2022 Early Visibility Release Notifications

COVID-19 Content

Content relating to COVID-19 can be viewed here SNOMED CT COVID-19 Related Content

2022 International Release and future releases

Browse Content Changes for the International Release

The daily build is available to review changes made to content for the International release https://dailybuild.ihtsdotools.org/

Forthcoming concept inactivations, new concepts and changes to existing concepts can be reviewed using the tab 'Daily build.'

Changes to Concept Inactivation Values

Please see new editorial guidance for changes to inactivation values here

Implementation of the new anatomy concept model

The completion of the revision of hierarchical relationships provides stable anatomy content and improves the quality of classification results in other hierarchies.

Over forthcoming releases, the plan is to implement the new anatomy concept model. There are almost 35,000 anatomy concepts and they will be modeled by different types of 'part of' relationships. The new model will enable us to automatically generate hierarchies to further improve quality and consistency. 

Information about the work completed in previous release for revision of IS_A relationships can be viewed here: https://confluence.ihtsdotools.org/display/IAP/Revision+of+IS-A+relationships+for+anatomy

2022 International Release and future releases

MRCM

Details for forthcoming changes can be seen here

Cardinality Changes for July 2022 Release

All historical content issues where two or more finding sites were included in a single role group have been resolved in the International release as part of the QI project.

There are two MRCM rules for finding site to accommodate the historical content. One MRCM is applicable to all content, it allows more than one finding site in a role group. The other MRCM is only applicable for 'All new precoordinated SNOMED CT content'.

The existing MRCM rules will be updated to only allow at most one finding site in a role group from the July 2022 release.

This early visibility notice is intended to provide additional time for content updates in national extensions. 

Quality Initiative

Information about the project can found here - Quality Initiative - Progress

Note: There are changes to the Service Level Agreement for the CRS as a result of the Quality Initiative:

https://www.snomed.org/SNOMED/media/SNOMED/documents/Changes-to-SLA_202005_MHA.pdf

Inactivation of "X by body site" concepts in various hierarchies

Concepts that include "X by body site" in multiple hierarchies are being inactivated, e.g., 371571005 |Imaging by body site (procedure)| and 301810000 |Infection by site (disorder)|, because they are classification groupers with no clinical use.

Remodeling of 74799003 |Flap graft (procedure)| hierarchy and 256683004 |Flap (substance)| hierarchy

QI work has commenced on the area of flap procedures, previously placed under 74799003 Flap graft (procedure), which has been inactivated and replaced with 1202017008 |Surgical procedure using flap (procedure)|. The work is still ongoing, and a new model has been developed and remodeling is now in process.

Work has commenced on improvements to the sub-hierarchy of 256683004 |Flap (substance)| (including planned inactivations).  The redesign involves adding new qualifier values as subtypes of 360032005 |Flap reconstruction - action (qualifier value)|. Editorial Guidance will be provided in due course.

Change for Clinical Drug Concepts Containing Pancreatic Enzymes

Clinical drug concepts in the International Release containing pancreatic enzymes will be modeled based on the discrete enzymes; because of variability between real clinical drugs, synonyms representing a total amount in a particular product will not be included in the International Release.

The editorial guide and existing content will be reviewed and updated accordingly in a future release.

Planned Inactivation of Concepts in the 260299005 |Number (qualifier value)| Hierarchy

Following the deployment of the concrete domain functionality in SNOMED CT, concepts in the 260299005 |Number (qualifier value)| hierarchy are no longer necessary and plans have been made for their inactivation.

To provide adequate time for any national extension or implementation affected by this change, concepts in the 260299005 |Number (qualifier value)| hierarchy will be inactivated in the January 2023 International Release.

Concepts will be inactivated with reason “Non-conformance to editorial policy” and no historical relationship or replacement concept will be provided.

Exceptions:

118586006 |Ratio (property) (qualifier value)| and descendants have been relocated to 118598001 |Property (qualifier value)| hierarchy.

272070003 |Ordinal number (qualifier value)| and descendants have been relocated to 362981000 |Qualifier value (qualifier value)| hierarchy.

A briefing note will also be distributed to selected Advisory and Project Groups.

Please contact info@snomed.org with any inquiries.

Nutrition Content

Information about the work of the Nutrition Care Process Clinical Project group is available here.

Cancer Synoptic Reporting

Concepts representing cancer synoptic reporting content will be added to the International release starting with the July 2021 release. 

Cancer synoptic reports are used by many member countries to record pathology examination of cancer specimens including the College of American Pathologists (US and Canada), Royal College of Pathology (UK), Royal College of Pathology Australasia (Australia, New Zealand), PALGA (The Netherlands), Swedish Society of Pathology, and others.

This content primarily encompasses observable entity concepts and also includes supporting concepts from other hierarchies, e.g. property values.

Planned areas of promotion for the July 2022 release include observable entity concepts for genomics, molecular pathology, immunohistochemistry, treatment effect and intactness/quality of specimen.

For more information about this project, please see the Cancer Synoptic Reporting Clinical Project Group here

Disorder X without Disorder Y

The vast majority of existing X without Y concepts originated from ICD-9 with the specific meaning of "X disorder without mention of Y disorder".  As the phraseology indicates a lack of data about disorder Y as opposed to a specific exclusion, this type of concept has not been included in ICD-10, nor proposed for ICD-11, except in the case of "Traumatic brain injury without open intracranial wound".  

Addition of new X without Y concepts may only be made under the following conditions:

1. The request for new content must be accompanied by a rationale as to the difference between "X disorder without Y disorder" and "X disorder."
2. Approval for addition is given by the Head of Terminology.

For the most part, existing X without Y concepts will be inactivated as AMBIGUOUS with a historical MAY BE relationship to "X disorder".  Exceptions to inactivation will be made on a case-by-case basis.

Content Improvements in the Substance and Product Hierarchies

Please see briefing notes here Drugs Project 

Inactivation of Poisoning by medicinal product role groupers (scheduled for release in first quarter of 2022)

Following the Briefing Note submitted to the MF and the CMAG in August 2021, and based on the members’ feedback, the poisoning concepts that are defined by a causative agent that is of type “medicinal product role” or “Medicinal product role + structure” that are not in use will be inactivated.

Addition of New Grouper Concepts in the Pharmaceutical Dose Form and Medicinal Product hierarchies (scheduled for release in second quarter of 2022)

As per the Briefing Note titled Editorial Guideline and Content Changes for Concepts Referring to “Infusion” or “Injection”, new grouper concepts for “infusion and/or injection” will be added to the Pharmaceutical Dose Form and Medicinal Product hierarchies beginning in the 2022-April Release. (The Briefing Note is located on the Drug Project space https://confluence.ihtsdotools.org/display/IAP/Drugs+Project).

WAS_A

Inactivation reason of LIMITED/WAS_A is not allowed for any new content inactivations after the July 2018 release. The WAS_A association refset has not been updated thereafter.

At the Editorial Advisory Group meeting in April 2019, agreement was reached to discontinue the maintenance of WAS_A relationships when inactivating concepts that have a historical association to an inactive concept. When changes are made to a historical relationship for a concept that was previously inactivated using WAS_A, effort will be made to assign a new historical relationship that facilitates traceability of the concept (e.g. DUPLICATE or AMBIGUOUS) as opposed to NON-CONFORMANCE TO EDITORIAL POLICY.

Existing WAS_A relationships will be inactivated in a future release once a plan for batch reassignment of historical relationships has been developed. Until then, SNOMED International will not continue to use or maintain WAS_A relationships.