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A value from the choices below must be chosen as a reason for inactivati= ng a concept. Inactivation replacement associations are ultimately at= the author's discretion. Especially in the instance of an infinite n= umber of possible replacements, clinical relevance and subset inclusion sho= uld be considered. Non-synonymous synonyms should also be inactivated= and reassigned.
= Inactivation reason | = Association type | = Cardinality | = Notes |
---|---|---|---|
Am= biguous | Possib= ly equivalent to |
1..* |
|
Classification-derived co= mponent |
Replaced by |
0..1 |
|
Partially equivalent to | 0..* |
|
|
Same as | 1..1 |
|
|
Er= roneous component | Replaced by |
1..1 |
|
Meaning of component unknown= |
No associatio= n type applied | 0..0 |
|
Non-conformance to editorial policy | 0..0 |
|
|
Replaced by <= /span> |
0..1 | ||
Alternative<= /td> | 0..* | ||
Outdated component | No suitable replacement= identified |
0..0 |
|
Possibly replaced by | 0..* | ||
Replaced by | 0..1 |
Historical relationships
When changes are made to= a historical relationship for a concept that was previously inactivated, s= uch as Limited/WAS_A, assign a new historical relationship that facilitates= traceability of the concept (duplicate, ambiguous, classification der= ived, etc.). The Limited component inactivation reason = (WAS_A association type) is no longer in use for new content inactivations = as of the July 2018 release.
All possible meanings should be repre= sented in the replacement targets when feasible, creating new concepts as r= eplacements when appropriate.
Ambiguous concepts with a single repl= acement target may be used if one of the two possible me= anings of the ambiguous concept is not clinically useful.
Many, but not all, concepts precoordinated with "with" and "a= nd" are derived from classifications; regardless, this is the acceptable in= activation reason.
For concepts with exclusions, such as NEC, NOS, etc., use the R= eplaced by association with the immediate parent concept as the value,= which is the clinical condition without any context. If a parent concept w= ithout the exclusion does not exist, it should be created as a new concept.=
For concepts with conjunctions such as 'and' and 'with', use the Partially equivalent to association with the two sep=
arate values as targets. For the purposes of patient care, it is reco=
mmended that each disorder is recorded individually.
The Partially equival= ent to association signifies that all applied ta= rgets must be implemented within the clinical notes to ensure the original = clinical idea is represented.
The Duplicate component is the inactivation for duplicated concepts:
Any possible duplicates between concepts among other paired hierarchies = not listed above should be reconsidered as duplicates and directed to anoth= er inactivation reason, likely Erroneous.
If the change is a request, inform the requestor as to which concept is = inactivated.
Where the error gives rise to potential ambiguity, use the inactivation = reason of Ambiguous component. Otherwise, the Erroneous component requires = a single Replaced by value.
Meaning of the concept is unknown, and an association type is not given.=
It will normally be necessary to search the clinical literature to e=
stablish that this is truly an unknown concept rather than an outdated clin=
ical concept.
This inactivation reason may be used where the meaning of the FSN is consid=
ered to be vague.
Concept which do not adhere to editorial guidance can be inactivated wit=
hout an association type. Else
Policies will often delineate how these two Association t= ype options will be used. Changes of this type often include bul= k updates and may relate to medicinal products, substances, and devices.
When an outdated concept simply falls into disuse without any appropriat= e replacement, no historical association is applied.
Replaced by is used for a single replacement concept that is se= mantically similar to or more general than the inactivated concept.
Possibly replaced by is used for multiple replacement concepts.
For example,
A substance or organism originally believ= ed to be a single entity has been reclassified as two or more substances or= organisms.
For more information, see the SNOMED CT Editorial Advisory Group Conflue= nce page, Management of Concept= Inactivation for details.