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    • Concept
      t4989003 |Electrical burn of skin (disorder)|
       has the 
      Concept
      t246075003 |Causative agent (attribute)|
       
      of 
      Concept
      t18213006 |Electricity (physical force)|

Warning

Although Pharmaceutical / biologic product (product) and its descendants are considered valid values for Causative agent (attribute) by the MRCM, they are not currently used as values for this attribute in the International Release. The only exception is 787859002 |Vaccine product (medicinal product)| and its descendants, which can be used as valid values for this attribute.

The following guidelines should be considered where the causative agent is a substance:

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Concepts representing a clinical finding caused by a substance role grouper (e.g., 372688009 |Antineoplastic agent (substance)|) currently follow the same guidelines noted above. However, role groupers will be transitioned from the Substance hierarchy to the 763158003 |Medicinal product (product)| hierarchy in a future release.

For example,

  • 295597003 |Antineoplastic overdose (disorder)|

Concepts representing a clinical finding caused by a substance modification (e.g., 82485006 |Pentamethonium bromide (substance)|) are generally not allowed. Exceptions may be included if the condition caused by the substance modification is significantly different from the one caused by the base substance. Exceptions may include Liposome or lipid complex substances, Pegylated substances, or salt forms:

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This attribute is used to subclass a Clinical finding concept according to its severity. However, this use is relative, i.e. it is incorrect to assume that the disease intensity or hazard is the same for all clinical findings to which this attribute is applied. 

The severity attribute 246112005 |Severity (attribute)| may be applied to subtypes of Clinical finding (excluding << Symptom severity (finding)) to represent the severity of a finding or disease.  

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Tip
titleModeling

Generally, 246112005 |Severity (attribute)|  is is not used to model concepts precoordinated in the International precoordinated in the International Release,  but but there are some exceptions. 

A valid exception requires an internationally accepted definition that can be consistently applied and used reliably for international comparison.  Even though a reference may be internationally sourced, its use may not always be uniformly applied by multiple countries. Classifications of severity that represent variation in clinical presentations and enact limitations with age ranges, sex, or pregnancy status, do not apply universally to all patients of all ages, prove problematic, and may not be generally useful. 

The requestor is responsible for obtaining permission for use in SNOMED CT if required by the international body.  

As an alternative to precoordination in the international release, this attribute can be used as a qualifier in postcoordination.  However, beware that postcoordination of severity results in the same irreproducibility issues as pre-coordination. 

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726633004 |Temporally related to (attribute)| applies to perioperative complications and clinical findings where there is no causal relationship , but a time-relative association exists.

The This attribute's subhierarchy specifies the associated time period (i.e. before, during, after) between two procedures, two clinical findings, or a procedure and a clinical finding, e.g., |Pediatric inflammatory multisystem syndrome temporally associated with COVID-19|; or between a clinical finding and a procedure, e.g., perioperative complications temporally related to a surgical procedure (i.e. preoperative, intraoperative, and postoperative); Multisystem inflammatory syndrome in children temporally associated with SARS-CoV-2.  

This attribute is self-grouped.