Page tree

Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

Overview of Current Notices

For additional Relevant links with regards to Content Development Information please click here Content Development Information

Improvement to the Release file naming convention for the Asssociation Reference file

In order to improve the description of this file, we will be updating the file naming convention from:

'der2_cRefset_AssociationReferenceSnapshot_INT_*.txt'

to:

'der2_cRefset_AssociationSnapshot_INT_*.txt'

....as of the January 2018 International Edition

TBC (ongoing)
ItemsProposed improvement

Planned Release date

(*this is provisional only and is subject to change)

1

Browse Content Changes for the January 2020 Release

The daily build is available to review changes made to content for the January 2020 release https://dailybuild.ihtsdotools.org/

Forthcoming concept inactivations, new concepts and changes to existing concepts can be reviewed using the tab 'Daily build.'

January 2020 International Release
2

Revision of IS A relationships for Skin structure anatomy concepts 

The new anatomy concept model has implemented the new enhanced Description Logic features, e.g. reflective reflexive and transitive propertyproperties, general concept additional axioms, for consistent logical modeling. However, the new model cannot be implemented in production because these DL features currently are not available in production. The implementation of them will depend on the enhanced logic profile for SNOMED CT which is under development by the Modeling AG. Yet, the inferred IS A relationship The inferred IS A relationships from the OWL anatomy ontology can be have been reviewed and the changes have been implemented in the production. This will utilise the outcomes of the new anatomy model as well as evaluate the design of the new model. In particular, it is important to review the changes of IS-A relationships in anatomy for quality assurance and minimise  The potential impact to other hierarchies, such as disorders, procedures, observables, situations etc are also reviewed as part of the project.

The revision of cardiovascular, digestive and genitourinary systems have been included in the July 2019 release. The respiratory, nervous, integumentary, endocrine, immune, sensory organs, lymphoreticular, hematological systems will be revised in the January 2020 International release.

Information about revision of IS_A relationships can be viewed here:

https://confluence.ihtsdotools.org/display/IAP/Revision+of+IS-A+relationships+for+anatomy

In the July 2019 release changes were made to 113345001|Abdominopelvic structure (body structure)| whilst retaining the ‘synonyms’ of Abdomen and Abdominal structure based on the most common usage.  Further work is currently underway to more explicitly describe and define concepts relating to regional anatomy

January 2018 International Edition
2

Improvement to the Release package naming convention

In order to ensure that the status of each package is correctly identified, we will be capitalising the third element of the naming convention. For example therefore, instead of the January 2018 International Edition release package being called:

SnomedCT_InternationalRF2_Production_20180131T120000Z.zip

It will instead be called:

SnomedCT_InternationalRF2_PRODUCTION_20180131T120000Z.zip

Alpha/Beta releases will be called:

SnomedCT_InternationalRF2_ALPHA_20180131T120000Z.zip

SnomedCT_InternationalRF2_BETA_20180131T120000Z.zip

This should have no impact on most users, this is provided for visibility of anyone who's upload routine might be case-sensitive.

January 2018 International Edition
3January 2018 International Edition

of the abdomen and pelvis with changes to content due to be implemented after a period of consultation. 

January 2020 International Release

July 2020 International Release







3

MRCM Changes

Please see:

MRCM changes in the January 2020 release

January 2020 International Release
4

Quality Initiative

Information about the project can found here - Quality Initiative - Progress

Note: There are changes to the Service Level Agreement for the CRS as a result of the Quality Initiative:

https://www.snomed.org/SNOMED/media/SNOMED/documents/Early-Visibility-of-Changes-to-Service-Level-Agreement-International-Content-Request-Service-(CRS).pdf

January 2020 International Release
5

Changes to Case Sensitivity

Over 31,000 descriptions have been reviewed and approximately 5,402 descriptions across 2806 concepts have had their case significance settings corrected as appropriate.   
The changes are across all SNOMED CT hierarchies but in particular disorder concepts (1774), procedure (978) and qualifier values (736). 

The Editorial Guidance on case significance related to descriptions containing numeric values and special characters has been updated for the January 2020 release.

January 2020 International Release
6

Planned changes to 'Co-occurrent and due to' pattern

During the implementation of the new Description Logic features a conflict was uncovered between the modeling of 'Co-occurrent and due to' and General Concept Inclusions (GCIs). This has resulted in the need to reconsider the modeling of "Co-occurrent and due' and update the Editorial Guide for this area.

There are a number of new concepts in the January 2019 release that are based upon the existing guidance for 'Co-occurrent and due to'. The plan is to update the Editorial Guide and all concepts that are currently modeled as 'Co-occurrent and due to' starting from the July 2019 release.

January 2020 International Release and future releases

7

WAS_A

Inactivation reason of LIMITED/WAS_A is not allowed for any new content inactivations after the July 2018 release. The WAS_A association refset has not been updated thereafter.

At the Editorial Advisory Group meeting in April 2019, agreement was reached to discontinue the maintenance of WAS_A relationships when inactivating concepts that have a historical association to an inactive concept. When changes are made to a historical relationship for a concept that was previously inactivated using WAS_A, effort will be made to assign a new historical relationship that facilitates traceability of the concept (e.g. DUPLICATE or AMBIGUOUS) as opposed to NON-CONFORMANCE TO EDITORIAL POLICY.

Existing WAS_A relationships will be inactivated in a future release once a plan for batch reassignment of historical relationships has been developed. Until then, SNOMED International will not continue to use or maintain WAS_A relationships.

January 2020 International Release and future releases
8

Known Content Issues July 2019 Release

Approximately 149 text definitions are missing either a US or GB spelling variation. These are all legacy issues that will be rectified in the January 2020 release.

A small set of disorder concepts have been identified with descendants that have a semantic tag of clinical finding. A further small set of concepts have been identified that have a semantic tag of disorder but are not descendants of 64572001|Disease (disorder)|. These concepts are all legacy issues that will be rectified in the January 2020 release.

Release validation rules have been enhanced to prevent recurrence of legacy issues for future content additions.

January 2020 International Release
9

Changes for 'On examination' (O/E) and 'Complaining of' (C/O) concepts

Jan 2020 release:

  • Addition of approximately new 230 concepts to cover content identified (to date) as having no base concept.
  • Continued analysis of O/E and C/O content to determine replacement content (current suitable concept, new or no value in replacing)

July 2020 release:

  • Addition of any further required content
  • Inactivation of the O/E and C/O content (Batch change) for return to the UK.

Content being inactivated will use the reason - component moved elsewhere. 

Note: some concepts will not have a replacement concept as they are groupers. For example:
On examination - sign irregular (finding)
On examination - neurological reflex (finding)

January 2020 International Release

July 2020 International Release

10

Inactivation of 33359002 |Degeneration (morphologic abnormality)|

In order to distinguish the degenerative process from the structure, 33359002 |Degeneration (morphologic abnormality)| has been inactivated as a DUPLICATE, SAME AS 107669003 |Degenerative abnormality (morphologic abnormality)|.

All morphologies in the disorder hierarchy have been replaced accordingly.

107669003 |Degenerative abnormality (morphologic abnormality)|

33359002 |Degeneration (morphologic abnormality)|

January 2020 International Release
11

Inactivation of 23583003 |Inflammation (morphologic abnormality)

In order to distinguish inflammatory process from structure, 23583003 |Inflammation (morphologic abnormality)| has been Inactivated as DUPLICATE, SAME AS 409774005 |Inflammatory morphology (morphologic abnormality)|.

All concepts in the Inflammatory disorder hierarchy have been remodeled accordingly. 

January 2020 International Release
12ICD-O project work

IACR have released ICD-O-3.2 as a listing of all new additions, changes and revisions to ICD-O-3.1 in Excel format. The new version, ICD-O-3.2, is recommended for use from 2020.  ICD-O-3.2 is not yet available online or in book format. In preparation for the update, the changes have been divided into types and are being investigated/addressed in the ICD-O-3.2 update project. The priority is being given to those that have an impact on clinical safety, e.g., changes of behaviour (benign, malignant etc.) and adding new content for SNOMED CT morphologies, this refers to the 400177003 |Neoplasm and/or hamartoma (morphologic abnormality)| hierarchy.

The descriptions with [obs] have been inactivated as outdated because they are artefacts of descriptions from the ICD-O-3 print version for their history tracking. 

The maps to ICD-O-3.1 are being updated only for error correction purposes for the January 2020 release. The maps to ICD-O-3.2 are out of scope for the January 2020 release and are planned for a future release.

January 2020 International Release
13

Over the Counter

Concepts referring to “over the counter” status have been inactivated. 

Concepts referring to regulatory status or characterization (e.g. over the counter) are out of scope for the International Release since the meaning may vary by jurisdiction and is not consistent internationally.

January 2020 International Release
14

Antigens Required for the Vaccine Products

As a Vaccine project work item and based on requests submitted mutually by Argentina and Canada, new antigen concepts (~150) have been added to the Substance hierarchy to be used in the modeling of vaccine products in a future release.

January 2020 International Release
15

Vaccine Poisoning

Concepts referring to vaccine poisoning have been inactivated from the International release and moved to the NHS extension per their request.

The notion of vaccine poisoning has persisted in ICD 10 under T50 but it is not included in ICD-11; the poisoning aspect seemingly referred to the adjuvants and carriers that are included in the vaccines as opposed to the biological component itself.

January 2020 International Release
16

Traumatic Dislocation

Traumatic dislocation concepts are being remodeled according to the new representation using DUE TO "Traumatic event".

This work has been partially completed for the Jan 2020 release, resulting in the remaining subhierarchies moving from under "Traumatic dislocation of joint" to "Dislocation of joint". These remaining subhierarchies will be remodeled for the July 2020 release.

January 2020 International Release

July 2020 International Release

17

Revision of 298180004 |Finding of range of joint movement (finding)

The concepts under the subhierarchy 298180004 |Finding of range of joint movement (finding)| are being remodeled to represent the finding site of <<785818007 |Structure of joint region (body structure)| instead of <<39352004 |Joint structure (body structure)|. 

Range of movement of a joint region can be impacted by both bone and soft tissues, therefore the use of 39352004 |Joint structure (body structure)| was too restrictive and caused issues in other areas of the terminology.  These changes will be made over the course of two releases due to the number of affected concepts.

July 2019 International Release

January 2020 International Release

18

Planned changes to Implantation and Insertion procedures

Work commenced on content tracker IHTSDO-175

Jira
serverIHTSDO JIRA
serverIdb202d822-d767-33be-b234-fec5accd5d8c
keyIHTSDO-175

Ongoing structural changes for the Procedure concepts related to the content tracker:

It was agreed that not all Insertion and Implantation procedures are surgical.

As a result, further work in the hierarchy under 129284003 |Surgical action (qualifier value)| has been undertaken for the January 2020 release and this includes:
Reactivation of 129338005 |Surgical implantation - action (qualifier value)|
Addition of a new concept 788288006 |Surgical reimplantation - action (qualifier value)|
Remodel of 'Reimplantation procedures' replaced METHOD = 129337000 |Reimplantation - action (qualifier value)| with new 788288006 |Surgical reimplantation - action (qualifier value)|.

Work on this project will continue for future releases after January 2020.

January 2020 International Release

19

Replacement of the Stated Relationship files with the new OWL Axiom refset files

A set of documentations has been developed to support the Logic Profile Enhancements. 

For any questions, please contact SNOMED International at support@snomed.org with “OWL Axiom refset files implementation question” in the subject line. 

4

Summary of Drug Changes The following describes some of the deliverables scheduled for the January 2018 that continue to contribute to the delivery of this Strategy:

NOTE: Numbers are still evolving and will likely change before the final version of the release notes are generated.

New hierarchies

  • Basic dose form (basic dose form): New concepts created (n ≈ 150)
  • Dose form administration method (administration method): New concepts created (n ≈ 10)
  • Dose form intended site (intended site): New concepts created (n ≈ 25)
  • Dose form release characteristic (release characteristic): New concepts created (n ≈ 10)
  • Dose form transformation (transformation): New concepts created (n ≈ 5)
  • Pharmaceutical dose form (dose form):
    • New concepts created (n ≈ TBD)
    • Concepts remodeled (n ≈ TBD)
  • State of matter (state of matter): New concepts created (n ≈ 5)

New semantic tags 

  • (administration method)
  • (basic dose form)
  • (dose form)
  • (intended site)
  • (release characteristic)
  • (state of matter)
  • (transformation)

New attribute types

  • Has basic dose form
  • Has concentration strength denominator unit
  • Has concentration strength denominator value
  • Has concentration strength numerator unit
  • Has concentration strength numerator value
  • Has dose form administration method
  • Has dose form intended site
  • Has dose form release characteristic
  • Has dose form transformation
  • Has state of matter

Attribute type changes (for existing attributes) None

Grouper None

Medicinal product (MP) Updated ≈ 1100 existing concepts in accordance with new modeling and/or terming guidelines

  • Existing concept IDs, stated parents and definition status were retained
  • Missing |Has active ingredient| attributes were added; errors in existing content were corrected as they were identified

Medicinal product form (MPF) Negligible number of changes

Clinical drug (CD) Updated ≈ 3000 existing concepts changing terming from "Product containing X" to "Product containing only X"

Note that the terming for these concepts was updated in the 2017-July release to reflect "Product containing X"; upon advice from the Working Group, we elected to notify the Member Forum, Project Group, and Working Group of the retraction/substitution rather than inactivate/replace these concepts

New or updated concepts to support future simple map refset development    

For SNOMED CT to EDQM simple map refset:

  • 741068007|SNOMED CT to European Directorate for the Quality of Medicines & HealthCare simple map reference set module (core metadata concept)
  • 735233007|European Directorate for the Quality of Medicines & HealthCare simple map reference set (foundation metadata concept)

For SNOMED CT to UCUM simple map refset:

  • 741814003|SNOMED CT to Unified Code for Units of Measure simple map reference set module (core metadata concept)
  • 733900009|Unified Code for Units of Measure simple map reference set (foundation metadata concept)

Documentation created or updated including:

  • Position Statement
  • Briefing Paper re: update terming for Clinical Drug concepts changing "Product containing X" to "Product containing only X"
  • Editorial Guidelines for Modeling and Terming for Dose Form related hierarchies, including identification of |Pharmaceutical dose form| concepts to be used for modeling concepts in the International Release moving forward
  • Editorial Guidelines for Modeling and Terming for Product hierarchy

General content maintenance including:

  • Inactivation of concepts that are missing strength denominator (incomplete)
  • Inactivation of concepts that refer to color (out of scope)
  • Inactivation of concepts containing caplet (out of scope)
  • Inactivation of concepts containing "controlled-release" (ambiguous)
TBC (ongoing)
5Summary of Substances Changes

New hierarchies: Disposition (disposition)

New semantic tags (disposition)

New attribute types Has disposition

Is modification of

Attribute type changes Populated |Has disposition| grouper (n ≈ 150)

Groupers Updated modeling, definition status, and terming for groupers representing disposition (n ≈ 150) with associated change in stated parents for existing descendants (n ≈ 9000)

Briefing papers:

Documentation created or updated including:

  • Editorial Guidelines for Modeling and Terming for Substance hierarchy
  • Editorial Guidelines for Modeling and Terming for Disposition concepts

General content maintenance including:

  • Addition of X concepts as a result of gap analysis to identify missing concepts representing hydrates.
  • Addition of X concepts to represent substances as a result of content requests, new drug approvals, or gaps identified internally.
where X will be updated in the next week or so.