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Overview of Current Notices

For additional Relevant links with regards to Content Development Information please click here Content Development Information

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 and following releases.

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

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 (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 "-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 Groupers

  • 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 (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. (n≈20).
  • Chemical element groupers Inactivated and recreated to avoid the use of 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

Role Groupers

  • Concepts that are Role grouper substances have been inactivated and others replaced (n≈100).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.

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 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.

IMPORTANT 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
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4 Comments

  1. Andrew Atkinson - can we re-arrange in Chronological Order?

  2. I see efforts around ICD-11 and ICD-O. Can someone from SNOMED CT comment on whether there are any plans to harmonize SCT with ICHI.  https://en.wikipedia.org/wiki/International_Classification_of_Health_Interventions

    The overlap of SNOMED CT procedures with ICHI is mind provoking.

    link to existing themes https://confluence.ihtsdotools.org/display/CDR/Content+Project+Details

  3. Hello Vojtech

    We are currently discussing with WHO how we will progress with linking SNOMED CT to the family of classification going forward, with the current focus on ICD-11 since it is released. We hope that the work we are doing on exploring how to more efficiently create a link with ICD-11 is work that can then be reused for the other WHO classifications.

    It would be helpful to understand the approach countries are going to be taking to implementing ICHI along with timelines, so that we can factor that in to our planning. Can you give us some information about this if you have it, or knowledge of any work already going on in this space

    Best wishes

    Jane Millar

    Collaboration Lead

     

  4. Thanks Jane Millar and Vojtech Huser for raising this message thread.

    Not being very familiar with ICHI myself, and knowing that we use CCI (Canadian Classification of Health Interventions) here in Canada, I reached out to Sharon Baker, the Manager of Classifications at CIHI based on Jane’s request to understand more.  Here is Sharon’s response: 

    Interesting email thread. ICHI is structured with various degrees of specificity for use at the different levels of the health systems, and uses a common accepted terminology in order to permit comparison of data between countries and services. To understand the differences between ICHI and CCI, Classifications and Terminologies have been undertaking mapping projects, as well as participating in field-trials. ICHI contains around 7,500 codes, whereas CCI has >16,000 codes so there definitely less coverage, and in some cases less specificity. However, ICHI covers all parts of the health system, and contains a wide range of new material not found in CCI e.g. Functioning and public health interventions, so we will asses if there is a need to incorporate this additional content into CCI. However, the long term implications of ICHI will require substantial discussion among interested parties in Canada.

    Of note, I am a member of the ICHI Task Force and we have a meeting in September so I can certainly bring this forward as a discussion point.

    If anyone is interested, more information about CCI can be found here: https://www.cihi.ca/en/submit-data-and-view-standards/codes-and-classifications