SNOMED CT Templates

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StatusIn progressReady for implementation
Version

1.0.1


Descriptions:

Termdescription typeLanguage/acceptabilityLangaugeLanguage/acceptabilityCase significance
Adverse [finding site] reaction to [agent]

[Accidental/Intentional] [course] [substance or product] overdose (disorder)

FSNus:Pgb:Pci
Adverse [finding site] reaction to [agent]

[Accidental/Intentional] [course] [substance or product] overdose

SYNus:Pgb:Pci

Concept model:

Role group cardinality1246075003Causativeagent[agent]<<105590001Substancesubstance373873005Pharmaceutical / biologic productproduct1363698007 Findingsitefinding site] <123037004 |Body structure (body structure
Attribute Group CardinalityAttribute CardinalityAttribute in Group CardinalityAttributeValue
0..01..1


Scg expression
116680003 |Is a (attribute)|



Scg expression
281647001 |Adverse reaction (disorder)|
N/A
1149222004 |Overdose (disorder)|


0..1
0..1


Scg expression
263502005 |Clinical course (attribute)|



Scg expression
< 288524001 |Courses (qualifier value)|


0..1
0..1


Scg expression
42752001 |
Due 
to (attribute)|



Scg expression
<< 
1148742001 
|
Intentional event (
event)| OR << 
418019003 |
Accidental event (
event)|


0..1
0..1


Scg expression
246075003|
Causative 
agent (attribute)|



Scg expression
[
agent] << 105590001|Substance (substance)| OR << 373873005|Pharmaceutical / biologic product (product)|


Definition status:  

Scg expression
900000000000073002|Defined (core metadata concept)|

Applies to:

Scg expression
<< 1149222004 |Overdose (disorder)|

Template Language

...

Scg expression
1149222004 |Overdose (disorder)|: 
[[

...

~0..1]] {[[~0..1]]

...

 263502005 |Clinical course (attribute)| = [[ +id ( <

...

 288524001 |Courses (qualifier value)|)

...

 @course]]}, 
[[

...

~0..1]] {[[~0..1]]

...

 42752001 |Due to (attribute)| = [[+id

...

 ( << 1148742001 |Intentional event (event)| OR << 418019003 |Accidental event (event)|) @dueto ]]}, 
[[~0..1]] {[[~0..1]] 246075003 |Causative agent (attribute)| = [[+id ( < 105590001 |Substance (substance)| OR < 373873005 |Pharmaceutical / biologic product (product)|) @causative]]}

Link to the misaligned concept report

Overdose misaligned concept report 2021-Dec-14

Rules for generating descriptions:

  1. Apply General rules for generating descriptions for templates

Applies to:

Scg expression
<< 282100009 |Adverse reaction caused by substance (disorder)| MINUS <<418634005 |Allergic reaction caused by substance (disorder)|

Editorial guidelines for selection of Causative agent attribute value:

The following editorial guidelines apply to concepts in the International Release; editorial guidelines for concepts in national extensions may vary.

Hierarchy
Causative agent
Concept typeAllowedExceptionExamples and Notes (Note: Examples are existing concepts and may not reflect the terming patterns described in the template.)
Substance
base
Baseyes
Adverse reaction concepts representing a substance base should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.
n/a

Example:

292392003 |Fluphenazine adverse reaction Substance modificationno, unless documented as exceptionAdverse reaction concepts representing a substance modification should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.
  • 295184007 |Morphine overdose (disorder)|

Expected classification:

  • Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy.
SubstanceModificationyesyes

Concepts representing substance modifications are exceptions and may be included if the

adverse reaction

overdose profile is significantly different from the substance base.

Exception examples:

  • Chemical element with multiple modifications (e.g. 422232005 |Calcium lactate gluconate (substance)|)
    • Liposome or lipid complex substances (e.g. 412088006 |Amphotericin B liposome (substance)|, 426490000 |Vincristine liposome (substance)|)
    • Pegylated substance (e.g. 385544005 |Pegfilgrastim (substance)|, 770965008 |Pegvaliase (substance)|)
    • Salt forms (e.g.
    412432007
    • 273948005 |
    Metoprolol succinate
    • Chloral hydrate (substance)|,
    72770009
    • 396063006 |
    Metoprolol tartrate
    • Fluphenazine decanoate (substance)|)

    Example:

    292389002 |Fluphenazine decanoate adverse reaction
    • 296136008 |Chloral hydrate overdose (disorder)|
    292390006
    • 296213007 |Fluphenazine
    enanthate adverse reaction
    • decanoate overdose (disorder)|

    Expected classification:

    • Classification results are expected to reflect that the concept modeled with the modified substance is a descendant of the concept modeled with the base substance (if such a concept exists (e.g. 292389002 |Fluphenazine decanoate adverse reaction (disorder)| has inferred parent 292392003 |Fluphenazine adverse reaction (disorder)|).
    Multiple substanceyesAdverse reaction concepts representing multiple substances
    SubstanceDisposition grouperyesn/a

    Overdose concepts representing a disposition grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

    Example:

    • 297053006 |Overdose of angiotensin-converting-enzyme inhibitors (disorder)|
    • 296515004 |Opiate antagonist overdose (disorder)|
    SubstanceRole grouperyesn/a

    Overdose concepts representing a role grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|

    ; preferentially modeling with the base rather than a modification unless the adverse reaction profile is significantly different from the substance base

    . Role groupers will be transitioned to the 763158003 |Medicinal product (product)| hierarchy in a future release.

    Example:

    292984002 |Ampicillin and cloxacillin adverse reaction 292989007 |Ticarcillin and clavulanic acid adverse reaction
    • 297006008 |Diuretic overdose (disorder)|
  • 292987009 |Piperacillin and tazobactam adverse reaction (disorder)|
    • 295217003 |Non-steroidal anti-inflammatory overdose (disorder)|
    Expected classification (Agreed 21-Jan-2020):
    Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the
    Substance
    hierarchy.
    Disposition
    Structure grouperyes
    Adverse reaction
    n/a

    Overdose concepts representing a

    disposition

    structure grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

    Example:

    293432006 |3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor adverse reaction
    • 295188005 |Pethidine analog overdose (disorder)|
    870376001 |Adverse reaction to dopamine receptor agonist
    • 1155996000 |Phenothiazine and/or phenothiazine derivative overdose (disorder)|

    Expected classification results:

    • Classification results are expected to reflect that the adverse reaction concepts are descendants of the appropriate disposition grouper based on the modeling of the 726542003 |Has disposition (attribute)| attribute in the substance hierarchy (e.g. 292113001 |Lansoprazole adverse reaction (disorder)| has inferred parent 292111004 |Proton pump inhibitor adverse reaction (disorder)|).
    ProductStructure groupernon/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    ProductDisposition groupernon/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    ProductRole groupernon/a

    Overdose

    Role grouperyesAdverse reaction

    concepts representing a role grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

    Note that role

    Role groupers will be transitioned to the 763158003 |Medicinal product (product)| hierarchy in a future release.

    Example:

    • 430136001 |Adverse reaction caused by antiparkinsonism drug (disorder)|
    • 292040004 |Analgesic adverse reaction (disorder)|

    Expected classification results (Agreed 21-Jan-2020):

  • Classification results are expected to reflect that the adverse reaction concepts are descendants of the appropriate disposition grouper based on the modeling of the 726542003 |Has disposition (attribute)| attribute in the substance hierarchy (e.g. 292113001 |Lansoprazole adverse reaction (disorder)| has inferred parent 292111004 |Proton pump inhibitor adverse reaction (disorder)|).
  • Classification results are expected to be consistent with the modeling in the Substance hierarchy for concepts modeled with an attribute value from the Substance hierarchy.
    • ProductMedicinal product-containingnon/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    ProductMedicinal product-onlynon/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    ProductMedicinal product form-containingnon/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    Product

    Medicinal product form-only

    		non/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    ProductClinical drugnon/aNo use case has been identified for use of this concept type for modeling in this subhierarchy.
    Structure grouperyes

    Adverse reaction concepts representing a structure grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

    Example:

    • 218638005 |Adverse reaction caused by hydantoin derivative (disorder)|
    • 419885006 |Beta lactam adverse reaction (disorder)|

    Expected classification (Agreed 21-Jan-2020):

    • Classification results are expected to be consistent with the modeling in the Substance hierarchy and with other existing concepts in the subhierarchy.
    Descendant of 373873005 |Pharmaceutical / biologic product (product)|no, unless documented as exceptionExceptions: None identified

    The following types of groupers are out of scope; existing concepts have been inactivated or will be addressed in future release:

    • Groupers based on more than one role (e.g. 292722006 |Chelating agents and antidotes adverse reaction (disorder)|)
    • Groupers based on body system or intended site or route of administration (e.g. 292548001 |Drug groups primarily affecting respiratory system adverse reaction (disorder)|) or 417895009 |Topical agent adverse reaction (disorder)|)
    • Groupers based on disposition, role, or structure combined with an individual substance (e.g. 287177000 |Sulfonamide/trimethoprim reaction (disorder)| or 292513008 |Methyldopa and diuretic adverse reaction (disorder)|)
    • Groupers based on "combined" or "compound" substances (e.g. 292983008 |Combined penicillin preparation adverse reaction (disorder)| or 293358005 |Compound iron preparations adverse reaction (disorder)|)
    • Groupers based on disposition or structure combined with intended site or route of administration (e.g. 433494006 |Adverse effect of oral diphosphonate (disorder)|)
    • Groupers based on disposition combined with role (e.g. 292265006 |Dopaminergic drug used in parkinsonism adverse reaction (disorder)|)

    Rules for description generation:

    1. For the FSN, align terming and case sensitivity with the FSN for the concept that is selected as the attribute value, excluding the semantic tag. 
    2. For the PT, align terming and case sensitivity with the US and GB PT for the concept that is selected as the attribute value.
    3. In cases where neither the US or GB PT matches the FSN, excluding the semantic tag, a synonym corresponding to the FSN is required unless explicitly identified as an exception.Additional synonyms "[agent] adverse reaction" should be added. Other synonyms are not allowed unless explicitly identified as an exception.

    JIRA ticket for implementation:

    Jira
    serverIHTSDO JIRA
    serverIdb202d822-d767-33be-b234-fec5accd5d8c
    keyINFRA-8098