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| Items | Proposed improvement | Planned Release date (*this is provisional only and is subject to change) | ||||
|---|---|---|---|---|---|---|
| 1 | LOINC timeline changes - please refer to Roadmap link here LOINC | July 2018 and potentially other future releases. | ||||
| 2 | Revision of IS A relationships for anatomy concepts The new anatomy concept model has implemented the new Description Logic features, e.g. reflective and transitive property, general concept 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 from the OWL anatomy ontology can be reviewed and 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 impact to other hierarchies, such as disorders, procedures, observables, situations etc. The first subject area for revision is the sub-hierarchy of skin structure. The majority changes have been made in the January 2018 release. The rest will be completed in July 2018 releaseand following releases. For July 2018 release, the The subject area for revision of IS A relationships will be determined and updated in the following confluence page. | July 2018 International Edition | ||||
| 3 | Summery Summary of Drugs changes Groupers Chemical structure New hierarchies 766940004 | Role (role) and subhierarchy 766941000 | Therapeutic role (role) created with additional subtypes to be added in future releases New semantic tags (role) Attribute types New attributes created:
Grouper concepts representing disposition, intended site, and/or structure Grouper concepts representing disposition, intended site, and/or structure sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈550). New high level grouper concepts created as an incremental improvement with additional subtypes to be added in future releases:
Product role concepts Concepts representing product role relocated as stated descendants of 763087004 | Medicinal product categorized by role (product) with definition status = primitive and attributes inactivated (n≈ 400) For further details see Briefing Note Use of Additional Axiom Functionality and Remodeling Product Roles Groupers Dispositions
Groupers Intended site All existing concepts remodeled, with modeling and terming updated per editorial guidelinesMedicinal product (MP)
concepts - MP-containing concepts sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈ 3750). Includes the following attributes:
Medicinal product form (MPF) concepts - MPF-containing concepts sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈2100). Includes the following attributes:
Clinical drug (CD)
Pharmaceuticaldose form
General The Alpha Release is a snapshot of the work-in-progress authoring environment; not all concepts are in scope for review at this time. Feedback given for concepts noted as out of scope will be rejected. For drugs:
For dose forms: concepts - CD-containing precisely concepts sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈ 4850). Includes the following attributes:
Documentation Notification for Briefing Notes, Editorial Guidelines, and other documentation updates are posted on the project group website as they become available; see Drug Model Working Group - Directory for details | July 2018 International Edition | ||||
| 4 | Summary of Substances ChangesTop Level Dietary subhierarchy. To remove context of use from the substance concepts and manage the situation where substances can be both a pharmaceutical ingredient and a foodstuff 80 substances(n≈80) that had a tag of “- dietary” in the Fully Specified Name (FSN) and the Preferred Term (PT) were inactivated. Replacement concepts concept withoutwithout "-dietary" in the FSN and PT were created. The top level concept "Dietary substance (substance)" has been inactivated and replaced with a new concept "Edible substance (substance)". Radioactive isotope substances. These concepts have been remodelled and the terming normalised to provide consistent representation without the use of carats. Cancer related substance. The subhierarchy has now been removed. Some concept have been inactivated. Some have been moved within the substances hierarchy. Disposition groupersGroupers
Role groupers Role groupers within the substances hierarchy are being inactivated where this is possible without creating disruption in other hierarchies. At the start of this work there were approximately 600 role groupers. Currently in the region of 100 role grouper substance concepts have been inactivated or remodelled.This work is ongoing. Many of these role grouper concepts remain in the substances hierarchy pending a solution for the roles concepts within the terminology as a whole and so will still be present in the July 2018 release. Structural groupers Structural groupers within the substance hierarchy have been modelled as primitive concepts. Existing structural grouper concepts in the substances hierarchy have been retained where appropriate and have been remodelled to conform to SCT Editorial policy. New structural grouper concepts have been added. Groupers that identify X or derivatives where X is a specific substance will be inactivated. Some of these concepts have already been inactivated. As the implementation of the IS Modification attibute is carried out the remainder of these concepts will be inactivated. Structural groupers that reference a chemical group will be retained. e.g. Amides and derivatives (substance) Where the structural group name also refers to a specific chemical the grouper has been re-termed “Substance with X structure” e.g. Substance with tetracycline structure (substance) Combined groupers Combined groupers that include a role will be inactivated where this is possible without causing disruption in other hierarchies. Inactivation of some of these concepts in the substances hierarchy is waiting on a solution for the roles concepts within the terminology as a whole and so will still be present in the July 2018 release. Groupers of disposition + structure will be retained in the substance hierarchy. Existing concepts have been remodelled to conform to SCT Editorial policy. Examples as below. Antimony compound with antiprotozoal mechanism of action (substance) Quaternary ammonium compound with anticholinergic mechanism of action (substance) Piperidine derivative with histamine receptor antagonist mechanism of action (substance) New concepts will be added as required. Use of the Is Modification attribute The implementation of the IS Modification attibute has been started. This has achieved a flattening of the substance hierarchy. Priority has been given to the remodelling of substances associated with the medicinal products. This work is ongoing. The following guidelines have been developed. 1. Substances may have zero to many Is modification attribute(s). e.g Iodine (131-I) labelled monoclonal antibody (substance) has 2 IS MODIFICATION attribute values. 2. Salts have a IS MODIFICATION relationship to the base e.g. Doxepin hydrochloride (substance) IS MODIFICATION of Doxepin (substance) 3. Hydrates have a IS MODIFICATION relationship to the unspecified salt e.g. Caffeine hydrate (substance) IS MODIFICATION of Caffeine (substance) 4. Anhydrous salts have a IS MODIFICATION relationship to the unspecified salt e.g. Theophylline anhydrous (substance) IS MODIFICATION of Theophylline (substance) 5. Stereoisomers are subtypes of the unspecified substance. e.g.. Dextrothyroxine IS A thyroxine. 6. There is no IS MODIFICATION relationship between stereoisomers. Further guidelines will be added to the published documentation as they are developed. The initial population of the IS MODIFICATION attribute is still subject to manual authoring input to ensure compliance to Editorial guidelines and so some areas of content may appear to be non-conformant in the Alpha release data.
Structural Groupers
Combined Groupers (Structure + Disposition)
Role Groupers
The "Is modification" of attribute has been implemented (n≈1200) resulting in flattening of the substances hierarchy. Overall 447 new concepts added to the substances hierarchy. Just over 460 substance concepts have been inactivated in the July 2018 SNOMED CT release. Documentation Notification for Briefing Notes, Editorial Guidelines, and other documentation updates are posted on the project group website as they become available; see Project Status Substance Hierarchy for details. | July 2018 International Edition | ||||
| 5 | Internal QA - Situation and Findings Test and procedure status: Inactivated 143 concepts in the Situations and Findings hierarchies with pattern "Test/procedure OFFERED" and "Test/procedure NOT OFFERED" as these represent an administrative status. | July 2018 International Edition | ||||
| 6 |
| 7 | Internal QA - Qualifier Value Inactivation of Agencies and organizations (qualifier value) and subtypes: moved to UK extension i.e. 66 concepts inactivated. | July 2018 International Edition | ||
| 7 | 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 | ||||
| 8 | 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 | ||||
| 9 | 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 Item 7 above), 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 |