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SNOMED CT is designed to allow the International Edition to be enhanced by adding Extensions that address national or local requirements. Additional content required to support national, local or organizational needs that may not have international relevance or may not meet the editorial guideline for inclusion in the International Edition.
SNOMED CT design also includes the Reference Set mechanism which provides a standard way to customize and enhance content for use in a particular  country, language, specialty, application or context. Reference Sets developed nationally or locally can modify search and display of content from the International Edition as well as enhancing Extension content.

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