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Figure 11
– Example of concept-based vs literal translation approach

As the ontology may contain errors, it is important that translators are aware of possible inconsistent or erroneous formal relationships and report modelling that contradicts the FSN.

SNOMED CT is a comprehensive terminology designed to meet the needs of a broad group of health care professionals in a range of settings. Translations should comply with the principles on which SNOMED CT was originally based:understandability, reproducibility and usefulness (URU). Therefore, the translation should adhere to the principles elaborated by Terminology Science for useable terms: terms should be transparent and reflect the essential characteristics of the designated concept; terms should satisfy the requirements of the users’ needs, i.e. they should be in accordance with clinical usage and they must be equally well understood by the different health professionals who use them. For each target language national linguistic guidelines, including syntactic, morphological and orthographic rules, are developed to support this approach.

... Case significance

The current version of SNOMED CT contains three case sensitive values (Table 3): initial case insensitive (cl - use if any other letter than the first is uppercase), entire sensitive (CS - use if first letter is case sensitive), and entire case insensitive (ci - default).

Case Sensitivity Indicator





First letter of the description may or may not be capitalized while the case of the rest of the description cannot be changed.

  • Family history of Prader-Willi syndrome (situation)
  • Born in Australia (finding)
  • Neonatal jaundice with Dubin-Johnson syndrome (disorder)


Cannot change any case in the description

Changing case may change the meaning of the term or is not commonly used

  • Down syndrome
  • English as a second language (finding)
  • pH measurement (procedure)
  • mm (qualifier value)


Entire description may be lower or upper case

Changing case does not change the meaning of the term

  • Fracture of tibia (disorder)
  • Blood compatibility test (procedure)
  • Bite of fish (event)
  • Floor mat (physical event)