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ItemsHierarchy/TopicEARLY VISIBILITY OF PROPOSED CONTENT CHANGES

Planned Release timing

(*this is provisional only and is subject to change)

1.Clinical Finding

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.
2024 International Release
2.Procedure

Update Hierarchy 363680008|Radiographic imaging Procedure (procedure)|and Descendants

A Briefing Note documenting the proposed changes for the hierarchy 363680008|Radiographic imaging procedure (procedure)| and descendants was shared with the Editorial Advisory Group, Clinical Leads Group, Member Forum, Content Managers Advisory Group, and other key stakeholders in July 2023.

Feedback was received from a wide range of stakeholders. In response to this feedback, the proposed changes to the hierarchy have been modified. These modifications will address issues raised in the feedback.

This Informational Briefing Note summarizes the changes that will be implemented.

Implementation of the content changes will commence in Q4 2023. The updates will be implemented in sub-hierarchies and promoted over a number of international monthly releases until complete.

Ongoing in phases across 2024 International Releases

3.Content Improvement

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. 

Q2-Q3 2024 International Release
4.Social Context

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.

In discussion - to be determined
5.Clinical Finding/Procedure

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.

On hold - to be determined
6.Procedure 

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.

Q1-Q2 2024 International Release
7.Annotation

OWL Axiom Expressions for Annotation Properties

The new annotation properties are 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)

  • All subconcepts of 1295447006 |Annotation attribute (attribute)| are represented as "SubAnnotationPropertyOf", instead of "subClassOf" as they previously were

    • 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)

These axiom updates are published in the March 2024 International Edition release. The authoring tool has been updated to ensure all new subconcepts of 1295447006 |Annotation attribute (attribute)| are represented as SubAnnotationPropertyOf(). Other tools will be updated to correctly consume the updated syntax. This will be carefully tested and rolled out over the next few months.

Q2 2024 International Release
8.Clinical Finding

Inactivation of Mechanical Complication of <x> Device

In October 2023 the Editorial Advisory Group made a decision that the concepts that represent a mechanical complication of <x> device are ambiguous. Following this a briefing note was shared with the community of practice to both inform and collect feedback. This feedback has been reviewed and the work will be proceeding. The concepts will be inactivated as ambiguous with a historical association to 473023007 |Complication associated with device (disorder)| or a suitable subtype.

Q2-Q3 2024 International Release
9.Procedure

Inactivation of 410770002 |Administration of anesthesia for procedure (procedure)| and Subtypes

A Briefing note was presented to Anesthesia CRG with a proposal for review and remodeling of 1263452006 |Anesthesia and/or sedation procedure (procedure)| hierarchy.

As part of that proposal, inactivation of 410770002 |Administration of anesthesia for procedure (procedure)| hierarchy was agreed.

This inactivation will affect 410770002 |Administration of anesthesia for procedure (procedure)|and subtypes, and 10745231000119102 |Cardiac arrest due to administration of anesthesia for obstetric procedure in pregnancy (disorder)|.

Concepts in 410770002 |Administration of anesthesia for procedure (procedure)|hierarchy will be inactivated with Inactivation reason = Outdated component and Replaced by 399097000 |Administration of anesthesia (procedure)|.

For 10745231000119102 |Cardiac arrest due to administration of anesthesia for obstetric procedure in pregnancy (disorder)|FSN will be changed to 10745231000119102 |Cardiac arrest due to administration of anesthesia in pregnancy (disorder)| and value for 42752001 |Due to (attribute)| will be changed to 399097000 |Administration of anesthesia (procedure)|.

Q2 2024 International Release
10.Dose Forms

Pharmaceutical Dose Forms with Two or More Intended Sites

Pharmaceutical Dose Forms with more than one intended site will use “and” in their descriptions and include all intended sites in the model. By representing combinations of intended sites as a conjunction ('and' in the description) this will facilitate searching by end users. The concepts are logically modeled as conjunction.

Existing dose forms with "or" will be updated to "and" in their descriptions, this will be included in the Editorial Guide.

9 clinical drugs using these dose forms will correspondingly have their descriptions updated to 'and'.

Note - pharmaceutical dose forms with two or more administration methods:
As this is a less common requirement any requests for this type of dose form will be reviewed on a case by case basis.

Q2/Q3 2024 International Release
11.Clinical Finding

Substance Abuse/Use

There has been a shift from the term "substance abuse" to a more nuanced understanding of substance use disorders in this domain which is reflected in both ICD-11 and DSM-5 indicating a greater emphasis on the spectrum of substance-related problems.  Several members have expressed the need for content updates to incorporate this change and to simplify the translation process.  Consequently, efforts to revise the content associated with 66214007 |Substance abuse (disorder)| will begin and is expected to be completed by the end of Q2. 

An example of the content structure and terming using opioid use is shown. Specifically, descriptions will be added with “harmful pattern of X substance use” replacing the term “abuse” in the FSN and PT however the “abuse” descriptions are persisted as synonyms to facilitate searching.  In most cases there is no change in meaning, therefore the concepts will not be inactivated.  Approximately 100 existing concepts relating to “abuse” will be affected together with the addition of new concepts to represent “harmful episode” and the higher level “Disorder caused by X substance”.


Q2 2024 International Release
12.Clinical Finding

Inactivation of Complication Disorder Concepts (371 concepts)

The inactivation of concepts that reference “complication” without specifying the nature of the complication is planned. 

The primitive “Complication (disorder)” grouper was inactivated in 2022 due to a lack of consistency or definition of what would properly be assigned as a subtype.

The concepts will be inactivated with inactivation reason “Classification derived concept” and replacement by the parent concept.  

June 2024 International Release
13.MRCM

Changes to MRCM

There are planned changes to MRCM for the attribute in group cardinality to four attributes:

  • "characterizes"
  • "precondition"
  • "technique"
  • "using device"

These changes are being made to support the implementation of role group changes to observables and evaluation procedures. 

The domain "administration via specific route (procedure)" will be removed and the attribute "route for administration" will be optional for the domain of procedure.

Q2 2024 International Release

2024 Published Content Changes With Confirmed Release Date

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