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

Summary 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.
ItemsProposed improvement

Planned Release date

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

1LOINC timeline changes - please refer to Roadmap link here LOINCJuly 2018 and potentially other future releases - On hold
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 sub-hierarchy 26107004|Structure of musculoskeletal system (body structure)| has been planned for the January 2019 release. The rest body systems will be revised in the future releases.

The subject area for revision of IS A relationships will be determined and updated in the following confluence page.

January 2018 2019 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
3

Summary of Drugs changes

Groupers (disposition, structural)

  • Preferred terms updated for existing concepts (n≈500)
  • Synonyms matching FSN removed for existing concepts (n≈500)

MP-containing

  • Preferred terms updated for existing concepts (n≈3800)
  • Synonyms matching FSN removed for existing concepts (n≈3800)

MP-only New concepts created (n≈3800)

MPF-containing

  • Preferred terms updated for existing concepts (n≈2800)
  • Synonyms matching FSN removed for existing concepts (n≈2800)

MPF-only New concepts created (n≈2800)

Clinical drug Synonyms matching FSN removed for existing concepts (n≈4900)

Role:

  • New additional axioms to model therapeutic role (n≈TBD; currently expect hundreds)
  • Populated new 766941000 |Therapeutic role (role)| hierarchy (n≈TBD; currently expect hundreds)
  • Created new 773830008 |Consumer product (product)| hierarchy as sibling of 763158003 |Medicinal product (product)|. Relocated descendants of 763087004 |Medicinal product categorized by therapeutic role (product)| as appropriate (e.g. Aftershave, Deodorant, Perfume) (n≈25)
  • Inactivated role concepts representing body site or body system (e.g. Gastrointestinal drug, Genitourinary drug) (n≈15)
  • Relocated 43747001 |Drug excipient (product)| as sibling of 763158003 |Medicinal product (product)|. Relocated descendants of 763087004 |Medicinal product categorized by therapeutic role (product)| as appropriate (e.g. Drug additive, Drug flavoring) (n≈15)

New semantic tags, attribute and hierarchies added and MRCM change made to support National Extension Model.

  • New top level concept added (for use by national extension model but not for International Release)
    • 781405001 |Medicinal product package (product)| 
  • New semantic tags added (for use by national extension model but not for International Release)
    • (product name)
    • (packaged clinical drug)
    • (real clinical drug)
    • (real medicinal product)
    • (real packaged clinical drug)
    • (supplier)
  • New attributes added (for use by national extension model but not for International Release)
    • 774158006 |Has product name (attribute)|
    • 774159003 |Has supplier (attribute)|
    • 774160008 |Contains clinical drug (attribute)|
    • 774161007 |Has pack size (attribute)|
    • 774163005 |Has pack size unit (attribute)|
  • New hierarchies added (for use by national extension model but not for International Release)
    • 774164004 |Supplier (supplier)|
    • 774167006 |Product name (product name)|

Updated briefing: Briefing note - Implications of describing liquid dose form product concepts v2, can be found on second table of this page Reference Documentation - Drug Model

January 2019 International Edition
4

Summary of Substances Changes

    • Flattening of Substance hierarchy: Implement/updated “Is modification” attribute where applicable
    • Regular maintenance of substance hierarchy:
      • Add new substances required for creation of new medicinal products
      • Add new dispositions and structural grouper concepts to model existing content
      • Update modelling for existing concepts by adding "has disposition" where applicable
    • Improve substance concepts in the areas of 
      • Updating case sensitivity based on editorial guidelines
      • Alignment to the International Nonproprietary Name
    • Changes in the substance hierarchy as the result of Allergy project requirements:
      • Inactivate top level groupers/Allergen classes in substance hierarchy by reassigning their children to appropriate structural and/or functional parents:
        • 414052000 | Drug allergen by structure |
        • 414058001 | Drug pseudoallergen by function |
        • 414057006 | Drug pseudoallergen |
        • 414053005 | Drug allergen or pseudoallergen |
      • Inactivate “Allergy to X” concepts where X is a modification of a base substance and replace it with Allergy to the base substance
January 2019 Release
5

Remodeling of hypersensitive conditions

  • Immunoglobulin E-mediated allergic contact hypersensitivity process (qualifier value) and Non-immunoglobin E-mediated allergic contact hypersensitivity process (qualifier value) have been created.
  • Hypersensitivity, allergy and pseudoallergy condition classes will be moved under 404684003 |Clinical finding (finding)| and modeled using GCIs in order to encompass allergic disorders, dispositions and processes (reactions).
  • Hypersensitivity, allergy and pseudoallergy dispositions (the latter renamed as Non-allergic hypersensitivity based on feedback from the Allergy CRG) will be moved under 404684003 |Clinical finding (finding)| and remodeled using proximal primitive parents with a role group consisting of 719722006 |Has realization (attribute)| with a value of 472963003 |Hypersensitivity process (qualifier value)| or an appropriate subtype and a causative agent relationship to a substance and follow a naming pattern of Hypersensitivity/Allergy/Non-allergic hypersensitivity to X (finding).
  • 414029004 |Disorder of immune function (disorder)| will be remodeled and fully defined using a pathological process of 769247005 |Abnormal immune process (qualifier value).
  • A new hierarchy of Intolerance to substance (finding) will be created.

Hypersensitivity, allergy and pseudoallergy condition are modelled by general concept inclusion (GCI) axioms. The relationships in the GCIs are sufficient conditions which are excluded from the inferred relationships. The GCIs in the OWL axiom refset must be used with stated relationship file to enable correct classification for hypersensitivity conditions.

In addition to the changes to the concept model, the FSNs and Preferred terms will be updated to ensure consistent description patterns. The changes are word order in descriptions and they do not change the meaning. For example, Amoxicillin allergy (disorder) would be changed to Allergy to amoxicillin (disorder).

changes in the substance hierarchy as the result of Allergy project requirements (Allergies-30 and Allergies-32):

  • Inactivate the following two top level groupers/Allergen classes in substance hierarchy by reassigning their children to appropriate structural and/or functional parents :
    • 414052000 | Drug allergen by structure |
    • 414058001 | Drug pseudoallergen by function

6

Summary of Organism Changes

  • Improve Organism concepts by
    • Applying consistent case sensitivity to organism descriptions containing "Taxon Rank"
    • Fixing spelling mistakes in FSN and synonyms
  • Correct Influenza virus descriptions
January 2019 Release
7

Quality improvements on Clinical Findings

  • 125666000|Burn
  • 416462003|Wound (including closed and opened wound)
  • 125605004|Fracture of bone
  • 34014006|Viral disease
  • 95896000|Protozoan infection
Jan 2019 International Edition
8

Replacement of OWL conversion script with a link to the open source directory

In January 2017 the original OWL conversion script (a.k.a. the "Spackman OWL script") was removed from the International Edition package, and has since been published as a separate artefact alongside each Release. 

Because this script does not recognize the two new OWL refsets (see section 3.3.2 of these Release Notes), the Terminology Release Advisory Group has determined that the script should no longer be distributed.

Going forward, Release Notes will now include a link to the new open source OWL conversion toolkit that can be found in the following repository (including documentation on its use):

https://github.com/IHTSDO/snomed-owl-toolkit

Please contact SNOMED International at support@snomed.org if you would like to provide any feedback on ways to extend and improve the new toolkit.

July 2018 International Edition
9

Deprecation of the Technical Guide Exemplars document from the International Edition release package

The Terminology Release Advisory Group has confirmed that there should be no impact from removing this almost entirely static document from the International Edition release package, and hosting it instead in a Confluence Page. From the July 2018 International release then, we will deprecate this file (doc_Icd10MapTechnicalGuideExemplars_[date].xlsx) from the Release package, and instead provide a link in the Release Notes to the new Confluence Page. Please see section 2.4.1.3 of the Release Notes for the relevant link.

July 2018 International Edition
10

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

Following the feedback, the normal stated relationship file will still be available in the January 2019 release package and the partial OWL axiom refset will include all description logic features that cannot be represented in the stated relationship file.

The complete OWL axiom reference set, which includes all logical definitions and the enhanced DL features, will be available on request in the January 2019 release.

In the July 2019 release, the stated relationship file will be replaced by the complete OWL Axiom refset file. The stated relationship file will NOT be included in the international release; however, it may still be available on request to support migration to the OWL Axiom refset.

Note
titleIMPORTANT NOTE FOR USERS
Users should carefully analyse any potential impact to their systems (upload routines, etc) and make provisions for these changes urgently (if not already done), in order to prevent any issues when these changes come into effect in January 2019.  Please contact SNOMED International at support@snomed.org with “OWL Axiom refset files implementation question” in the subject line.    

  

The inferred relationship file will maintain the same format and structure, though it will no longer contain all necessary and sufficient conditions. The inferred relationship file is represented in Necessary Normal Form for distribution of relationships. It is a collection of all the necessary conditions and represents a subset of the full semantics from the 2018 July release and onwards. Most users will benefit from the improvements in the inferred relationships without requiring changes to their existing systems.

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


3

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)
4January 2019 International Edition