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Developing reference sets can be done in different ways, depending on requirements, resources and skills of the organization who wish to develop a reference set. In some situation it may be the best approach to build the reference set without making use of or relying on any previous work for assistance. In other situations, existing reference sets may meet the requirements for another organization that wants to develop a reference set, and in these cases there are different approaches to utilize the existing work. In this section we introduce different general approaches to the creation of SNOMED CT reference sets, including: