1 Introduction
SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.
The International Health Terminology Standards Development organisation (IHTSDO®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.
2 Background
This document provides a summarized description of the content changes included in the November 2022 Production release of the SNOMED Clinical Terms® Managed Service Belgium Extension package.
It also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.
This Belgium Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® September 2022 International Edition release.
2.1 Scope
This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.
3 Content Development Activity
3.1 Summary
Content from the SNOMED CT® September 2022 International Edition release has been translated.
This extension contains concepts, relationships and reference sets with their Dutch and French translations for healthcare professionals/for use in healthcare profession.
3.2 New and Updated Content
New Belgian content in this release:
New concepts
No new concepts have been created in this release.
New reference sets
4 new subsets have been created containing the concepts for within 4 value sets corresponding to the Care Sets of AllergyIntolerance and Vaccination:
- AllergyIntolerance subsets
- SubsetForAllergyIntoleranceCausativeAgentDrug
- SubsetForAllergyIntoleranceCausativeAgentNondrug
- SubsetForAllergyIntoleranceManifestation
- Vaccination
- SubsetForVaccination
New translated content
For Regarding the GP language refset:
- 1850 concepts have been added to the GP subset
This gives the following total result per hierarchy.The following table contains the total number of translations included in the GP subset:
DUTCH
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hierarchy | Preferred | Acceptable | Total |
body structure/morphologic abnormality | 2 | 2 | |
event |
21 |
12 |
33 |
finding |
5219 |
2063 |
7282 |
procedure |
48 |
9 |
57 |
situation |
58 |
13 |
71 |
Total |
5348 |
2097 |
7445 |
FRENCH
Scroll Table Layout orientation default sortDirection ASC repeatTableHeaders default style Resolved Issues Table widths 40%,20%,20%,20% sortByColumn 1 tableStyling confluence sortEnabled false cellHighlighting true
hierarchy | Preferred | Acceptable | Total |
body structure/morphologic abnormality | 2 | 2 | |
event |
21 |
12 |
33 |
finding |
5219 |
1983 |
7202 |
procedure |
48 |
11 |
59 |
situation |
58 | 6 |
64 |
Total |
5348 |
2012 |
7360 |
For Regarding the national language refset:
New translations have been introduced, both for concepts that didn't have a translation yet as for concepts with existing translations.
The new translated concepts belong to the following hierarchies.following table contains the number of concepts with new translations:
DUTCH
Scroll Table Layout orientation default sortDirection ASC repeatTableHeaders default style Resolved Issues Table widths 40%,20%,20%,20% sortByColumn 1 tableStyling confluence sortEnabled false cellHighlighting true
Hierarchy | Preferred | Acceptable | Total |
event | 19 | 9 | 28 |
finding | 86014 | 103754 | 189768 | metadata | 1 | 1 |
procedure | 45503 | 52690 | 98193 |
product | 3 | 3 | 6 |
situation | 4610 | 5552 | 10162 |
substance | 2946 | 3363 | 6309 |
Total | 139096 | 162371 | 304467 |
body structure | 32674 | 29923 | |
environment / location | 846 | 361 | |
event | 1 | 1 | |
finding | 3456 | 2746 | |
metadata | 297 | 189 | |
observable entity | 2632 | 1883 | |
organism | 1981 | 937 | |
physical force | 161 | 76 | |
physical object | 8278 | 3434 | |
procedure | 3037 | 2387 | |
product | 182 | 144 | |
qualifier value | 1775 | 1072 | |
record artifact | 22 | 10 | |
situation | 33 | 29 | |
social concept | 2875 | 908 | |
special concept | 2 | ||
specimen | 1548 | 1141 | |
staging scale | 15 | 8 | |
substance | 54 | 43 | |
Total | 59869 | 45292 |
FRENCH
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Hierarchy | Preferred | Acceptable | Total | ||||
finding | 231467956 | 1658 | 24804 | metadata | 1 | 6271 | 142271 |
procedure | 176985474 | 7364601 | 1843410075 | ||||
product | 351 | 3 | 6 | ||||
situation | 188 | 40 | 228 | ||||
9 | 60 | substance | 2197 | 192 | 2389 | ||
Total | 4322313481 | 262910881 | 4586224362 |
The other changes are updates of existing content.
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Differences found in package Comparison | No RF2 records impacted | Rationale | |||
Concept files | 151 record | 5 records added/updated | |||
Association files | 2202 records added | 19 records added/updated, plus 1 inactivated | |||
AttributeValue files | 24104389 | 2408 4381 records added/updated, plus 2 8 inactivated | |||
Description files (EN) | 28 | 2 8 records added | |||
Description files (FR) | 4964130131 | 48498 records 29803 records added/updated, plus 1143 323 inactivated | |||
Description files (NL) | 307161,658830307 | 161,374 records 738 records added/updated, plus 284 85 inactivated | |||
Language files (EN) | 28 | 2 8 records added | |||
Language files (FR) | 4812131980 | 47010 31678 records added/updated, plus 1111 302 inactivated | |||
Language (FR) context specific GP Refset | 22172765 | 2184 2742 records added/updated, plus 33 23 inactivated | |||
Language files (NL) | 306159,023788 | 305159,788 717 records added/updated, plus 235 71 inactivated | |||
Language (NL) context specific GP Refset | 22252750 | 2175 2736 records added/updated, plus 50 14 inactivated | |||
Inferred Relationship files | 325 | 3 13 records added/updated, plus 12 inactivated | |||
OWLExpression files | 17 | 1 7 record added/updated | |||
RefsetDescriptor files | 110 | 1 record 4 records added (for new medical problems refset)4 new refsets added this cycle) + 6 updated | |||
Translated Plant Materials Simple Refset | 0 | 0 records added/updated updated, plus 0 inactivated | |||
Translated Edible Substances Simple Refset | 01 | 0 records added/updated updated, plus 1 inactivated | |||
Translated Animal Materials Simple Refset | 01 | 0 records added/updated, plus 1 inactivated | |||
Belgian GP refset files | 12961859 | 1280 1850 records added/updated, plus 16 9 inactivated | |||
Belgian POC FHIR no allergy Refset files | 070 records added/updated | ALL 7 records inactivated in preparation for deprecation in next cycle | |||
Belgian POC FHIR causative agent, no drug Refset files | 06570 records added/updated | ALL 657 records inactivated in preparation for deprecation in next cycle | |||
Belgian POC FHIR manifestation Refset files | 0370 records added/updated | ALL 37 records inactivated in preparation for deprecation in next cycle | |||
Extended Map files (containing the new BE ICD-10 map content) | 0 | 0 records added/updated updated, plus 0 inactivated | |||
Belgian subset for medical problems in patient health records refset files | 7979 | files | 22 | 0 records added/updated, plus 22 inactivated | |
Belgian subset for Vaccination Simple Refset | 51 | 51 records added for this new refset (50831000172102) | |||
Belgian subset for Allergy Intolerance Causative Agent Drug Simple Refset | 6403 | 6403 records added for this new refset (50841000172109) | |||
Belgian subset for Allergy Intolerance Causative Agent Non-Drug Simple Refset | 1194 | 1194 records added for this new refset (50851000172106) | |||
Belgian subset for Allergy Intolerance Manifestation Simple Refset files | 67 | 67 | 7979records added for this new refset ( | 4081100017210850861000172108) | |
Metadata .json file | n/a | New field added - "previousPublishedPackage" | Delta files | n/a | All Delta files removed from package, as planned in line with MS & International Edition packaging conventions |
4 Technical notes
4.1 Known Issues
Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented. This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.
For the SNOMED CT Managed Service - Belgium Extension Release, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:
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4.2 Technical notes
Please be aware that the following new files have been added to the Belgium Extension Release package, representing the new refsets being introduced in this editing cycle:
- der2_Refset_SubsetForAllergyIntoleranceCausativeAgentDrugSimpleRefsetSnapshot_BE1000172_20221115.txt
- der2_Refset_SubsetForAllergyIntoleranceCausativeAgentNondrugSimpleRefsetSnapshot_BE1000172_20221115.txt
- der2_Refset_SubsetForAllergyIntoleranceManifestationSimpleRefsetSnapshot_BE1000172_20221115.txt
- der2_Refset_SubsetForVaccinationSimpleRefsetSnapshot_BE1000172_20221115.txt
Please also be aware that as of the November 2022 Release of the BE Extension onwards, the RF2 package naming convention has been changed in order to bring it in line with the naming standards across all Managed Service products. This is being changed from:
- SnomedCT_BelgiumExtensionRF2_PRODUCTION_[date]T[time]Z.zip
...to the following:
- SnomedCT_ManagedServiceBE_PRODUCTION_BE1000172_[date]T[time]Z.zip
So, for the November 2022 BE Extension Release, for example, the RF2 package would have originally been called:
- SnomedCT_BelgiumExtensionRF2_PRODUCTION_20221115T120000Z.zip
...whereas from now on it will instead be called:
- SnomedCT_ManagedServiceBE_PRODUCTION_BE1000172_20221115T120000Z.zip
4.3 Notice of changes to the International Edition Release Schedule
As you may already know SNOMED International are transitioning to a monthly delivery schedule for the International Edition of SNOMED CT. The move towards more frequent releases of SNOMED CT will realize several benefits, including:
- The potential to be able to get content changes into the terminology in a shorter time frame.
- The fostering of better interoperability, as a result of entities being able to consume release content that is more aligned with other organizations.
- The prevention of circular dependencies that occur in longer projects, due to the move towards smaller, more manageable authoring projects.
- More automated validation services, as a result of the inherent removal of the Alpha/Beta stages in the Release cycle.
Whilst most users will continue unaffected (as they can simply continue to download the releases every 6 months as always), this transition will necessarily involve a few changes to process/packages:
- Delta files have been removed from both International and Managed Service release packages, including the Belgium Extension. A Delta Generation service will be provided for those who need it. The Delta Generation Tool allows users to create their own Delta between two fixed release dates - you can find it here:
- The ICDThe ICD-0O/ICD-10 Maps will continue to be published in each Monthly International Edition release package (in line with that month's content) for the foreseeable future, unless we experience issues with the new process in Production, and they need to be removed at a later date.
The first monthly Release of the SNOMED CT International Edition was published on the 28th February 2022 with the Delta files having been removed, and therefore they have been removed from the Belgium Extension from the March 2022 Release onwards.
Please note - While the SNOMED CT International Edition is moving to monthly releases, the Belgium Extension of SNOMED CT will remain on the new bi-annual release schedule of May and November.
4.4 Notice of changes to the Belgian Extension Release Dates
As we have already communicated in a separate notification, the release dates of the Belgian extension have changed.
From now on the new dates of the six-monthly release of the Belgian extension will be:
- 15 May
- 15 November
This change has been made for organisational reasons, taking into account the availability of our human resources.
Please note that the release cycle of 6 months remains (for now), only the dates have changed.
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Approvals
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Draft Amendment History
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