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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

January 2018 International Edition - COMPLETE
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.
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

Summary of Drugs changes

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:

  • 766953001 |Count of active ingredient (attribute)|
  • 766954007 |Count of base and modification pair (attribute)|
  • 766952006 |Count of base of active ingredient (attribute)|
  • 763032000 |Has unit of presentation (attribute)|
  • 766939001 |Plays role (attribute)|

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:

  • 766779001 |Medicinal product categorized by disposition (product)|
  • 763760008 |Medicinal product categorized by structure (product)|
  • 767102007 |Medicinal product categorized by chemical element (product)|

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

Medicinal 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:

  • Has active ingredient (n≈4650)

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:

  • Has active ingredient (n≈2400)
  • Has manufactured dose form (n≈2150)

Clinical drug (CD) 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:

  • Count of base of active ingredient (n≈4850)
  • Has basis of strength substance (n≈5600)
  • Has concentration strength denominator unit (n≈1450)
  • Has concentration strength denominator value (n≈1450)
  • Has concentration strength numerator unit (n≈1450)
  • Has concentration strength numerator value (n≈1450)
  • Has manufactured dose form (n≈4850)
  • Has precise active ingredient (n≈5550)
  • Has presentation strength denominator unit (n≈4750)
  • Has presentation strength denominator value (n≈4750)
  • Has presentation strength numerator unit (n≈4750)
  • Has presentation strength numerator value (n≈4750)

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

Briefing

Briefing note - Use of Additional Axiom Functionality and Remodeling Product Roles.pdf

Briefing note - Implications of describing liquid dose form product concepts using presentation strength.pdf

July 2018 International Edition
4

Summary of Substances Changes

Top 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

without 

without "-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.

Substance groupers including Disposition, Structure and Combined groupers have been remodelled and additional grouper concepts created as required. The inactivation of role groupers in the substances hierarchy has been initiated.

Disposition Groupers had been updated, modeled and fully defined in Jan2018 release. Just under 50  additional Disposition concepts have been created in the July 2018 data.

  • Existing Disposition groupers for substances have been remodeled and are now Fully Defined in the July 2018 data.
  • Additional Disposition Groupers for substances have been created . A total of approx. 300 Disposition grouper substances(n≈50).
  • A new substance top level concept of “Substance categorized by disposition (substance)” has been created to allow substances with dispositions to be modeled as proximal primitive.

Structural Groupers 

  • Existing structural groupers have been retained as primitive substance concepts.
  • Additional Structural Groupers for substances have been created. Approx 20(n≈20).
  • Chemical element
groupers Inactivated
  • groupers Inactivated and recreated to avoid the use
of AND
  • of AND/
OR and
  • OR and provide consistent modeling.

Combined Groupers (Structure + Disposition)

  • Existing concepts be have been remodeled as Fully Defined concepts in the July 2018 data

The "Is modification" of attribute has been implemented resulting in a to flattening of the substances hierarchy.

Role Groupers in the substances hierarchy have been reviewed. In the region of 100 substance Role grouper concepts

Role Groupers

  • Concepts that are Role grouper substances have been inactivated and others replaced (n≈100).
 This
  • This work is ongoing and further inactivations will be made in future releases. The retention of some role based groupers in the substances hierarchy means that some substances are not currently classifying correctly.

General content updates

  • Radiopharmaceutical concepts have been remodelled and the terms updated to provide consistent representation of these concepts.
  • Dietary subhierarchy. To remove context of use from the substance concepts 80 substances inactivated. In some instances replacement concepts have been created without  “ – dietary” tag. The concept “Dietary substance (substance)" has been inactivated and replaced with a new concept "Edible substance (substance)“

    The "Is modification" of attribute has been implemented (n≈1400) 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  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

    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 the Stated Relationship files with the new OWL Axiom refset files

    In the January 2019 release, the stated relationship file will be replaced by the OWL Axiom refset files, that will include all logical definitions and other features specified in the SNOMED CT logic profile specification. 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. 


    Jan 2019 International Edition
    10

    Summary of Drugs changes

    MP and MPF containing (Ed Guides and refine exisitng content)

    MP only (Ed Guides and create new content)

    MPF only (Ed Guides and create new content)

    Roles

    Alpha release planned for August 2018

    CD only (Ed Guides and refine exisitng content)

    CD only gap analysis with selected national extensions

    Vaccines concept model Ed Guides incl prototyping

    Vaccines content revision (~ <500 incl MP, MPF and CD)

    Alpha release 30-SEP if needed

    Jan 2019 International Edition
    11

    Summary of Substances changes

    Flattening of Substance hierarchy

    Regular maintenance of substance hierarchy - Add missing structural parents

    Regular maintenance of substance hierarchy - Disposition and Structure groupers

    Review of the remaining existing JIRA tickets for Substance project

    Review of the existing JIRA tickets for Allergies project

    Replace Substance concepts with product concepts, where role concepts have been used to define procedures or findings
    1. Retirement of role concepts

    Gap analysis on selected national extensions Substances to support the product Active ingredients not in SNOMED - RxNORM, AMT

    Jan 2019 International Edition

    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 - COMPLETE
    8