Purpose

An 900000000000516008 | Annotation type reference set| allows String (data type) to be associated with components for any specified purpose.

Data structure

An annotation reference set String (data type) reference set used to apply text annotation (field) to selected SNOMED CT components .

Field	Data type	Purpose
id (field)	UUID (data type)	A 128 bit unsigned Integer (data type), uniquely identifying this reference set member . Different versions of a reference set member share the same id (field) but have different effectiveTime (field). This allows a reference set member to be modified or made active (field) (i.e. removed from the active set) at a specified time.
effectiveTime (field)	Time (data type)	The inclusive date or time at which this version of the identified reference set member became the current version. The current version of this reference set member at time T is the version with the most recent effectiveTime (field) prior to or equal to time T .
active (field)	Boolean (data type)	The state of the identified reference set member as at the specified effectiveTime (field) . If active (field) = 1 (true) the reference set member is part of the current version of the set, if active (field) = 0 (false) the reference set member is not part of the current version of the set.
moduleId (field)	SCTID (data type)	Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime (field) . The value must be a subtype of 900000000000443000 \| Module (core metadata concept)\| within the metadata hierarchy .
refsetId (field)	SCTID (data type)	Identifies the reference set to which this reference set member belongs. In this case, set to 900000000000516008 \| Annotation type reference set\| .
referencedComponentId (field)	SCTID (data type)	The identifier of the component to be annotated.
annotation (field)	String (data type)	The text annotation (field) to attach to the component identified by referencedComponentId (field) .

Metadata

The following metadata in supports this reference set :

900000000000454005 | Foundation metadata concept|
- 900000000000455006 | Reference set|
  - 900000000000516008 | Annotation type|
    - 900000000000517004 | Associated image|

Descriptor template

The tables below show the descriptors that define the structure of the 900000000000516008 | Annotation type reference set| pattern and examples of the descriptors for specific reference sets that follow this pattern.

refsetId	referencedComponentId	attributeDescription	attributeType	attributeOrder
900000000000456007 \| Reference set descriptor\|	900000000000516008 \| Annotation type\|	900000000000518009 \| Annotated component\|	900000000000461009 \| Concept type component\|	0
900000000000456007 \| Reference set descriptor\|	900000000000516008 \| Annotation type\|	900000000000519001 \| Annotation\|	900000000000465000 \| String\|	1

The attributeType (field) for the Annotation field can be any descendant of the " string " concept in the metadata hierarchy. This hierarchy is described in more detail under the " Reference set descriptor" section.

The table below holds the Descriptor for the "Associated image" annotation (field) reference set, which allows URLs to be associated with concepts :

refsetId	referencedComponentId	attributeDescription	attributeType	attributeOrder
900000000000456007 \| Reference set descriptor\|	900000000000517004 \| Associated image\|	900000000000518009 \| Annotated component\|	900000000000461009 \| Concept type component\|	0
900000000000456007 \| Reference set descriptor\|	900000000000517004 \| Associated image\|	900000000000520007 \| Image\|	900000000000469006 \| URL\|	1

Note that in the table above, the 900000000000469006 | URL| concept is a descendant of | string | concept in the metadata.

Note: The tables above omit the initial four columns of data present in the release file. These follow the standards versioning pattern id (field), effectiveTime (field), active (field), active (field). Additionally, to aid understanding, the tables above also show the term from one of the descriptions associated with each of the identified concept. The release file only contains the identifier .

Annotation reference set example

As no annotation reference sets are included in the International Release, these sample rows are for illustration only.

refsetId	referencedComponentId	Annotation
900000000000517004 \| Associated image\|	80891009 \| Heart structure\|	http://en.wikipedia.org/wiki/Heart#mediaviewer/File:Wiki_Heart_Antomy_Ties_van_Brussel.jpg
900000000000517004 \| Associated image\|	86174004 \| Laparoscope\|	http://www.educationaldimensions.com/eLearn/endoscope/bigScope.html

In the above example, the two URLs have been used to annotate two SNOMED CT concepts with images on the web. It is not recommended that this mechanism be used to annotate concepts with text that may require translation to other languages. Instead, such text should be included under an appropriate description type within the Description file .