion McMurtrie

    Shane Byrnes, if it would be helpful, I’m happy to share the full set of AMT MRCM extensions here. This includes:

    • Changes to the domain and range for existing international attributes

    • Additional attributes defined by AMT, along with their intended purpose and usage – for example, Linda discussed 30465011000036106 | Has container type | at the Oslo meeting

    It would also be valuable to gather MRCM extensions from other drug extensions wherever they exist.

    We could build a shopping list of attributes for other NRCs to consider. If others have similar needs, optional attributes and MRCM extensions could be added to the international edition to make them easy to use - some already exist like "Has supplier".

    This would be better than NRCs having to develop their own attributes and MRCM extensions or "side promote" – which can be both time-consuming and complex.

    Before I go ahead, could I please get permission to upload files (e.g. images) to this page? I’d like to include visual examples alongside the text, which will make the explanation more concise and accessible.

  2. Linda Bird

    Here is a summary of the full set of attributes proposed by Canada (including potential opportunities for promotion from the AMT and CMT).
               NOTE: Our priorities are to agree on the Container type, Subpacks (containered packages), and Multicomponent attributes.

    • Container and device: Promote the following attributes from the AMT:
      • 30465011000036106 |Has container type| - Grouped
      • 999000081000168101 |Contains device| - Grouped
      • Either reuse the international attribute 1142142004 |Has pack size (attribute)| or add a new attribute |Has device count| for this - Grouped
      • 999000101000168108 |Count of device type|
    • Subpacks: Either promote the following AMT attributes
      • 999000011000168107 |Contains packaged clinical drug| – as long as this actually means "Contains containered packaged clinical drug" - Grouped
      • 999000091000168103 |Count of containered package type| - Grouped
      • Either reuse the international attribute 1142142004 |Has pack size (attribute)| or promote the CMT attribute 62601000087108 |Has subpack count|
        OR promote the following CMT attributes (if my assumption about the 'contains packaged clinical drug' attribute above isn't correct):
      • 62511000087106 |Contains subpack| -  This defines the inner containered packs within a multi-container product - Grouped
      • 62601000087108 |Has subpack count| - The number of this particular type of subpack (ie containered pack) in the outer package. - Grouped
      • 62521000087103 |Count of subpack type| - The number of different types of containered packs
    • Multi-component MP/MPF/CD: Add the following new attributes (required, but not yet created in the CMT)
      • |Has medicinal product component| – The component MPs of a multi-component MP - Grouped
      • |Count of medicinal product component type| – The number of types of MP components (to ensure universal restriction logic)
      • |Has medicinal product form component| – The component MPFs of a multi-component MPF - Grouped
      • |Count of medicinal product form component type| – The number of types of MPF components (to ensure universal restriction logic)
      • |Has clinical drug component| – The component CDs of a multi-component CD - Grouped
      • |Count of clinical drug component type| – The number of types of CD components (to ensure universal restriction logic)
    • Additional defining information – Promote the following CMT additional defining attributes (assuming that they don't exist anywhere else)
      • 62591000087100 |Has excipient ingredient| – A non-active (excipient) substance in the drug product
      • 62611000087105 |Is free of excipient ingredient| – A non-active (excipient) substance, which is not contained in the drug product.
      • 62721000087105 |Has dose form characteristic| – Additional product characteristics that relate to the dose form, e.g. “Light” (of powder)
      • 62731000087107 |Has unit of presentation characteristic| – Additional product characteristics that relate to the unit of presentation, e.g. “Single dose”, “Multidose”
      • 92611000087107 |Has dose form after transformation| – Required to distinguish between dose forms that have the same transformation method, but transform into different dose forms, e.g. granules for oral solution, granules for oral syrup.
    • Non-defining information (additional relationships) – Additional non-defining attributes that others may need as well
      • 62191000087109 |Has registered route of administration|
      • 62701000087104 |Target population| (as a non-defining characteristic)
      • 62181000087107 |Has product registration status|
      • 62151000087104 |Has drug schedule|
      • 62581000087102 |Has drug class|
    • Non-defining information (annotations) – Additional non-defining concrete values that others may need as well
      • 62711000087102 |Has Global Trade Item Number (GTIN)|
      • 62201000087106 |Has unit of use GTIN|
      • 62161000087101 |Has package GTIN|
      • 62131000087108 |Has WHO ATC code|
      • 62141000087102 |Has last batch on market product expiration date|
      • 62171000087105 |Has product monograph URL|

  3. Linda Bird

    After chatting with Dion and Matt (Australia) to clarify the meaning of some of the AMT attributes, I have a few adjustments to make in the proposed list of attributes below:

               NOTE: Canada's priorities (in blue) are to agree on the Container type, Subpacks (containered packages), and Multicomponent attributes.

    • Container and device: Promote the following attributes from the AMT:
      • 30465011000036106 |Has container type| - Grouped
      • 999000081000168101 |Contains device| - Grouped
      • Add a new attribute |Has device count| for this - Grouped (... or reuse the international 1142142004 |Has pack size (attribute)| as the AMT has done)
      • 999000101000168108 |Count of device type|
    • Subpacks: Promote the following attributes
      • AMT: 999000011000168107 |Contains packaged clinical drug| - Grouped
        • We've come to the conclusion that the semantics of this are the same as Canada's 62511000087106 |Contains subpack| attribute, so are happy to use the AMT attribute if promoted. However, we would request a clarification of the FSN to distinguish the term 'packaged clinical drug' from the existing class with the same name in SNOMED Int.'s national drug extension model (which defines the quantity of each clinical drug within, without distinguishing how the inner containers are organised). Possible attributes names include "Contains containered package" or "Contains package in container" or "Has subpack".
      • CMT: 62601000087108 |Has subpack count| - Grouped
        • Note: The AMT reuses an attribute like 1142142004 |Has pack size (attribute)| for this, which would be the alternative.
      • AMT: 999000091000168103 |Count of containered package type|
    • Multi-component MP/MPF/CD: Add the following 4 new attributes (and reuse the 2 existing international attributes below) with 2 role chains (1) |Contains medicinal product form| o |Has active ingredient| → |Has active ingredient|, (2) |Contains clinical drug| o |Has manufactured dose form| → |Has manufactured dose form|
      • SCTID |Contains medicinal product| – The component MPs of a multi-component MP - Grouped
        • SCTID |Contains medicinal product form| – The component MPFs of a multi-component MPF - Grouped
          • 774160008 |Contains clinical drug| - The existing attribute (to be a subtype of |Contains MPF| and |Contains MP|
      • SCTID |Count of medicinal product type| – The number of types of MP components (to ensure universal restriction logic)
      • SCTID |Count of medicinal product form type| – The number of types of MPF components (to ensure universal restriction logic)
      • 1142143009 |Count of clinical drug type| – The existing international attribute
    • Additional defining information – Promote the following CMT additional defining attributes
      • 92611000087107 |Has dose form after transformation| – Required to distinguish between dose forms that have the same transformation method, but transform into different dose forms, e.g. granules for oral solution, granules for oral syrup.
      • 62591000087100 |Has excipient ingredient| – A non-active (excipient) substance in the drug product
      • 62611000087105 |Is free of excipient ingredient| – A non-active (excipient) substance, which is not contained in the drug product.
      • 62721000087105 |Has dose form characteristic| – Additional product characteristics that relate to the dose form, e.g. “Light” (of powder)
      • 62731000087107 |Has unit of presentation characteristic| – Additional product characteristics that relate to the unit of presentation, e.g. “Single dose”, “Multidose”
    • Non-defining information (concept values)
      • 62191000087109 |Has registered route of administration|
      • 62701000087104 |Target population| (as a non-defining characteristic)
      • 62181000087107 |Has product registration status|
      • 62151000087104 |Has drug schedule|
      • 62581000087102 |Has drug class|
    • Non-defining information (concrete values)
      • 62711000087102 |Has Global Trade Item Number (GTIN)|
      • 62201000087106 |Has unit of use GTIN|
      • 62161000087101 |Has package GTIN|
      • 62131000087108 |Has WHO ATC code|
      • 62141000087102 |Has last batch on market product expiration date|
      • 62171000087105 |Has product monograph URL|