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NOTICE PROPOSED CHANGE(s) TO THE COVERAGE OF LANGUAGE IN ANNOTATIONS REFSET

After discussions with the community, SNOMED International is proposing to change the coverage of language in the Annotations refsets in the following way:

The langueCode field was specified as the two characters of ISO-639-1 code for the language of the annotation text. The change is to include support for specifying dialect when it is applicable by adhering to RFC 5646, which allows the combination of two characters of ISO 639-1 code and two uppercase letters of country code (ISO 3166) separated by a hyphen. The "languageCode" will be changed to "languageDialectCode" in the field column. A new metadata c "Language dialect", a subconcept of "Language Code", will be used for the metadata of this column in the descriptor refset.

Please provide any feedback to info@snomed.org by Friday 26th January 2024 at the absolute latest, as lack of response will be taken as acceptance, and the changes will proceed as planned. 

Inactivation of 9258009|Gravid uterus structure (body structure)|

This concept will be inactivated, content that is modeled with this concept will be remodeled with a site of 35039007|Uterine structure (body structure)| along with occurrence <<307159006|Pregnancy time period (qualifier value)|.  

The domain of 246454002 |Occurrence (attribute)| has been extended in the October 2023 release to include << 71388002 |Procedure (procedure)| to support these content changes. Content areas that will be updated include 386811000|Fetal procedure (procedure)| and 386637004|Obstetric procedure (procedure)|.

Inactivation of Concepts Specified Male/Female in Descriptions

Subtypes of 67770001 |Male mammary gland structure (body structure)| and 91532001 |Female mammary gland structure (body structure)| and their associated disorder and specimen concepts.  Further information is available here (Confluence log in required).

Update for Concepts Using 'Caused by'

Clinical finding concepts containing "Caused by" in their FSN will be reviewed and will be updated (if applicable) according to the editorial guidelines related to causation here. 

There is one area where work is still in progress:  

• Clinical finding caused by radiation.

Q1-Q2 2024 International Release

Updates to the Inactivation Reason and Historical Association for 'On Examination' and 'Complaining of' Inactive Content

Many of the 'on examination' and 'complaining of' concepts were previously inactivated with the inactivation reason of |Moved elsewhere| with a historical association value |Extension Namespace 1000000|.

This content will be updated with an inactivation reason of |Non-conformance to editorial policy| and a historical association of |Alternative| to a suitable international concept. 

Ethnic/Racial Group Social Context Content Inactivation

The subtypes of 372148003 |Ethnic group (ethnic group)| and 415229000 |Racial group (racial group)| will be inactivated as they are out of scope for the International Edition.  A briefing note is available here.

Patient/Subject concepts in the Clinical finding and Procedure Hierarchies

Concepts in the Clinical finding and Procedure hierarchies that contain the explicit context of patient or subject will be inactivated and replaced with concepts without this explicit context. For further information please see briefing note.

Inactivation of 277132007|Therapeutic procedure (procedure)

The concept 277132007 |Therapeutic procedure (procedure) will be inactivated with the inactivation reason of Outdated and a replacement association target of 71388002 |Procedure (procedure)|. The nearly 2000 descendants will be reviewed as to the appropriateness of either the Has intent (attribute) of Therapeutic intent, or a Method (attribute) of Therapy - action.

For further information please see briefing note.

OWL Axiom Expressions for Annotation Properties

The new annotation properties should be represented in the OWL expression axiom refset as follows:

• The 1295447006 |Annotation attribute (attribute)| is correctly represented as subClassOf
  • 01300ccd-d1d7-417d-a70a-f688e72c4d8c 20231201 1 900000000000012004 733073007 1295447006 SubClassOf(:1295447006 :246061005)

• However, all subconcepts of 1295447006 |Annotation attribute (attribute)| should be represented as "SubAnnotationPropertyOf", instead of "subClassOf" as they currently are.
  • e6cd65fe-cb81-4db4-9ac4-040dc74fce28 20231201 1 900000000000012004 733073007 1295448001 SubClassOf(:1295448001 :1295447006)
  • 3729ce47-a96e-4dc7-9eff-83c34740c414 20231201 1 900000000000012004 733073007 1295449009 SubClassOf(:1295449009 :1295447006)

They should therefore be changed to:

• SubAnnotationPropertyOf(:1295448001 :1295447006)
• SubAnnotationPropertyOf(:1295449009 :1295447006)

However, the authoring tool will then need to be updated to ensure all new subconcepts of 1295447006 |Annotation attribute (attribute)| will be represented as SubAnnotationPropertyOf() in the future.  Numerous other tools will also need to be updated first in order to correctly consume the new format.

There are numerous systems that require updating, and that this will therefore need to be carefully tested and rolled out over the next few months.  As the potential impact was analysed and deemed to be low, the Annotations deployment will still go ahead as planned in the January 2024 International Edition release, whereas these axiom updates will be published in subsequent releases.  Please, therefore, be aware that this issue will persist for the first few International Edition releases of 2024.

Inactivation of Congenital Morphologic Abnormality Concepts

61295008 |Congenital abnormal number (morphologic abnormality)|

125226006|Congenital malposition, left (morphologic abnormality)|

125225005|Congenital malposition, right (morphologic abnormality)|

56457002|Congenital atresia (morphologic abnormality)| 

41086002 |Congenital smallness (morphologic abnormality)|

81850003 |Congenital sequestration (morphologic abnormality)|

These concepts will be inactivated and replaced by a concept that does not specify congenital. Concepts that are modeled with these morphologic abnormality concepts will be remodeled using the replacement concept. This change aligns with the Editorial Guide.

Addition of New Technique Qualifier Value Concepts

Around 80 new laboratory technique concepts will be added in the 272394005 |Technique (qualifier value)| subhierarchy.

Change Parent for 410460000|Illumination - action (qualifier value)| and Subtypes

410460000|Illumination - action (qualifier value)| and descendants will be updated to be a subtype of 272394005|Technique (qualifier value)|.  The concepts will not be inactivated.  Descriptions that currently include '- action’ will be inactivated and replaced. 

Concepts that are currently modeled with method 410460000|Illumination - action (qualifier value)| will be remodeled with a method of 360037004|Imaging - action (qualifier value)|.  These changes will complete this Content Tracker.

Inactivation of 118661008|Physician service (procedure)| and Descendants

118661008|Physician service (procedure)| and subtypes will be inactivated and replaced with concepts that are a subtype of 224891009|Healthcare services (qualifier value)| where appropriate.

These changes will complete this Content Tracker.