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Recognizing the goal that SNOMED CT should become the accepted international terminological resource for health care, it must therefore be capable of supporting multilingual terminological renderings of common concepts. For the terminology to be acceptable to the widest possible range of users it must include translations as well as alternative spellings and other variations that arise from a national and regional dialect. Furthermore it must be capable of representing differences between the underlying concepts that arise from cultural, ethnic or linguistic variations.
Clinical terminology development is challenging for a variety of reasons. Even in a single country or language people often use the same words to mean different things, as well as using different words for the same thing. The names assigned to some clinical conditions are sometimes based on an earlier incomplete or erroneous understanding and often these misleading names remain in use long after knowledge has moved on. Progress of medical knowledge and evolution of pathogenic organisms creates a continual, growing requirement to add new content and revise definitions. Efforts by specialty bodies to establish diagnostic criteria and staging scales also lead to changes, and sometimes to divergence between different or overlapping sources of authority. In the face of these challenges, content development is directed to address current and emerging priorities identified by IHTSDO Members and other stakeholders.
Continuous quality improvement is the aim of IHTSDOSNOMED International. Quality processes are included as part of the work completed by the team of modeler's involved in SNOMED CT development. A documented scientific process is followed and content is defined and reviewed by multiple clinician editors. Conflicts between editors are resolved through an iterative process, based on achieving agreement and consensus, before being entered into the terminology. As necessary, the authoring team consult with additional experts to review the scientific integrity of the content.

Requesting Content Additions and Changes

IHTSDO SNOMED International provides a request submission service to gather and process requests for additions and changes to the content of the SNOMED CT International Edition. This service is directly accessible by National Release Centers (NRC) in Member countries and recognized Terminology Authorities within organizations with whom IHTSDO SNOMED International is actively collaborating. Organizations within Member countries can submit their requests for additions and changes to the National Release Centre. In some cases, requests with particular local relevance may be added to a National Extension. The NRC forwards requests that it considers have international relevance to the IHTSDO SNOMED International for a decision. If a request is deemed to have high priority it should result in action in the next release cycle. However, requests that require significant changes that would impact on other content may take longer.

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