The purpose of the REPLACED_BY association type is to indicate that the suggested target replacement concept is NOT semantically equivalent to the inactivated concept (ie SAME_AS can not apply).
The stated REPLACED_BY target represents an alternative which, although not semantically exactly the same, is considered to be clinically useful and - in the judgement of the author/editor - represents the intended original meaning of the inactivated concept closely enough for some unspecified data processing use cases, most likely data repair in the context of data retrieval.
The target concept chosen should normally be of the same semantic category as the inactive concept, and have the same or less specificity than the inactivated concept.
Only one REPLACED_BY can be declared for an inactive concept.
This association type may be used in the following circumstances:
- Where the concept to be inactivated is considered to be "Outdated"
- Where the concept to be inactivated is considered to be "Erroneous"
Combinatorial Logic:
Whenever an already stated REPLACED_BY target itself also becomes inactive - whether at the same release or later - the combinatorial logic of associations should be:
(A) REPLACED_BY (B) and (B) SAME_AS (C) implies (A) REPLACED_BY (C)
(A) REPLACED_BY (B) and (B) REPLACED_BY (C) implies (A) REPLACED_BY (C)
(AIntEd) REPLACED_BY (BIntEd) and (BIntEd) MOVED_TO (CNRC) implies (AIntEd) MOVED_TO (CNRC)
(AIntEd) REPLACED_BY (BIntEd) and (CNRC) MOVED_FROM (BIntEd) implies (AIntEd) REPLACED_BY (CNRC)
(A) REPLACED_BY (B) and (B) POSSIBLY_EQUIVALENT_TO (C, D) implies (A) POSSIBLY_EQUIVALENT_TO (C, D)
(A) REPLACED_BY (B) and (B) WAS_A (C AND D) implies (A) WAS_A (C AND D)
Examples from historical data
Numerous examples exist in the historical data that appear to be within the intended model of use, such as:
| 102455002 Hemorrhagic nephroso-nephritis (disorder) | REPLACED_BY | 716864001 Hemorrhagic fever with renal syndrome (disorder) |
| 10441006 Poisoning by other agent affecting skin and mucous membrane, NEC (disorder) | REPLACED_BY | 43124005 Poisoning caused by skin AND/OR mucous membrane drug (disorder) |
| 10512004 Sprain of other site of shoulder and upper arm (disorder) | REPLACED_BY | 123536004 Sprain of upper extremity (disorder) |
| 10125004 No diagnosis on Axis II (finding) | REPLACED_BY | 116367006 Psychological finding (finding) |
| 10234003 Engaged in job-related physical activity (finding) | REPLACED_BY | 80638004 Work-related activity, function (observable entity) |
| 102489001 Hypermobility (finding) | REPLACED_BY | 40507009 Musculoskeletal hypermobility (finding) |
| 102944006 Sexual behavior (finding) | REPLACED_BY | 118199002 Finding relating to sexuality and sexual activity (finding) |
| 103279008 Ear sign or symptom (finding) | REPLACED_BY | 118236001 Ear and auditory finding (finding) |
| 103642003 Reactive cellular changes associated with intrauterine contraceptive device (morphologic abnormality) | REPLACED_BY | 733529001 Reactive cellular changes caused by intrauterine contraceptive device (finding) |
| 103683000 Marginal zone lymphoma (morphologic abnormality) | REPLACED_BY | 128803008 Marginal zone B-cell lymphoma (morphologic abnormality) |
| 103684006 Mucosal-associated lymphoid tissue (MALT) lymphoma (morphologic abnormality) | REPLACED_BY | 128803008 Marginal zone B-cell lymphoma (morphologic abnormality) |
| 103687004 Acute lymphoblastic leukemia, L2 type (morphologic abnormality) | REPLACED_BY | 128822004 Precursor cell lymphoblastic leukemia (morphologic abnormality) |
| 10080009 Salmonella III arizonae 38:z52:z35 (organism) | REPLACED_BY | 404389000 Salmonella IIIb 38:z52:z35 (organism) |
| 10307004 Pseudomonas putrefaciens (organism) | REPLACED_BY | 113700003 Shewanella putrefaciens (organism) |
| 103440000 Enterococcus solitarius (organism) | REPLACED_BY | 431990001 Tetragenococcus solitarius (organism) |
| 10267004 Primary repair of torn capsule of knee, cruciate (procedure) | REPLACED_BY | 118750007 Procedure on knee joint (procedure) |
| 103731000 Diagnostic medical procedure (procedure) | REPLACED_BY | 103693007 Diagnostic procedure (procedure) |
| 10433006 Incision of lacrimal passage (procedure) | REPLACED_BY | 417117000 Incision of lacrimal drainage structure (procedure) |
| 103351004 Transorbital (qualifier value) | REPLACED_BY | 129226004 Transorbital approach (qualifier value) |
| 102715003 Aliphatic carboxylic acid, C24-0 (substance) | REPLACED_BY | 78573001 Lignoceric acid (substance) |
| 102767004 Clinically relevant enzymes with no Enzyme Commission designation (substance) | REPLACED_BY | 90668006 Enzyme (substance) |
| 103037007 11-Oxy fraction of 17-KS (substance) | REPLACED_BY | 103039005 11-oxy-17-ketosteroid (substance) |
| 103043009 Androstanedione (substance) | REPLACED_BY | 56146000 Androstenedione (substance) |
| 103047005 11-Oxycorticosterone (substance) | REPLACED_BY | 103036003 11-oxycorticosteroid (substance) |
However, there are also significant numbers where the original (inactive) and target concepts are semantically much closer together than might be expected.
If not, in fact, identical.
For example, trivially the following extract of 213 examples in current data where the FSNs are lexically identical:
| 362800001 Entire calf of leg (body structure) | REPLACED_BY | 244015008 Entire calf of leg (body structure) |
| 123287002 Acute cecitis (disorder) | REPLACED_BY | 25552000 Acute cecitis (disorder) |
| 123268008 Thrombosis of renal vein (disorder) | REPLACED_BY | 15842009 Thrombosis of renal vein (disorder) |
| 63495002 Fetishistic transvestism (disorder) | REPLACED_BY | 472981000 Fetishistic transvestism (disorder) |
| 123277001 Single umbilical artery (disorder) | REPLACED_BY | 204470001 Single umbilical artery (disorder) |
| 123203001 Condyloma latum (disorder) | REPLACED_BY | 91554004 Condyloma latum (disorder) |
| 172422001 Disorder of pregnancy (disorder) | REPLACED_BY | 173300003 Disorder of pregnancy (disorder) |
| 123305006 Contraction of eye socket after enucleation (disorder) | REPLACED_BY | 39209001 Contraction of eye socket after enucleation (disorder) |
...and also the following examples where the clinical meaning appears to be identical even though the words are different, or where the inactive code is clearly a list closure concept from a classification such as ICD but where similar codes from that classification have been treated differently1
| 103057006 Intact parathyrin (substance) | REPLACED_BY | 4076007 Intact parathyroid hormone (substance) |
| 10010002 Tuberculosis of cervical lymph nodes (disorder) | REPLACED_BY | 54084005 Cervical tuberculous lymphadenitis (disorder) |
| 10156007 Other early complication of trauma, NEC (disorder) | REPLACED_BY | 22564003 Early complication of trauma (disorder) |
| 10483001 Toxic effect of other alcohol, NEC (disorder) | REPLACED_BY | 67426006 Toxic effect of alcohol (disorder) |
Notes
- Compare with 206207002 Other specified scalp injury due to birth trauma (disorder) SAME_AS 37384000 Birth injury to scalp (disorder)