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Narrative description

2 concepts appear to have the same meaningbe semantically equivalent. This may arise for the following reasons:

• Identical FSNs with slightly different logical definition
• Identical FSNs but with a different semantic tag
• The FSNs have different word order but the implied meaning is the same
• The FSNs contains word equivalents or an eponym
• Where an organism has multiple equivalent names e.g. common and scientific name
• The concept shares the same descriptions (synonyms) but the FSNs are slightly different
• The FSNs are slightly different but the 2 concepts share the same modelling (implies one being SD and the other primitive leading to equivalency issue if both are SD)is primitive and one sufficiently defined)
• Identical FSNs but with a different semantic tag
  

Details

SAME_AS association reference set (foundation metadata concept)

SAME_ASmeans A is semantically equivalent to B

Known issues

1. Establishing semantic equivalence is key and may be difficult. If there is doubt consider using ambiguous as the inactivation reason.
2. If the ancestors and descendants (if any) of the concept are inconsistent with what is implied by the FSN then consider inactivating as ambiguous.
3. Ensure that the synonyms are appropriate and represented within the active concept.
4. To reduce the impact on users/vendors consider keeping the concept with the oldest effective date as this is likely to have had the most usage.
5. Where both concepts have subtypes ensure that they are all present as subtypes of the active concept.
6. Where the modelling indicates significant semantic difference establish whether these differences impact other concepts and analytics. If there is doubt consider using ambiguous as the inactivation reason.
7. Consider whether the following might be semantically equivalent:

8. xxx disorder and xxx disorder without yyy disorder

9. xxx disorder and xxx finding

on examination xxx and xxx findingQuestion: Where the FSN is the same but the semantic tags are: disorder and finding OR procedure and regime/therapy is it acceptable to call these duplicates?

Examples

Simple Example

145857006 Soft tissue X-ray abnormal (situation)
SAME_AS
168711005 Soft tissue X-ray abnormal (finding)

235998001 Perinephric abscess (disorder)
SAME_AS
80640009 Perirenal abscess (disorder)

136852007 Computer operator (occupation)
SAME_AS
8651002 Electronic computer operator (occupation)

232141000 Cycloplegic paralysis of accommodation (finding)
SAME_AS
68158006 Cycloplegia (disorder)

312186009 L-Phenylalanine (substance)
SAME_AS
63004003 Phenylalanine (substance)

274374000 Endoscopic surgical procedure (procedure)
SAME_AS
363687006 Endoscopic procedure (procedure)

156240002 Primary postpartum haemorrhage (disorder)
SAME_AS
27214003 Atonic postpartum hemorrhage (disorder)

Impact

•  Authors

• Requirement to establish true semantic equivalence
• Ensure that the active concept has an FSN which adheres to editorial guidance
• Ensure any that all of the concepts descriptions are appropriately assigned/reassigned or inactivated

•  Release Management Team

•  Developers

• Review and update Refsets and ECL queries
• Where the developer makes extensive use of ECL, identify the impact of the changed modelling of the active component and loss of the concept implied by the modelling of the inactivated concept

•  End Users/NRC

• Generally minimal, when the inactivated concept points to the duplicate.
• The change may require terminology merging or remapping of local Refsets.
• Recognise that any loss of descriptions which were deemed non-synonymous may impact accessibility
• Reinstate within the local edition descriptions which were inactivated because they were deemed to be region specific

Potential improvement

No changes proposed

Supporting resources

(Provide links to any resources relevant for this scenario)

Metrics for historical inactivations

Usage over time 20020131 to 20200731 - 38,862

Most recent usage:

• 20200731 - 312
• 20200131 - 274
• 20190731 - 330
• 20190131 - 357

Review of historical inactivations

Error rate

Example of typical error

Managing incoming inactivations

Original inactivation A SAME_AS B

New inactivation B SAME_AS C

Therefore A SAME_AS B SAME_AS C and A SAME_AS C

Original inactivation A REPLACED_BY B

New inactivation B SAME_AS C

Action required: Check to a establish whether there is a better replacement (D)

YES: Change A REPLACED_BY B with AREPLACED_BY D and then B SAME_AS C

NO: Change A REPLACED_BY B with AREPLACED_BY C

Original inactivation A REPLACED_BY B

New inactivation B SAME_AS C

Action required: Check to a establish whether there is a better replacement (D)

YES: Change A REPLACED_BY B with A REPLACED_BY D and then B SAME_AS C

NO: Change A REPLACED_BY B with A REPLACED_BY C