Page tree
Skip to end of metadata
Go to start of metadata

This page has been set up to support awareness of the work planned for these concepts. 


After a review there has been a decision that O/E and C/O content is to remain in the International Edition (given it is used by two countries) with the content to potentially be managed by use of a module. Module work is still be undertaken so timing on time work is yet to be planned.

There is the a plan to check for the base concept to ensure it exists. Work on this is yet to be planned. 

Note: CMAG meeting 18 October 2017 next steps up for discussion. Outcome to be noted here after meeting.  

Final Outcome:

O/E and C/O concepts in the International Edition will be inactivated. Prior to this occurring a check for the 'base' concept will be undertaken. The timing of this is yet to be determined. Input from CMAG  representatives is required in relation to the timing e.g. the UK require this to be undertaken after April 2018 given user requirements. 

CTR-3 - Getting issue details... STATUS


DateRequested actionRequester(s)Response required by:Comments
18 October 2017
  • Advice on timing (given user requirements) of inactivation of On examination and Complaining of Clinical Finding concepts
  • John Fountain Please advise if you have any requirements in relation to the timing of the inactivation of the O/E and C/O concepts given your users requirements  
  • Johannes Gnaegi Please advise if you have any requirements in relation to the timing of the inactivation of the O/E and C/O concepts given your users requirements  
  • Jostein Ven Please advise if you have any requirements in relation to the timing of the inactivation of the O/E and C/O concepts given your users requirements  
Given country input to date, this is requested only from New Zealand and new CMAG members, not involved in previous discussions. The UK response has been provided (April 2018) and other countries not listed here have not expressed any requirements in the previous discussions or CMAG meeting 18th October 2017.

Meetings topic discussed in:

2016-02-09 - CMAG meeting

2016-07-12 - CMAG Meeting

2016-08-09 - CMAG Meeting

2017-10-18 - CMAG Meeting Face to face in Bratislava Slovakia

JIRA links:

IHTSDO-852 - Getting issue details... STATUS

IHTSDO-433 - Getting issue details... STATUS

PCP-48 - Getting issue details... STATUS

PCP-115 - Getting issue details... STATUS


Relevant documents

No files shared here yet.

Country response 




Member countries without a CMAG rep  
  • No labels


  1. CMAG advised 9 August 2016- no further updates to information provided here. Paged transferred to resolved topics at this point in time. 

  2. Hi Cathy,

    What could potential user requirements be to postpone inactivation? After the new release is published, they have half an year to update to the new version, it will come anyway as far as I understood?  

    1. Hi Johannes

      It is probably easier for me to explain this.  The UK is migrating all of Primary care GP's in England from Read codes to SNOMED CT by April 2018.  This involves a mapping process from Read codes to SNOMED CT so we have created a GP subset of SNOMED from the Read code data to start this process of migration.  This mapping process ensures all historical records make sense as Read codes have been used in GP electronic records for some time.  As the majority of this content originated from the UK Read codes this could cause significant churn in the mapping tables at a time when we want them to be stable and familiar.  This content will be in historical records so migration is a key factor for us as if inactivated the mapping tables would need to change.  The mapping tables are also clinically assured and again this process takes time. Also the relationship with suppliers to support this migration is eased if churn is at a minimal for this content.

      Hope this explains

  3. Thanks Elaine .

    Johannes let me know if you've further questions.



  4. We are looking into this one actively now in NZ and obtaining feedback.

    Elaine - may have to swap notes with you regarding the status of the UK Read to SNOMED mapping and your thinking on the way forward...



  5. Thank you Elaine for the clarification.

    For Switzerland we do not have such timing requirements then.



  6. No timing requirement at this point in time from Norway.

    Regards, Jostein

  7. Hi All, After a wide polling within NZ there appear to be no immediate concerns regarding the proposed changes. Users will review how they are using SNOMED for issues related to O/E and C/O, including the biggest user of the UK Read to SNOMED map  (our Accident Compensation Corporation). Therefore no additional timing requirements beyond what the UK has proposed.



  8. Hi Cathy, Is there any indication of what exactly is planned for this content? Will it be retired? How?

    E.g. 164530001 On examination - joint movement (finding)
    Might be replaced with 
    298179002|Finding of joint movement (finding)| OR 364563006|Joint movement (observable entity)|
    (Depending on what it's supposed to mean?) 

    As far as I can tell these are all findings, precoordinated with either "as reported by the patient" or "as seen by clinician".

    If we know the destiny of these concepts extensions might be able to do something about them (so that they don't start getting used).

  9. Matt Cordell -sorry for the delay here. The plan is to inactivate the concepts after checking the base finding concept exists. If the base concept does not exist it will be created. The inactivated O/E or C/O concept would have a historical association to the base finding concept. The one you've noted here 164530001 On examination - joint movement (finding) is a grouper. Where a base concept for those grouping concepts does not exist, the value of creating a "base" concept for those as well as editorial guidance would need to be considered The timing of this work is currently being discussed.

  10. Cathy Richardson - can you please add CTR-3 to the agenda and update that ticket - Thanks

  11. Just to confirm the UK have requested if this could be delayed until the July 19 release as it has significant impact on the Primary Care migration so we would be very grateful if this can be accommodated. 

  12. Is there any update on this Cathy Richardson?
    I'm keen to get rid of this content from our release but also take into consideration SI's eventual action?
    It doesn't look like there's anything in the July19 release (daily build). Do you know what the reason for inactivation value will be? (outdated? ambiguous?)

  13. Matt Cordell I'll be raising this at a meeting next week and will provide a response following this. Kind regards, Cathy

  14. Matt Cordell Just advising that I am still following up on this. Given a UK public holiday the meeting did not proceed. I will come back to you shortly. Kind regards, Cathy

  15. I looked for O/E and C/O in the value sets used in Clinical Quality Measures in the US. (Cursory inspection rather than detailed analysis),

    A small number of O/E codes (50 or less) are used in value sets, primarily related to gait and respiratory issues. These codes are often used "in parallel" with similar finding codes not showing "O/E". For example 

    163685000 | On examination - gait spastic (finding) |


    9447003 | Spastic gait (finding) |

    Arguably, the O/E codes are unnecessary in this context (and might not be listed if they were not children of the corresponding "regular" code).

    Similar issue with C/O, but much fewer codes used in value sets (a small handful), also listed together with the corresponding "regular" codes.

    In summary, the use of O/E and C/O codes in value sets seems redundant (and potentially accidental). Not essential in this context.

  16. To answer Sheree's query about what our alternative is, such detail is generally captured in the information model.
    So a "Presenting problem" field populated by the value 271807003|Rash| - would indicate the patient is complaining of (presenting with/complaining of/Reason for presenting) a rash.

    Whereas a "Diagnosis" or "Observations" field populated by the value 271807003|Rash| - would indicate the clinician has observed a rash.

    This for any use cases where making a distinction between patient or clinician reported findings - one would query the appropriate field.

    Similarly to Olivier's observations - some of our reports on SNOMED usage in the wild include both O/E and "regular" concepts. But this is generally because both have been available, and clinicians will just pick whatever.