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Date

20171031

Document Version

1.0

Release Status

PRODUCTION







© 2018 International Health Terminology Standards Development Organisation.  Todos los derechos reservados.  SNOMED CT® fue creada originalmente por el College of American Pathologists.

Este documento forma parte de esta versión de la Edición Internacional de SNOMED CT® distribuida por la International Health Terminology Standards Development Organisation, operando como SNOMED International, y está sujeto a la Licencia de Afiliados de SNOMED CT®, cuyos detalles se pueden encontrar en http://www.snomed.org/snomed-ct/get-snomed-ct/.

Ninguna parte de este documento puede ser reproducida o transmitida en cualquier forma o por cualquier medio, o almacenarse en cualquier tipo de sistema de recuperación, excepto por un afiliado de la SNOMED International de acuerdo con la Licencia de Afiliados de SNOMED CT®. Cualquier modificación de este documento (incluyendo, sin limitación, la eliminación o modificación de este aviso) está prohibida sin el permiso expreso por escrito de la SNOMED International.

Cualquier copia de este documento que no sea obtenida directamente de la SNOMED International [o un Miembro de la SNOMED International] no está controlada por SNOMED International, y puede haber sido modificada y encontrarse desactualizada. Se anima a que cualquier receptor de este documento, que lo haya recibido por otros medios, a obtener una copia directamente de SNOMED International [o un Miembro de la SNOMED International. Los detalles de los Miembros de SNOMED International se pueden encontrar en http://www.snomed.org/members/].



  


 Page At A Glance


1 Introducción

1.1 Generalidades

La terminología SNOMED CT provee un lenguaje común y un medio consistente para indizar, almacenar, recuperar y agregar datos clínicos de diferentes especialidades y ámbitos de atención de la salud.

SNOMED International mantiene el diseño técnico y la arquitectura de la terminología, y el contenido de su núcleo (que incluye las tablas de conceptos, de descripciones, de relaciones y de historial, así como referencias cruzadas a la CIE) y la documentación técnica relacionada.

1.2 Propósito

Este documento presenta una breve descripción de los cambios realizados en el contenido de la Edición Internacional de SNOMED Clinical Terms® (SCT) de julio de 2017.

También incluye anotaciones técnicas que detallan algunos problemas conocidos del contenido o aspectos técnicos con causas identificadas pero cuya solución aún no se ha implementado.

Este documento está disponible junto con la Edición en Castellano correspondiente a octubre de 2017.

1.3 Alcance

Este documento está escrito para los fines mencionados anteriormente y no incluye detalles sobre las especificaciones técnicas para SNOMED CT ni abarca cada cambio realizado durante la publicación

1.4 A quién se dirige este documento

Este documento está dirigido a los Centros Nacionales, Centros Colaboradores de la OMS-FCI, proveedores de historias clínicas electrónicas, desarrolladores de terminologías y administradores que deseen conocer los cambios incorporados a la Edición en Castellano de SNOMED CT de abril de 2017.

 

2 Actividad de desarrollo de contenido

2.1 Resumen

La mejora continua de la calidad y del contenido existente se basa en las solicitudes recibidas a través del Sistema de Presentación de Solicitudes (SPS). La Edición Internacional de julio de 2017 continuó el trabajo impulsado por las contribuciones del proyecto de Terminología Médica Convergente de Kaiser Permanente (CMT), la Agencia Global Medical Device Nomenclature Agency (GMDNA, Nomenclatura Global de Dispositivos Médicos), la Edición Beta de la CIE-11 de la Organización Mundial de la Salud (OMS) y Orphanet para agregar nuevo contenido a SNOMED CT.

Además, proyectos prioritarios identificados por los miembros dieron lugar a mejoras en la jerarquía de anatomía, mientras que otros cambios igualmente impulsados por proyectos se reflejaron en numerosas modificaciones que incluyeron nuevos agregados y mejoras al contenido existente y que se detallan más adelante.

2.2 Mejora en la calidad del contenido

Resumen de cambios

  • A parir de la Edición de octubre de 2017 las descripciones en castellano de SNOMED CT tienen el espacio de nombres 1000209.
  • En total, en la Edición en Castellano se crearon 10.766 conceptos  y 39.825 descripciones nuevas 


Estadística de SCTNuevos conceptos agregados
Concepto de SNOMED CT (SNOMED RT+CTV3)10766
Estructura corporal (estructura corporal)5994
Hallazgo clínico (hallazgo)2144
Evento (evento)10
Entidad observable (entidad observable)25
Organismo (organismo)123
Producto farmacéutico / biológico (producto)83
Objeto físico (objeto físico)224
Procedimiento (procedimiento)665
Calificador (calificador)735
Elemento de registro (elemento de registro)13
Componente del modelo de SNOMED CT (metadato)76
Situación con contexto explícito (situación)198
Contexto social (contexto social)2
Concepto especial (concepto especial)27
Estadificaciones y escalas (escala de estadificación)19
Sustancia (sustancia)435

2.2.1 Anatomía 


  1. En esta edición se crearon e incorporaron dos nuevos conjuntos de referencias de asociaciones, que ayudarán a identificar conceptos faltantes, garantizarán la calidad del modelo conceptual y permitirá la aplicación sistemática de convenciones de denominación para los conceptos SEP (acrónimo correspondiente a estructura [Structure], como un todo [Entire] y parte [Part]):
    • conjunto de referencias de la asociación entre estructuras anatómicas y estructuras [como un todo]
    • conjunto de referencias de asociación entre estructura anatómica y partes

 

2. El conjunto de referencias de estructuras corporales lateralizables se actualizó en la herramienta de conjuntos de referencia de SNOMED Internacional como se detalla a continuación:

    • Se agregaron 3728 nuevos miembros y se inactivaron 5 para la Edición Internacional de julio de 2017

 

3. Se agregó nuevo contenido según lo requerido para el desarrollo de un nuevo modelo conceptual para anatomía y alineación con otros estándares terminológicos anatómicos:

    • 5.768 conceptos nuevos: 5.427 corresponden a conceptos con la estructura [como un todo], que se agregaron para completar el modelo SEP.
    • Alrededor de 200 nuevas estructuras corporales lateralizadas y
    • 800 nuevos procedimientos y trastornos lateralizados
    • Se agregaron 11 nuevos conceptos de entesis para apoyar la revisión de la subjerarquía de 23680005 |entesopatía (trastorno)|, que estaba modelada incorrectamente con dos estructuras corporales


2.2.2 Hallazgo clínico

  • Se agregaron 13 nuevos conceptos correspondientes a hallazgos clínicos y anomalías morfológicas utilizados para representar hallazgos de laboratorio. 
  • Efermedad de Crohn - Revisión y/o remodelado de 55 conceptos más creación de 2 nuevos.

2.2.3 Terminología Médica Convergente (CMT)

Se agregaron en total 668 conceptos:

  • CMT Cardiología - 12 conceptos
  • CMT Emergencias - 12 conceptos
  • CMT Endocrinología - 6 conceptos
  • CMT Hemato-oncología - 6 conceptos
  • CMT Antecedentes personales y familiares - 82 conceptos
  • CMT Lesiones traumáticas - 14 conceptos
  • CMT Salud MEntal - 31 conceptos
  • CMT Varios - 104 conceptos
  • CMT Musculoesquelético - 272 conceptos
  • CMT Neurología - 2 conceptos
  • CMT Obstetricia y ginecología - 2 conceptos
  • CMT Oftalmología - 52 conceptos
  • CMT Ortopedia y Fracturas de extremidades - 2 conceptos
  • CMT Pediatría - 2 conceptos
  • CMT Radiología - 66 conceptos
  • CMT 2500 conceptos más usados - 3 conceptos

2.2.4 Procedimientos de diagnóstico por imágenes

  • Aproximadamente 342, incluyendo:
    • RM 120
    • TC 102
    • Radiología general 12
    • Flebografía 2
    • Fluoroscopia 31
    • Procedimientos con guía ecográfica 59
    • Ecografía 16
    • Conceptos de RM, TC, radiología, ecografía y radiología intervencionista relacionados con lateralidad

2.2.5 Trastornos

2.2.5.1 Orphanet

2.2.5.2 Plan de armonización con CIE-11

    • Se agregaron 1200 conceptos de CIE-11 de la Linearización de Mortalidad y Morbilidad

2.2.5.3 Revisión de 12962009|Histoplasmosis (trastorno) - Reelaboración de la jerarquía para solucionar problemas de herencia y  verificar el uso coherente de atributos.

2.2.6  LOINC

  • 114 nuevos conceptos agregados para apoyar las referencias cruzadas entre partes de LOINC y conceptos de SNOMED CT para el Proyecto de Colaboración entre LOINC y SNOMED CT. Incluyeron propiedades, técnicas, poblaciones de células, células, etc.

2.2.7 Anomalías morfológicas

  •  Se agregaron 114 nuevos conceptos y posteriormente se crearon referencias cruzadas a la Clasificación Internacional de Enfermedades para Oncología, Tercera Edición (CIE-O Primera Revisión o CIE-O-3.1) 2011.

2.2.8 Entidades observables

  • Se renombraron 5 conceptos con la estructura "detalle de X (entidad observable)" como "característica observable de X" para mayor claridad y se retiró un concepto con la estructura "detalle de X (entidad observable)" por ambiguo. También se retiró un concepto agrupador  por el mismo motivo, así como uno relacionado de la jerarquía Hallazgo clínico. 

2.2.9 Organismos

  • Se realizaron 605 cambios a términos que utilizaban incorrectamente mayúsculas y minúsculas en nombres de serovariedades de Salmonella.
  • Se realizaron 170 cambios para apoyar los reportes de Microbiología. La mayoría corresponden a nuevos conceptos de organismos.

2.2.10 Producto farmacéutico/biológico

Se agregaron  más de 15 nuevas descripciones con "medicamento" cuando se utilizaba "fármaco".

Proyecto Modelo de Fármacos

Para mayores detalles sobre los cambios planeados en esta área, véase la sección Drug Model Working Group Directory (Directorio de Grupo de Trabajo del Modelo de Medicamentos). Recuerde que para acceder a este proyecto es posible que deba registrarse para la cuenta de usuario de Confluence.

Resumen de cambios

Nuevas jerarquías
  • Número (calificador) - descendientes solamente
    • Conceptos existentes actualizados (n ≈ 20)
    • Nuevos conceptos creados (n ≈ 625)

  • Unidad de presentación (unidad de presentación) - concepto raíz y descendientes
    • Nuevos conceptos creados (n ≈ 50)
Nuevos identificadores semánticos
  • Jerarquía |Calificador (calificador)|:
    • unidad de presentación

  • Jerarquía |Producto farmacéutico/biológico (producto)|:
    • producto medicinal
    • forma farmacéutica de producto medicinal
    • medicamento clínico

Nuevos tipos de atributos

  • tiene base de sustancia de la potencia
  • tiene valor de numerador para la potencia de presentación 
  • tiene unidad de numerador para la potencia de presentación 
  • tiene valor de denominador para la potencia de presentación
  • tiene unidad de denominador para la potencia de presentación
Cambios en descripciones de atributos
  • |tiene forma farmacéutica|
    • La descripción completa y el término preferido existentes se inactivaron y reemplazaron por |tiene forma farmacéutica de elaboración|
Agrupadores
  • Las descripciones para ≈ 10 conceptos existentes que representan agrupadores basados en formas farmacéuticas por sitio para el cual el medicamento fue preparado se actualizaron de acuerdo con los nuevos lineamientos de denominación.
  • Los conceptos se definieron completamente utilizando el patrón de modelado del supertipo primitivo proximal.
Producto medicinal (PM)
  • Se actualizaron las descripciones de ≈ 1300 conceptos existentes de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "producto medicinal" 
  • Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
  • Se agregaron atributos |tiene componente activo| faltantes; se corrigieron errores en el contenido existente a medida que fueron identificados
Forma farmacéutica de producto medicinal (FPM)
  • Se actualizaron las descripciones de ≈ 1300 conceptos existentes de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "forma farmacéutica de producto medicinal"
  • Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
  • Se agregaron atributos faltantes |tiene componente activo| y |tiene forma farmacéutica de elaboración|se corrigieron errores en el contenido existente a medida que fueron identificados
Medicamento clínico (MC)
  • Se actualizaron las descripciones de ≈ 3000 conceptos existentes que representan comprimidos y cápsulas para administración oral capsules de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "medicamento clínico"
  • Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
  • Se agregaron atributos faltantes |tiene componente activo| y |tiene forma farmacéutica de elaboración|
  • Se agregaron los nuevos atributos |tiene base de sustancia de la potencia|, |tiene valor de numerador para la potencia de presentación|, |tiene unidad de numerador para la potencia de presentación|, |tiene valor de denominador para la potencia de presentación| y |tiene unidad de denominador para la potencia de presentación|


2.2.11 Objetos físicos

  •  Se agregaron 218 nuevos conceptos de dispositivos. 
     

2.2.12 Procedimientos

  • Revisión de la jerarquía 23968004 |colectomía (procedimiento)| y sus subtipos
  • Solicitudes de conceptos con lateralidad para RM, TC, radiología general, ecografía y radiología intervencionista..
     

2.2.13 Contexto social

No se realizaron cambios significativos en esta edición.

2.2.14 Espécimen

  • Se agregaron 30 nuevos conceptos.

2.2.15 Sustancias

  • Resumen de cambios:
  1. Se agregó una nueva jerarquía con identificador semántico 726711005 |disposición (disposición)|.
  2. Se agregó un nuevo atributo: 726542003 |tiene disposición (atributo)|
  3. Se inactivaron conceptos con disyuntivos, por ejemplo,
    • Antígeno de Neisseria meningitidis A + Y (sustancia)
    • Butirilcarnitina + isobutirilcarnitina (sustancia)
    • Anticuerpo inmunoglobulina A anti-hemaglutinina filamentosa de Bordetella pertussis + toxina de Bordetella pertussis (sustancia) 

4. Se inactivaron ceonceptos que correspondían a marcas registradas, por ejemplo:

    • bebida Horlicks (sustancia)
    • bebida Ovaltine (sustancia)


Planes de Publicación - Jerarquía de Sustancias

Para mayores detalles sobre los cambios planeados en esta área, véase el Proyecto de Sustancias. Recuerde que para acceder a este proyecto es posible que deba registrarse para la cuenta de usuario de Confluence.

2.2.16 Componentes de metadatos fundacionales

Las descripciones inactivadas en la Edición Internacional utilizarán uno de los siguientes valores:

  • |componente no equivalente semánticamente (metadato fundacional)| - nuevo concepto
  • |componente obsoleto (metadato fundacional)|
  • |componente erróneo (metadato fundacional|
  • |no conformidad de componente con la política editorial (metadato fundacional)|

Estos valores no se aplicarán en forma retroactiva.

2.3. Mejora interna en la calidad del contenido

 2.3.1 Indicador de relevancia del uso de mayúsculas y minúsculas

Para cumplir con la especificación de RF2 se realizó un cambio masivo del valor de la relevancia del uso de mayúsculas o minúsculas en más de 760.000 descripciones.

  • Se cambió 900000000000020002 |uso de mayúsculas y minúsculas irrelevante para el primer carácter (metadato del núcleo)| por 900000000000448009 |uso de mayúsculas y minúsculas sin relevancia para la totalidad del término (metadato del núcleo)|

Para mayores detalles, véase el documento  IHTSDO-950 Update of case significance assignment following the RF2 specification

2.3.2 Conjunto de referencias de axiomas OWL

De acuerdo con la recomendación del Grupo Asesor de Modelado, se agregaron cuatro nuevos conceptos para apoyar el desarrollo del conjunto de referencias de axiomas OWL:

  • 733073007 |conjunto de referencias de axiomas OWL|
  • 733929006 |axioma general de concepto|
  • 734147008 |encabezado de ontología OWL|
  • 734146004 |espacio de nombres de ontología OWL|

2.3.3 Conjunto de referencias de odontografías

  • Odontografías - Como anticipo de la publicación del Conjunto de Referencias de Odontografías en agosto de 2017, se agregaron todos los conceptos de apoyo después de la aprobación del grupo de proyectos de Odontología en la reunión de Londres.

2.3.4 Nuevos atributos y valores

Atributo

(referencedComponentId_term)

Restricción de rango

Restricción de dominio

Antes<< 71388002 |Procedimiento (procedimiento)|

Hallazgo clínico

Evento

Componente<< 123037004 |Estructura corporal (estructura corporal)| O << 410607006 |Organismo (organismo)| O << 105590001 |Sustancia (sustancia)| O << 123038009 |Espécimen(espécimen)| O << 260787004 |Objeto físico (objeto físico)| O << 373873005 |Producto farmacéutico/biológico (producto)| O << 419891008 |Elemento de registro (elemento de registro)|

Hallazgo clínico

Evento

Debido a<< 404684003 |Hallazgo clínico (hallazgo)| O << 272379006 |Evento (evento)| O << 71388002 |Procedimiento (procedimiento)|

Hallazgo clínico

Evento

Durante<< 71388002 |Procedimiento (procedimiento)|

Hallazgo clínico

Evento


Durante Y/O después<< 404684003 |Hallazgo clínico (hallazgo)| O << 71388002 |Procedimiento (procedimiento)|

Hallazgo clínico

Evento

Contexto del hallazgo<< 410514004 |Valor del contexto de un hallazgo (calificador)|Hallazgo con contexto explícito (situación)
Comunicador del hallazgo<< 420158005 |Realizador de un método (persona)| O << 419358007 |Sujeto de registro u otro proveedor de información (persona)| O << 444018008 |Persona con característica relacionada con el sujeto de registro (persona)|Hallazgo clínico
Tiene base de sustancia de la potencia (atributo)< 105590001 |Sustancia (substance)|Producto farmacéutico/biológico (producto)
Tiene disposición< 726711005 |Disposición (disposición)| 

Sustancia

Tiene interpretación<< 260245000 |valores de hallazgos (calificador)| O << 263714004 |Colores (calificador)|Hallazgo clínico
Tiene unidad de denominador de potencia de presentación (atributo)< 258666001 |Unidad (calificador)|Producto farmacéutico/biológico (producto)
Tiene valor de denominador de potencia de presentación (atributo)< 260299005 |Número (calificador)|Producto farmacéutico/biológico (producto)
Tiene valor de numerador de potencia de presentación (atributo)< 258666001 |Unidad (calificador)|Producto farmacéutico/biológico (producto)
Tiene valor de numerador para la potencia de presentación (atributo)< 260299005 |Número (calificador)|Producto farmacéutico/biológico (producto)
Proceso patológico263680009 |Autoinmunitario (calificador)| O << 441862004 |PRoceso infeccioso (calificador)| O << 472963003 |Proceso de hipersensibilidad (calificador)| O << 308490002 |Proceso de desarrollo patológico (calificador)| Hallazgo clínico
Relacionado temporalmente con<< 404684003 |Hallazgo clínico (hallazgo)| O << 71388002 |Procedimiento (procedimiento)|

Hallazgo clínico

2.4 Productos derivados de SNOMED CT

2.4.1 Referencias cruzadas a CIE-10

Las referencias cruzadas de SNOMED CT a la Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud Versión 2010 (© Organización Mundial de la Salud 1994) (Referencias cruzadas de SNOMED CT a CIE-10) se incluye en la Edición Internacional de SNOMED CT a modo de referencia. Las referencias cruzadas de SNOMED CT a CIE-10 se crearon para apoyar las necesidades de datos epidemiológicos, estadísticos y de notificación administrativa de los países miembros de la IHTSDO y los Centros Colaboradores de la OMS.

Las Referencias cruzadas de SNOMED CT a CIE-10 se publican en el formato de publicación 2 (RF2) solamente. ISe encuentran en el fichero der2_iisssccRefset_ExtendedMapFull_INT_20170131.txt, en la carpeta Map incluida en la carpeta Refset, en cada una de las tres carpetas Release Type de RF2.

Las Referencias cruzadas de SNOMED CT a CIE-10 se publican como 447562003 |conjunto de referencias cruzadas complejas a la Clasificación Internacional de Enfermedades, décima revisión (metadato fundacional)|.

2.4.1.1 Resumen de la actividad de desarrollo de contenido

Las referencias cruzadas son un conjunto de relaciones originadas en conceptos de SNOMED CT hacia códigos de la clasificación CIE-10. Los dominios de SNOMED CT incluidos como origen se limitan a los subtipos de 404684003 |hallazgo clínico (hallazgo)|, 272379006 |evento (evento)| y 243796009 |situación con contexto explícito (situación)|. Los códigos de destino de la clasificación corresponden a la edición de 2010 de CIE-10.

2.4.1.2 Contenido referenciado para la Edición Internacional de julio de 2017

Se actualizaron las referencias provistas para la Edición Internacional de enero de 2017, que ahora representan una versión completa de las referencias cruzadas de la Edición Internacional de SNOMED CT a CIE-10 versión 2010.

  • Se agregaron 315 nuevos conceptos

Agradeceremos los comentarios sobre cualquier problema detectado por los usuarios durante la utilización de las referencias cruzadas, informado a través de mapping@ihtsdo.org

3 Notas técnicas

3.1 Problemas conocidos

Los problemas conocidos son aquellos de índole técnica o relacionados con el contenido cuyas causas se comprenden y su solución se ha discutido y acordado, pero aún no se ha implementado. Esto último puede deberse a diversas razones, desde falta de suficientes recursos para resolverlos en el ciclo de edición actual, hasta el riesgo de impacto en la estabilidad de SNOMED CT si la solución se implementara en esa etapa del ciclo de vida del producto.  

Para la Edición Internacional de julio de 2017 se identificaron los siguientes problemas conocidos y se acordó resolverlos en el próximo ciclo de edición (a publicarse en julio de 2017):

3.2 Problemas resueltos

Los problemas resueltos son problemas conocidos que no se habían solucionado en la etapa previa del ciclo de vida del producto, pero se resolvieron en la última publicación – en este caso, la Edición Internacional de julio de 2017. También se incluyen en esta sección problemas detectados durante las pruebas alfa y beta de la publicación actual, que se resolvieron antes de la publicación para los miembros asociados. Por último, podrían incluirse problemas informados o hallados durante la fase de prueba, pero que se cerraron sin haber realizado ninguna acción.  

Los problemas resueltos para la Edición Internacional de julio de 2017 pueden encontrarse aquí:

ClaveResumenDescripciónResuelta
ISRS-46MOVED_TO status acceptability (RF1)

Ten RF1 descriptions for active concepts are status 10 (MOVED_TO), alongside descriptions with active status:
473038012: Hyperprolinemia type II
473040019: Hyperprolinemia, type II
357693015: Lichen planus pigmentosus
377070012: Joubert syndrome
378213010: Irapa type spondyloepimetaphyseal dysplasia
1787720010: Frontal fibrosing alopecia
473039016: Hyperprolinaemia type II
473043017: Hyperprolinaemia, type II
113698011: Warkany syndrome
187742012: Caroli's disease

RESOLUTION: SNOMED International Content team have inactivated all of the descriptions in question with reason "moved elsewhere"

2016-nov-21
ISRS-50Open RVF failures from the Production build

The following failures occurred after we added new RVF assertions in to cover issues found during the Alpha/Beta feedback period.

0cc708af-6816-4370-91be-dba8da99d227 "Description: id=60213011 is in the delta file, but no actual changes made since the previous release."

4478a896-2724-4417-8bce-8986ecc53c4e "Concept: id=10082001 is in the delta file, but no actual changes made since the previous release."

35680574-3ac6-4b68-9efe-de88b677eb35 "Association refset id=0e23f0c4-3dfa-5278-b35f-03e2cda41a7e is in the delta file, but no actual changes made since the previous release."

cab60a2f-4239-4933-91d6-dc910a8ac08b "Stated relationship: id=3862464027 is in the delta file, but no actual changes made since the previous release."

These failures can be safely ignored for this release, as they are simply highlighting the results of the manual fixes that we had to implement as part of the Alpha/Beta feedback period, in order to resolve some teething issues with the SCA.

They therefore simply need to be verified after the final release has been deployed, in order to ensure that, as expected, they have not re-occurred.

RESOLUTION: Remaining failures were resolved as planned.

2017-may-15
ISRS-102Two concepts in scope from the ICD-11 perspective that aren’t mapped

There are 2 concepts that after new type of validation have been shown to not have any equivalent ICD-10 maps:

ID Preferred Name

722302009 Glycogen storage disease type II infantile onset (disorder)

722343009 Glycogen storage disease type II late onset (disorder)

This was not reported until very late in the January 2017 release cycle. It was therefore discussed with the relevant Stakeholders, and the potential risk of impact involved in implementing a change to the content at this late stage in the release cycle was decided to be far greater than the perceived benefit of adding in just two map records. This will therefore be resolved in the July 2017 editing cycle, in order to preserve the quality of the January 2017 International edition.

RESOLUTION: SNOMED International Mapping Team have now mapped both concepts in the July 2017 editing cycle, and so these will be included in the July 2017 International Edition release.


ISRS-149Removal of the SNOMED Identifier refset from the International Edition package as per the planned deprecation

As per the planned deprecation of antecedent SNOMED works (https://confluence.ihtsdotools.org/download/attachments/12779613/Antecedent%20SNOMED%20versions_External%20Newsletter%20Q1_v1.0.docx?version=1&modificationDate=1438866649000&api=v2), the SNOMED CT Identifier refset will be removed from the International Edition package as of the July 2017 International Edition.

RESOLUTION:  SNOMED CT Identifier refset removed from the July 2017 International Edition as planned.


ISRS-150Refinement of ISRS-117 - Active "WAS A" historical associations that have not been updated when the target concepts are inactivated

The resolution for -ISRS-117- was completed for the January 2017 International Edition.

This now needs to be further refined in order to ensure that the historical audit trail remains intact.

RESOLUTION:  The 64 cases found in the current release with these issues have now been resolved in the July 2017 International Edition.


ISRS-153Text definition set as the en-GB preferred term of a concept

The following issue was reported during the July 2017 International edition editing cycle:

For concept 722183007 | Embolization of hepatic artery using selective internal radiation therapy (procedure) |, two descriptions were created, one for en-GB and one for en-US, due to the difference in spelling.

3331000018 is the en-GB textDefinition, and has been assigned a descriptionType of "preferred synonym", instead of "preferred definition".

RESOLUTION: The SNOMED International content team have updated the descriptionType in question, as part of the current cycle of content changes. It will therefore be published as part of the July 2017 International Edition. The Release Validation Framework will also be updated to include a validation check to capture any similar issues going forward.


ISRS-166Inactive Historical Associations discovered with invalid targetComponentID's

The following Historical Associations have had invalid inactive records added in the previous release cycle:

https://docs.google.com/spreadsheets/d/1X_T8t2d5SFqBICorUORYhJbl9L8pWHMeKRJBjq0bMds/edit#gid=1682849169

RESOLUTION:  Historical Association records fixed in time for the July 2017 International Edition.

2017-may-12
ISRS-167Delete born inactive stated relationships found in the dailybuild validation report

Born inactive stated relationships need to be deleted before alpha release.

https://docs.google.com/a/ihtsdo.org/spreadsheets/d/1_tcm-qiyJ29zXbIzXjkyp8teSBIRnfySrcghwVrwH54/edit?usp=sharing

https://rvf.ihtsdotools.org/api/v1/result/1494474563274?storageLocation=international/snomed_ct_ts_release/2017-05-11T03:15:01

RESOLUTION:  Born inactive Stated Relationship records were removed accordingly.


ISRS-170Potential MRCM Validation failure - domain=Domain{domainConstraint='<< 404684003 |Clinical finding (finding)|'

The following 2 records appears to contravene the Domain constraint, as follows:

42752001=Due to (attribute) applied to 268460000=Contraceptive device (physical object)

Relationship_snapshot records: 
id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
7008666020 20170731 1 900000000000207008 733528009 268460000 0 42752001 900000000000011006 900000000000451002
7008672020 20170731 1 900000000000207008 733529001 268460000 0 42752001 900000000000011006 900000000000451002

RESOLUTION:  The relevant Relationships have been removed accordingly.


ISRS-171RVF Assertion failure: c3249e80-84f0-11e1-b0c4-0800200c9a66

"assertionUuid": "c3249e80-84f0-11e1-b0c4-0800200c9a66",
"assertionText": "Calling procedure testing that terms that contain EN-US language-specific words are in the same US language refset.",
"queryInMilliSeconds": 8862,
"failureCount": 481,
"firstNInstances": [

{ "conceptId": "372401005", "detail": "DESCRIPTION: id=1210952018: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: acanthamoeba" }

,

{ "conceptId": "444612005", "detail": "DESCRIPTION: id=2872859011: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: acanthamoeba" }

,

{ "conceptId": "247894000", "detail": "DESCRIPTION: id=370105019: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: aggrandisement" }

,

{ "conceptId": "391747009", "detail": "DESCRIPTION: id=1485745018: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: aluminium" }

,

{ "conceptId": "391749007", "detail": "DESCRIPTION: id=1485746017: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: aluminium" }

,

{ "conceptId": "392682000", "detail": "DESCRIPTION: id=1486658017: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaemia" }

,

{ "conceptId": "393572004", "detail": "DESCRIPTION: id=1487426012: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaemia" }

,

{ "conceptId": "393640005", "detail": "DESCRIPTION: id=1487494015: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaemia" }

,

{ "conceptId": "469433000", "detail": "DESCRIPTION: id=2942363019: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaesthesia" }

,

{ "conceptId": "701275000", "detail": "DESCRIPTION: id=2992662016: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaesthesia" }

,

{ "conceptId": "393358009", "detail": "DESCRIPTION: id=1487234016: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaesthetics" }

,

{ "conceptId": "394308008", "detail": "DESCRIPTION: id=1488063014: Synonym is prefered in US Language refset but refers to a word that has en-gb spelling: anaesthetics" }

,

RESOLUTION: This is just a warning and not an error and so no action is required.

2017-may-20
ISRS-172RVF Assertion failure: cc9c5340-84f0-11e1-b0c4-0800200c9a66

"assertionUuid": "cc9c5340-84f0-11e1-b0c4-0800200c9a66",
"assertionText": "Calling procedure testing that terms that contain EN-GB language-specific words are in the same GB language refset.",
"queryInMilliSeconds": 46787,
"failureCount": 2036,
"firstNInstances": [

{ "conceptId": "426217000", "detail": "DESCRIPTION: id=2675118011: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: aleukemic" }

,

{ "conceptId": "426248008", "detail": "DESCRIPTION: id=2675183013: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: aleukemic" }

,

{ "conceptId": "22695001", "detail": "DESCRIPTION: id=2763854012: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: aleukemic" }

,

{ "conceptId": "35750002", "detail": "DESCRIPTION: id=2765156010: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: aleukemic" }

,

{ "conceptId": "70321000119108", "detail": "DESCRIPTION: id=2989886018: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: aluminum" }

,

{ "conceptId": "2468001", "detail": "DESCRIPTION: id=5221017: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: analyzer" }

,

{ "conceptId": "8615009", "detail": "DESCRIPTION: id=15217012: Synonym is preferred in the GB Language refset but refers to a word that has en-us spelling: analyzer" }

,

RESOLUTION: This is just a warning and not an error and so no action is required.

2017-may-20
ISRS-173RVF Assertion failure: d9f8a8d6-2c02-11e7-b0e7-3c15c2c6e32e

"assertionUuid": "d9f8a8d6-2c02-11e7-b0e7-3c15c2c6e32e",
"assertionText": "The FSN term should be unique in active content when case sensitivity is ignored.",
"queryInMilliSeconds": 2049276,
"failureCount": 15,
"firstNInstances": [

{ "conceptId": "15469000", "detail": "FSN=Blood group antibody p (substance) concept=15469000: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "37300006", "detail": "FSN=Blood group antibody h (substance) concept=37300006: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "3807007", "detail": "FSN=Blood group antigen c (substance) concept=3807007: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "38194003", "detail": "FSN=Weak e phenotype (finding) concept=38194003: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "45969000", "detail": "FSN=Blood group antibody i (substance) concept=45969000: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "45992000", "detail": "FSN=Blood group antigen s (substance) concept=45992000: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "47662005", "detail": "FSN=Blood group antigen h (substance) concept=47662005: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "61271006", "detail": "FSN=Blood group antibody s (substance) concept=61271006: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "62523009", "detail": "FSN=Blood group antibody e (substance) concept=62523009: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "64259001", "detail": "FSN=Blood group antigen e (substance) concept=64259001: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "64846003", "detail": "FSN=Blood group antigen i (substance) concept=64846003: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "81835007", "detail": "FSN=Weak c phenotype (finding) concept=81835007: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "8362009", "detail": "FSN=Blood group antibody c (substance) concept=8362009: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "88341002", "detail": "FSN=Blood group antibody k (substance) concept=88341002: FSN term is not unique in description snapshot when case is ignored" }

,

{ "conceptId": "406002002", "detail": "FSN=cde haplotype (finding) concept=406002002: FSN term is not unique in description snapshot when case is ignored" }

RESOLUTION: These have been confirmed by the SNOMED International Content Team to be false positives, which can therefore be safely ignored.

2017-may-23
ISRS-174The first letter of the FSN should be capitalized.RVF Assertion failure: dd0d0406-7481-444a-9f04-b6fc7db49039

"assertionUuid": "dd0d0406-7481-444a-9f04-b6fc7db49039",
"assertionText": "The first letter of the FSN should be capitalized.",
"queryInMilliSeconds": 2060,
"failureCount": 58,
"firstNInstances": [

{ "conceptId": "198030008", "detail": "DESC: id=582480013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "228961005", "detail": "DESC: id=616608018:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "228969007", "detail": "DESC: id=616618011:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "228979009", "detail": "DESC: id=616629010:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "258259005", "detail": "DESC: id=649653011:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "258889007", "detail": "DESC: id=650356013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259011007", "detail": "DESC: id=650492013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259047008", "detail": "DESC: id=650532013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259048003", "detail": "DESC: id=650533015:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259049006", "detail": "DESC: id=650534014:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259060002", "detail": "DESC: id=650546013:First letter of the active FSN of active concept not capitalized." }

 

RESOLUTION:  Invalid descriptions inactivated, and valid descriptions added in for July 2017 with capitalised first words.


ISRS-175RVF Assertion failure: f7117eb0-7cd6-11e1-b0c4-0800200c9a66

"assertionUuid": "f7117eb0-7cd6-11e1-b0c4-0800200c9a66",
"assertionText": "Active historical association refset members have inactive concepts as reference components.",
"queryInMilliSeconds": 1663,
"failureCount": 14379,
"firstNInstances": [

{ "conceptId": "280164007", "detail": "MEMBER: id=80024464-d5ea-4a12-b933-606a6056c06f:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "88731002", "detail": "MEMBER: id=800637ed-978e-4dfa-be08-4e01bf5ad2c1:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "278772006", "detail": "MEMBER: id=800b7f78-fd36-4a42-b900-73aa4ab11a75:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "58287003", "detail": "MEMBER: id=80214885-ea37-4768-ae39-b985e0f8384b:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "299701004", "detail": "MEMBER: id=8024c43a-54bb-4ea3-8555-5af9c8adda76:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "84540008", "detail": "MEMBER: id=802c0ca6-beba-4a2b-a3be-93b1a6478451:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "279793002", "detail": "MEMBER: id=802e89f1-312f-4027-be34-581724e7b03d:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "81661008", "detail": "MEMBER: id=80313789-951a-4633-b550-42e78f380362:Historical refset member is active, but refers to an active concept." }

,

{ "conceptId": "20963009", "detail": "MEMBER: id=803634b8-86f5-4ed1-804b-04a3824d7d9b:Historical refset member is active, but refers to an active concept." }

,

RESOLUTION: The RVF assertion needs to be updated in order to allow for the new SEP refsets in the Association Reference set. These failures can therefore safely be ignored for now.

2017-may-22
ISRS-178Unexpected ICD-0 inactivation records in the termServer simpleMap export

In the SimpleMap Delta we exported from the mapping file, it contained 95 new activations for ICD-0.

However, in the final SimpleMap files in the release package, we're getting 105 records referencing ICD-0, including the following 10 inactivations that we've traced back to the simpleMap file exported from the termServer:

> 20170731 0 900000000000207008 446608001 128507001 C49.2
> 20170731 0 900000000000207008 446608001 128507001 C49.9
> 20170731 0 900000000000207008 446608001 244256001 C49.3
> 20170731 0 900000000000207008 446608001 245484003 C54.9
> 20170731 0 900000000000207008 446608001 303982006 C44.6
> 20170731 0 900000000000207008 446608001 361904009 C49.2
> 20170731 0 900000000000207008 446608001 367612008 C54.9
> 20170731 0 900000000000207008 446608001 56322004 C49.3
> 20170731 0 900000000000207008 446608001 76083001 C71.7
> 20170731 0 900000000000207008 446608001 84732004 C49.2

The mapping team are unaware of why these should have ben updated, and so we need to prove whether or not they are valid changes.

RESOLUTION: SNOMED International Content Team confirmed that these were expected changes, and Mapping Team confirmed everything as expected, therefore no action required.

2017-jun-01
ISRS-179RVF Assertion failure: 89ceaf00-79b9-11e1-b0c4-0800200c9a66

"assertionUuid": "89ceaf00-79b9-11e1-b0c4-0800200c9a66",
"assertionText": "All stated relationships inactivated in current release must have been active in the previous release.",
"queryInMilliSeconds": 24173,
"failureCount": 2,
"firstNInstances": [

{ "conceptId": "733529001", "detail": "Stated relationship: id=7002472022 is inactive in the current release but no active state found in the previous snapshot." }

,

{ "conceptId": "733528009", "detail": "Stated relationship: id=7002479029 is inactive in the current release but no active state found in the previous snapshot." }

],

 

RESOLUTION:  Relevant born inactive Stated Relationships removed accordingly.


ISRS-180RVF Assertion failure: eff30fb0-7856-11e1-b0c4-0800200c9a66

"assertionUuid": "eff30fb0-7856-11e1-b0c4-0800200c9a66",
"assertionText": "All language refset members inactivated in current snapshot must have been active in the previous release.",
"queryInMilliSeconds": 64307,
"failureCount": 8,
"firstNInstances": [

{ "conceptId": "3499616017", "detail": "Language Refset: id=85d31301-45a6-4344-a28e-1c357975dd62 is inactive but no active state found in previous release." }

,

{ "conceptId": "3499616017", "detail": "Language Refset: id=c1e2364a-9413-4e70-aaa1-9abe62165a2b is inactive but no active state found in previous release." }

,

{ "conceptId": "3499619012", "detail": "Language Refset: id=e97fc6fd-68de-451b-b7c2-fdab05db4d00 is inactive but no active state found in previous release." }

,

{ "conceptId": "3499617014", "detail": "Language Refset: id=f3814870-ee80-459d-bdb6-310688626fa5 is inactive but no active state found in previous release." }

,

{ "conceptId": "3499617014", "detail": "Language Refset: id=fd8a80da-a79a-4f9f-bf93-378657935e85 is inactive but no active state found in previous release." }

,

{ "conceptId": "3499618016", "detail": "Language Refset: id=1575a4c0-b70f-4267-81cf-47f44dfad066 is inactive but no active state found in previous release." }

,

{ "conceptId": "3499618016", "detail": "Language Refset: id=2168b9f2-6ab3-4911-b14d-01d20c08e3d7 is inactive but no active state found in previous release." }

,

{ "conceptId": "3499619012", "detail": "Language Refset: id=65ae52bb-ed7f-4df1-8d5a-55388ffb223b is inactive but no active state found in previous release." }

],

RESOLUTION: This is just a warning and not an error and so no action is required.

2017-may-24
ISRS-181RVF Assertion failure: 2b193a88-8dab-4d19-b995-b556ed59398d

"assertionUuid": "2b193a88-8dab-4d19-b995-b556ed59398d",
"assertionText": "New inactive states follow active states in the DESCRIPTION snapshot.",
"queryInMilliSeconds": 15019,
"failureCount": 4,
"firstNInstances": [

{ "conceptId": "733528009", "detail": "DESCRIPTION: id=3499616017 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "733528009", "detail": "DESCRIPTION: id=3499617014 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "733529001", "detail": "DESCRIPTION: id=3499618016 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "733529001", "detail": "DESCRIPTION: id=3499619012 is inactive but no active state found in the previous snapshot." }

],

RESOLUTION: These warnings are due to a system defect - WRP-3146 ticket has been raised to resolve. These can therefore be safely ignored for this release.

2017-may-24
ISRS-182MRCM validation failure on concepts having invalid attribute 424876005(Surgical approach)

The following concepts are reported by the MRCM validation to have inappropriate attributes:

  • 429062005
  • 448396008
  • 710285001
  • 428563002
  • 428565009
  • 448603000

Inferred view:
id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
7001611029 20170731 1 900000000000207008 428563002 261449002 2 424876005 900000000000011006 900000000000451002
7001616023 20170731 1 900000000000207008 428565009 261449002 2 424876005 900000000000011006 900000000000451002
7001621021 20170731 1 900000000000207008 429062005 261449002 2 424876005 900000000000011006 900000000000451002
7001627020 20170731 1 900000000000207008 448396008 103387006 2 424876005 900000000000011006 900000000000451002
7001630029 20170731 1 900000000000207008 448603000 103387006 2 424876005 900000000000011006 900000000000451002
7001638020 20170731 1 900000000000207008 710285001 103387006 1 424876005 900000000000011006 900000000000451002

Stated view:
id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
6994054029 20170731 1 900000000000207008 429062005 261449002 1 424876005 900000000000010007 900000000000451002
6994436023 20170731 1 900000000000207008 448396008 103387006 1 424876005 900000000000010007 900000000000451002

Note: MRCM rule states that 424876005(Surgical approach) applies to Domain 387713003 (Surgical procedure)

RESOLUTION:  Concepts re-modelled accordingly in time for the July 2017 International Edition.


ISRS-183RF2 to RF1 conversion issue

The RF2 to RF1 conversion is failing and it appears to be data related - attached log file gives details but it looks like there is an issue calculating the value of a description status in RF1. Whatever is in RF2 is not giving enough information to calculate the RF1 value and it is coming back as null, which fails the query.

There are two possible causes from the information in the log file:

1. An un-attached description, i.e. where we had a reference to a concept ID in the descriptions file that was no in the concepts file. Checked this and all is good...

2. Alternative was a value (or values) in the Attribute Value reference set that was not being handled by the conversion code when associated with an inactive description ID. Bingo, we have our culprits, there are two concept IDs used in the valueId field of the Attribute Value reference set that have not been used before. Next checked the actual source code on Github for the RF2 to RF1 conversion routine and found the hard coded list of maps between the valueId and RF1 description status does not have these two values in it. This is the list referenced by the getMagicNumber method. The values at issue are 723277005 ‘Nonconformance to editorial policy component (foundation metadata concept)’ and 723278000 ‘Not semantically equivalent component (foundation metadata concept)’ occurring in reference set 900000000000490003.

RESOLUTION: RF2 to RF1 conversion utility has been updated accordingly.

2017-jun-01
ISRS-184SCTID's using Description ID format instead of Concept ID's

Seven Concept ID's were found to be unexpectedly using partition ID's appropriate for Description ID's:

· 3446012016
· 3446013014
· 3446014015
· 3446015019
· 3446016018
· 3446017010
· 3446018017

This was found to be a result of these concepts having been loaded in manually through the CRS, which by-passed the standard validation and therefore allowed them to be created in the wrong format in the termServer.

 

RESOLUTION:  Offending concepts were removed accordingly.


ISRS-185Relationship with invalid typeID

Relationship 6923064024 (sourceId= 724482006) should have a typeId of 363714003|Interprets|

This is a result of the Concept having two attributes, one of which should be "363714003|Interprets|"

Amended in https://authoring.ihtsdotools.org/#/tasks/task/RFBINTJULA/RFBINTJULA-11/

RESOLUTION:  Concept re-modelled accordingly for the July 2017 International Edition.


ISRS-186Descriptions that could potentially be textDefinitions

The following descriptions look like text definitions:
92105015 55402005 Hospital admission, for laboratory work-up, radiography, etc. - Suggest CRS request: old concept since 2002 could be inactivated as it is ambiguous but not touched in this release. 
2988848017 32456001 Medulloblastoma with extensive nodularity and advanced neuronal differentiation. - looks like definition incorrectly marked as syn.
3042799019 710025005 Hamular notch is well defined to establish the posterior extension of the denture base.
3311128017 718089001 Post extubation acute respiratory failure requiring reintubation.
638911000124112 435801000124108 Alter the consistency of foods to optimize chewing and swallowing. (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648331000124115 439021000124105 Liquids included in the diet are provided at a viscosity of 51--350 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648361000124112 439031000124108 Liquids included in the diet are provided at a viscosity of 351-1750 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648391000124116 439041000124103 Liquids included in the diet are provided at a viscosity of > 1750 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648501000124118 439081000124109 Liquids included in the diet are provided at a viscosity of 1-50 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648571000124112 439101000124101 Replace very hard, sticky or crunchy foods with those that are soft and moist. Treatment for dental problems and mouth soreness. (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).

RESOLUTION:  Synonyms changed to TextDefinitions, or inactivated as ambiguous as appropriate.


ISRS-187Born inactive descriptions

Several inactive descriptions have never been published, and so don’t need to be in the release files:

3499616017 2017-07-31 00:00:00.0 0 900000000000207008 733528009 en 900000000000013009 Morphological change in endometrium due to intrauterine contraceptive device 900000000000448009
3499617014 2017-07-31 00:00:00.0 0 900000000000207008 733528009 en 900000000000003001 Morphological change in endometrium due to intrauterine contraceptive device (finding) 900000000000448009
3499618016 2017-07-31 00:00:00.0 0 900000000000207008 733529001 en 900000000000013009 Reactive cellular changes due to intrauterine contraceptive device 900000000000448009
3499619012 2017-07-31 00:00:00.0 0 900000000000207008 733529001 en 900000000000003001 Reactive cellular changes due to intrauterine contraceptive device (finding) 900000000000448009

RESOLVED: Ticket closed as already resolved in ISRS-180 and ISRS-181

2017-jun-05
ISRS-188Born inactive language reference set records

Several inactive language reference set records have been published as inactive, but never been published before:

85d31301-45a6-4344-a28e-1c357975dd62 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499616017 900000000000548007
c1e2364a-9413-4e70-aaa1-9abe62165a2b 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 3499616017 900000000000548007
e97fc6fd-68de-451b-b7c2-fdab05db4d00 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499619012 900000000000548007
f3814870-ee80-459d-bdb6-310688626fa5 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499617014 900000000000548007
fd8a80da-a79a-4f9f-bf93-378657935e85 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 3499617014 900000000000548007
1575a4c0-b70f-4267-81cf-47f44dfad066 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 900000000000548007
2168b9f2-6ab3-4911-b14d-01d20c08e3d7 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499618016 900000000000548007
65ae52bb-ed7f-4df1-8d5a-55388ffb223b 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 3499619012 900000000000548007

RESOLUTION:  Born inactive members already removed in TPFIX-16

2017-jun-05
ISRS-189RefsetDescriptor queries

There’s a whole bunch of stuff in the Descriptor refset that I’m not sure about, from a content perspective… (not necessarily defects).

· looks like descriptor entries have been created for all the “refset patterns”? 
447250001|Complex map type reference set (foundation metadata concept)|, 
446609009|Simple type reference set (foundation metadata concept)|,
447258008|Ordered type reference set (foundation metadata concept)|
and more. I don’t think actual reference sets even exist for some? Though perhaps this is a technical decisision. Just not something I was expecting.
· I can guess at the intent here, just not something I was expecting.

RESOLUTION: Reporter happy with the level of information provided in the Release Notes to explain all of this, therefore ticket closed accordingly.

2017-jun-02
ISRS-190Attributes using the attribute 371881003|During|

Several attributes using the attribute 371881003|During| - I’ve found some working documents and ECE stuff, but nothing official? Though I saw it mentioned in the MRCM refsets, so I assume it’s now permissible and updated editorial rules will come out in July? (Once confirmed I’ll update our checks)

6967032028 2017-07-31 00:00:00.0 1 900000000000207008 10561000087108 387713003 0 371881003 900000000000011006 900000000000451002
6967036025 2017-07-31 00:00:00.0 1 900000000000207008 10581000087102 387713003 0 371881003 900000000000011006 900000000000451002
6967040023 2017-07-31 00:00:00.0 1 900000000000207008 10661000087107 387713003 0 371881003 900000000000011006 900000000000451002
6967045029 2017-07-31 00:00:00.0 1 900000000000207008 10701000087104 387713003 0 371881003 900000000000011006 900000000000451002
6967048027 2017-07-31 00:00:00.0 1 900000000000207008 10901000087102 387713003 0 371881003 900000000000011006 900000000000451002
6967050024 2017-07-31 00:00:00.0 1 900000000000207008 11051000087106 387713003 0 371881003 900000000000011006 900000000000451002
6993353020 2017-07-31 00:00:00.0 1 900000000000207008 242991000 71388002 0 371881003 900000000000011006 900000000000451002
6993354025 2017-07-31 00:00:00.0 1 900000000000207008 242992007 71388002 0 371881003 900000000000011006 900000000000451002
6993356028 2017-07-31 00:00:00.0 1 900000000000207008 242993002 71388002 0 371881003 900000000000011006 900000000000451002
6993368021 2017-07-31 00:00:00.0 1 900000000000207008 269769006 71388002 0 371881003 900000000000011006 900000000000451002
6993551023 2017-07-31 00:00:00.0 1 900000000000207008 714381001 71388002 0 371881003 900000000000011006 900000000000451002
6993552027 2017-07-31 00:00:00.0 1 900000000000207008 714386006 71388002 0 371881003 900000000000011006 900000000000451002
6994092028 2017-07-31 00:00:00.0 1 900000000000207008 733041001 71388002 0 371881003 900000000000011006 900000000000451002]

RESOLUTION: Explanation of new attribute added to the Release Notes (section 2.3.5) to ensure those not reading the Editorial Guide updates are made aware of the changes.


ISRS-191Query on the use of new attributes

There are 17,000 relationships for product concepts that use attributes, not in the documented model. Again, these seem to be in the MRCM – so might be fine.
However, as far as I was aware, none of these had actually been approved? Though that could be a misunderstanding on my side… However, the draft circulated has been changed since the April meeting, so still seems like a work in progress?

RESOLVED: Requester agreed that the level of information in the Release Notes covered the required updates to NRC systems, and so this ticket was closed without any action required.

2017-jun-05
ISRS-193Concepts using invalid surgical procedure attributes

There’s 6 concepts that use the surgical approach attribute, are not permitted to. They are not “surgical procedures”.
From the EG - 6.2.2.13 SURGICAL APPROACH - "The domain for | SURGICAL APPROACH | is descendants of | Surgical procedure (procedure) | 387713003".
The MRCM refset supports this too.

These are all embolization procedures, for which we encountered the exact same problem. Part of the problem is that “What is a surgical procedure”.
The EG (6.2.5.1) gives a definition “A surgical procedure is defined as a procedure that involves intentional non-transient alteration of structures of the body, and/or a procedure that necessarily involves cutting into the body.” – Not entirely sure what that means.
The next sentence says "From a practical standpoint, this definition is implemented to include all procedures defined by the METHOD attribute with a value of any action that is listed under surgical action."
Our solution was to add 129335008|Embolization - action (qualifier value)| as a sub type 129284003|Surgical action (qualifier value)|.
We considered a new action "surgical embolisation", but that seems odd "chemoembolisation". And just about every reference described these procedures as (minimally invasive) surgical.
It worked and we didn't violate the concept model. (though did change the stated relationship for a core concept...)

428563002 Stent assisted embolization of aneurysm using transluminal coil (procedure) - no new changes this release, existing issue, needs review and remodelling - CRS
428565009 Balloon assisted embolization of aneurysm using transluminal coil (procedure) - no new changes this release, existing issue, needs review and remodelling - CRS
429062005 Embolization of aneurysm using transluminal coil (procedure) - this is new this release and I believe could be remodelled under surgical procedure so the attribute would be allowed. - MRCM rule?
448396008 Transarterial embolization (procedure)
448603000 Transarterial embolization of abdominal artery (procedure)
710285001 Transarterial chemoembolization using fluoroscopic guidance (procedure)

 

RESOLUTION:  Already resolved as part of the fix for ISRS-182 - this ticket therefore closed with no action required.

2017-jun-02
ISRS-194Redundant entry in the refsetDescriptor file

There’s a redundant entry in the descriptor for the lateralisable refset.

bbdcc9fc-5bc6-415a-a5ee-c5adfc569bd5 2017-01-31 00:00:00 1 900000000000207008 900000000000456007 723264001 449608002 900000000000461009 0
31919d48-e54b-4993-abe1-9c2fa9568d78 2017-07-31 00:00:00 1 900000000000207008 900000000000456007 723264001 449608002 900000000000461009 0

RESOLUTION:  Redundant record (31919d48-e54b-4993-abe1-9c2fa9568d78) removed accordingly.


ISRS-195Invalid CTV3 map records

The CTV3 map includes 7 invalid entries (same 7 description Ids described before).

id refsetId referencedComponentId
9f652ba8-c4ca-49f1-90f8-8138e27beded 900000000000497000 3446016018
a105309b-06da-44e6-9884-7aa86992f511 900000000000497000 3446018017
a1f400d0-bca7-454d-a37d-b503927b0078 900000000000497000 3446013014
a86b5b16-cd16-448e-8cf1-54d7bd0e8ac2 900000000000497000 3446015019
d82ce717-b99d-4586-bc59-e15c7fc4d5dd 900000000000497000 3446017010
53c15d4f-e988-434a-baa5-e785b7ca5305 900000000000497000 3446012016
74d45743-767e-4bb7-9036-570a08b04b10 900000000000497000 3446014015

RESOLUTION:  Seven invalid records removed accordingly.


ISRS-196Attribute description not found within correct hierarchy

Attribute description not found within correct hierarchy. Attribute descriptions are expected to be subtypes of 900000000000457003 ("Reference set attribute"). The following two records contain values outside this hierarchy:-

de0f4894-9aff-4d5c-8702-60eeb33b7a96|410662002|Concept model attribute (attribute)
2d1ccbbf-bf08-4740-a80e-44fe774c5a2d|900000000000444006|Definition status (core metadata concept)

RESOLUTION:  Offending refsetDescriptor records removed accordingly.


ISRS-197refsetDescriptor record with inactive referencedComponentID

Record 662b1db8-4b23-4dd1-8bf6-3964f99fe77e contains an inactive referenced component (447564002).

RESOLUTION:  The refsetDescriptor record for the reference set 447564002 has now been inactivated accordingly.


ISRS-198Concept has no active FSN within its module

Concept 411116001 is a member of module 900000000000012004 ("SNOMED CT model component module"), while its only active FSN, 3495166019, is in module 900000000000207008 ("SNOMED CT core module").

RESOLUTION:  FSN (3495166019) and synonym (3495165015) have both been moved to 900000000000012004 ("SNOMED CT model component module") accordingly.


ISRS-199Concepts have no active synonyms within their modules

These four concepts lack any active synonyms:

326342007
377389001
377416002
377417006

Note that all four of these concepts are inactive.

RESOLUTION: SNOMED International Content Team confirmed that these are inactive concepts so therefore adding new synonyms is not the correct approach. Therefore no action is required in this case.


ISRS-200Changes to caseSignificance ID's

Descriptions which have had their case significance ids altered to 900000000000448009 ("Entire term case insensitive") for this release.

RESOLUTION: UKTC confirmed that this issue was with the QA test rather than the content - this is therefore not a valid issue and so has been closed down without action required.

2017-jun-01
ISRS-201Namespace ID required for July 2017

New namespace added for upcoming October 2017 Spanish Edition release, resolved in TPFIX-25

RESOLUTION:  New namespace (734535006) created as planned.


ISRS-202RVF Assertion failure: eff30fb0-7856-11e1-b0c4-0800200c9a66

"assertionUuid": "eff30fb0-7856-11e1-b0c4-0800200c9a66",
"assertionText": "All language refset members inactivated in current snapshot must have been active in the previous release.",
"queryInMilliSeconds": 60635,
"failureCount": 12,
"firstNInstances": [

{ "conceptId": "648501000124118", "detail": "Language Refset: id=800c4ddb-54c1-47ec-af2e-0816b797c616 is inactive but no active state found in previous release." }

,

{ "conceptId": "648391000124116", "detail": "Language Refset: id=8146604c-2d6e-4a3f-a25a-191e4f3b0945 is inactive but no active state found in previous release." }

,

{ "conceptId": "648361000124112", "detail": "Language Refset: id=81b10a87-2ab5-41b0-b89f-e2ac70babfd8 is inactive but no active state found in previous release." }

,

{ "conceptId": "638911000124112", "detail": "Language Refset: id=9b7f61d6-04f1-4b89-8ba4-79aa7bb0e401 is inactive but no active state found in previous release." }

,

{ "conceptId": "648571000124112", "detail": "Language Refset: id=bace38c7-afbf-4448-aeeb-84b184f53a4f is inactive but no active state found in previous release." }

,

{ "conceptId": "648501000124118", "detail": "Language Refset: id=ce266e08-6be8-4fad-97ee-b4c53ad5867f is inactive but no active state found in previous release." }

,

{ "conceptId": "638911000124112", "detail": "Language Refset: id=07e5cf11-9088-40cd-97e2-d1c7bf178e3d is inactive but no active state found in previous release." }

,

{ "conceptId": "648571000124112", "detail": "Language Refset: id=21aa1482-1a05-4852-8730-079ff2b37177 is inactive but no active state found in previous release." }

,

{ "conceptId": "648331000124115", "detail": "Language Refset: id=28606ec3-edbc-4f73-953f-098f7fc15708 is inactive but no active state found in previous release." }

,

{ "conceptId": "648361000124112", "detail": "Language Refset: id=3a671dec-8667-49e1-8a65-c867feb76e97 is inactive but no active state found in previous release." }

,

{ "conceptId": "648391000124116", "detail": "Language Refset: id=44adb6e9-5ea0-41fa-8fb9-2f3d59698169 is inactive but no active state found in previous release." }

,

{ "conceptId": "648331000124115", "detail": "Language Refset: id=619326a5-7a54-476e-b52a-d4915fc0d6e3 is inactive but no active state found in previous release." }

],

RESOLUTION: This is just a warning and not an error and so no action is required.

2017-jun-02
ISRS-203RVF Assertion failure: 2b193a88-8dab-4d19-b995-b556ed59398d

"assertionUuid": "2b193a88-8dab-4d19-b995-b556ed59398d",
"assertionText": "New inactive states follow active states in the DESCRIPTION snapshot.",
"queryInMilliSeconds": 33619,
"failureCount": 6,
"firstNInstances": [

{ "conceptId": "435801000124108", "detail": "DESCRIPTION: id=638911000124112 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439021000124105", "detail": "DESCRIPTION: id=648331000124115 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439031000124108", "detail": "DESCRIPTION: id=648361000124112 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439041000124103", "detail": "DESCRIPTION: id=648391000124116 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439081000124109", "detail": "DESCRIPTION: id=648501000124118 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439101000124101", "detail": "DESCRIPTION: id=648571000124112 is inactive but no active state found in the previous snapshot." }

RESOLUTION:  The six born inactive Descriptions above have been removed accordingly.


ISRS-204RVF Assertion failure: 4478a896-2724-4417-8bce-8986ecc53c4e

"assertionUuid": "4478a896-2724-4417-8bce-8986ecc53c4e",
"assertionText": "There must be actual changes made to previously published concepts in order for them to appear in the current delta.",
"queryInMilliSeconds": 6660,
"failureCount": 1,
"firstNInstances": [

{ "conceptId": "448396008", "detail": "Concept: id=448396008 is in the detla file, but no actual changes made since the previous release." }

RESOLUTION:  Concept removed from the Delta file accordingly.


ISRS-205New record in Concept delta for existing component with no changes

Concept 448396008 experienced issues with the branch problem during the Alpha feedback period - when it was fixed in the Alpha the termServer believed it to be new an so added another active record to the delta, thus corrupting the Full and Snapshot files.

RESOLUTION:  Resolved as part of ISRS-204


ISRS-207One description has a full stop at the end

There’s still one description that might be text definition? Though it’s the presence of a period/full stop at the end of the description (which is unusual) is what’s causing the fail.

718089001 3311128017 2017-07-31 00:00:00 Post extubation acute respiratory failure requiring reintubation.

RESOLUTION:  Description inactivated, as turned out to be a duplicate.


ISRS-208AttributeValue Snapshot record is outdated by record in full file

Possibly inconsequential. Members of refset 900000000000490003 ("Description inactivation indicator attribute value reference set") for which a more recent record in the Full release expresses the same relationship (but with a different id). Note that the members in question are inactive: the QA is objecting to the same relationship appearing with two different ids.

RESOLUTION:  Four invalid AttributeValue records removed, plus four valid records re-activated for July 2017:

Removed:

6937d3ce-9b92-46a5-915c-105ef53a85a3 20170731 1 900000000000207008 900000000000490003 350608017 900000000000495008
2b1419fb-6396-4d96-b67a-bf3404e4e24f 20170731 1 900000000000207008 900000000000490003 377741012 900000000000495008
55c7c001-05d3-4476-b0c2-29205a0387d8 20170731 1 900000000000207008 900000000000490003 2737731017 900000000000495008
78e492ae-9b4f-4da5-9ebb-a37f8eb70ee1 20170731 1 900000000000207008 900000000000490003 622260016 900000000000495008

Re-activated:

ff7de500-472d-5380-930e-b5ddfb184d98 1 900000000000207008 900000000000490003 377741012 900000000000495008
7f442764-3b09-5827-9629-81c0407c828b 1 900000000000207008 900000000000490003 350608017 900000000000495008
12a081ef-baf8-5a46-b93d-a4c9de998790 1 900000000000207008 900000000000490003 622260016 900000000000495008
66e03cc0-51fd-535c-907a-5761cd1d2e36 1 900000000000207008 900000000000490003 2737731017 900000000000495008

 


ISRS-210MRCM Cardinality constraint failure - mandatory 'attributeInGroupCardinality' of 0..1

The 363714003 |Interprets| attribute has a mandatory 'attributeInGroupCardinality' of 0..1. However, the concept 724758000 |Manic symptoms co-occurrent and due to primary psychotic disorder (disorder)| - with an effectiveTime of 20170731 - has 3 x 363714003 |Interprets| relationships in the same relationship group (Role group 3). This therefore breaks the concept model rule.

RESOLUTION:  Three extraneous Stated relationships removed and re-classified to resolve the errors.


ISRS-211MRCM Cardinality constraint failure - concept model states all new precoordinated content must have at most 1 x 363698007 |Finding site| relationship in any relationship group

The concept model states that all NEW precoordinated content must have at most 1 x 363698007 |Finding site| relationship in any relationship group (where relationshipGroup > 0). However, several concepts break this rule. 

RESOLUTION:  The MRCM validation rule was proven to require refinement, in order to restrict it to the Stated view rather than Inferred.  This has now been implemented and is now producing just 3 failures.  The SNOMED International Content Team have therefore re-modelled the following 3 concepts:

  • 15665401000119102
  • 15665361000119106
  • 15665321000119101

The related born-inactive components created by this re-modelling after Versioning the content have also been removed.


ISRS-213MRCM Cardinality constraint failure - concept model states all new precoordinated content must have at most 1 x 116676008 |Associated morphology| in any relationship group (where relationshipGroup > 0)

The concept model states that all NEW precoordinated content must have at most 1 x 116676008 |Associated morphology| in any relationship group (where relationshipGroup > 0). However several concepts appeared to contravene this rule:

RESOLUTION:  The MRCM validation rule was proven to require refinement, in order to restrict it to the Stated view rather than Inferred.  This has now been implemented and is now producing no failures.  This ticket has therefore been closed down with no action required.

2017-jun-20
ISRS-214MRCM Domain constraint failure -

The domain of 405815000 |Procedure device| is << 71388002 |Procedure|. However, there are 3 concepts, which are << 363787002 |Observable entity|, which have an attribute that is a descendant of |Procedure device| (namely 424226004 |Using device|). This is valid, from a content perspective - however the MRCM rules are incorrect. The reason for this is that domain constraints are inherited by an attribute's children. And since 424226004 |Using device| has recently been added to the |Observable entity| domain, this should have also been added to the domain of the parent attribute (ie 405815000 |Procedure device|.

RESOLUTION: 1 new row (row 103) has been added to the 'Attribute domain' refset for the Member Release. This has also updated the 'attributeRule' value in row 57 of 'Attribute range' refset.


ISRS-215Duplicate description found

734059009 Intraductal papillary neoplasm with high-grade intraepithelial neoplasia (morphologic abnormality)

3482536011 20170731 1 900000000000207008 734059009 en 900000000000003001 Intraductal papillary neoplasm with high-grade intraepithelial neoplasia (morphologic abnormality) 900000000000448009
3482537019 20170731 1 900000000000207008 734059009 en 900000000000013009 Intraductal papillary neoplasm with high-grade intraepithelial neoplasia 900000000000448009

 

734133009 Intraductal papillary neoplasm with high grade intraepithelial neoplasia (morphologic abnormality)

3483018012 20170731 1 900000000000207008 734133009 en 900000000000003001 Intraductal papillary neoplasm with high grade intraepithelial neoplasia (morphologic abnormality) 900000000000448009
3483019016 20170731 1 900000000000207008 734133009 en 900000000000013009 Intraductal papillary neoplasm with high grade intraepithelial neoplasia 900000000000448009

 

RESOLUTION: SNOMED International Content team have resolved this for the July 2017 Member release, by removing duplicate Concept 734059009.


ISRS-216Fix RVF assertion error 89ceaf00-79b9-11e1-b0c4-0800200c9a66

https://rvf.ihtsdotools.org/api/v1/result/1497864338295?storageLocation=international/snomed_ct_international_edition_july_2017_beta_release_package/2017-06-19T08:48:47

testCategory: "release-type-validation",
assertionUuid: "89ceaf00-79b9-11e1-b0c4-0800200c9a66",
assertionText: "All stated relationships inactivated in current release must have been active in the previous release.",

Delete the following 3 born inactive stated relationships:

id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
6905147028 20170731 0 900000000000207008 724758000 285854004 1 363714003 900000000000010007 900000000000451002
6905148022 20170731 0 900000000000207008 724758000 247774004 1 363714003 900000000000010007 900000000000451002
6905149025 20170731 0 900000000000207008 724758000 3850002 1 363714003 900000000000010007 900000000000451002

Note: This is the result of ISRS-210 fixes.

RESOLUTION:  3 Born inactive Stated Relationships removed for the July 2017 Member release.


ISRS-217Potential equivalency

A change in the mapping history of 121161000000105 | Chickenpox vaccination. Unsure of the main cause of this but looks like it needs to be reviewed by SNOMED International. It is marked as a duplicate to 68525005 | Varicella vaccination (procedure) this has now been made duplicate to 722215002 | Administration of herpes zoster vaccine. However, I think this is incorrect and should be mapped to one of its child concepts 571611000119101 | Administration of varicella live vaccine (procedure). Researching this, the herpes zoster vaccine is a slightly different vaccine to the varicella vaccine.

RESOLUTION: SNOMED International Content team have resolved this for the July 2017 Member release, by amending the mapping to 571611000119101

 


ISRS-219Delete born inactive stated relationships after ISRS-211 fix

RVF failed several Stated Relationships which have been born inactive in July 2017:

"assertionText": "All stated relationships inactivated in current release must have been active in the previous release.", 

"failureCount": 12,

"firstNInstances": 

[{"conceptId": "15665361000119106","detail": "Stated relationship: id=6807693029 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665361000119106","detail": "Stated relationship: id=6807695020 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665361000119106","detail": "Stated relationship: id=6807696021 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665321000119101","detail": "Stated relationship: id=6807707026 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665321000119101","detail": "Stated relationship: id=6807709028 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665321000119101","detail": "Stated relationship: id=6807710022 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807712025 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807714029 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807715028 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807716027 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807718026 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807719023 is inactive in the current release but no active state found in the previous snapshot."}

RESOLUTION:  All born inactive Stated relationships removed from the July 2017 International Edition accordingly.

 


ISRS-221Retired concepts must have a historical relationship of the appropriate type (RF1)

Retired concepts must have a historical relationship of the appropriate type (unless their concept status is 1 or 3)

RESOLUTION:  The majority of these issues were proven by the SNOMED International Content team to be valid, with the root cause being invalid QA routines.  One historical association (for concept 192203002) was proven to be invalid, and has now been amended accordingly for the July 2017 Member release.


ISRS-222Concepts with multiple historical relationships (RF1)

Concepts may not have more than one historical relationship (except MAY_BE_As, MOVED_TOs OR WAS_As). The following concepts have all come through RF2 to RF1 conversion with more than the expected number of historical relationships attached to them:

 

RULEIDSCTIDDETAILSTERMLIST
432667050042 historical relationships266705004: Preoperative/postoperative procedures (procedure)
432871030003 historical relationships287103000: Open wound of chest/back/buttock (disorder)
432310350072 historical relationships231035007: Destruction of spinal nerve root or ganglion (procedure)
431931570052 historical relationships193157005: Hereditary and idiopathic peripheral neuropathy (disorder)
433979670032 historical relationships397967003: Thermal/explosive injury (disorder)
431573790033 historical relationships157379003: Open wound of chest/back/buttock (disorder)

This may be another RF2 to RF1 conversion issue, rather than any problem with the RF2 source.

RESOLUTION:  All concepts changed to have AssociationReference refsetId equal to "POSSIBLY EQUIVALENT TO", and their AttributeValue valueId equal to "AMBIGUOUS"


ISRS-223Active concepts with invalid historical relationships (RF1)

Historical relationships must belong to concepts of appropriate status. Three active concepts have come through conversion with odd historical relationships attached: 

RULEIDSCTIDDETAILSTERMLIST
446599212024422221005 (status 1); attribute 168666000422221005: Bacterial infection caused by Klebsiella mobilis (disorder)
168666000: SAME AS (attribute)
4465996900221541000119106 (status 1); attribute 1490160081541000119106: Skin ulcer associated with type II diabetes mellitus (disorder)
149016008: MAY BE A (attribute)
446599629026192203002 (status 10); attribute 149016008192203002: [X] (Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction) or (organic psychosyndrome) (disorder)
149016008: MAY BE A (attribute)

These may be odd entries in the RF2 reference sets or another group of RF2 to RF1 conversion issues.

RESOLUTION:  Concepts inactivated, plus historical associations corrected.


ISRS-226Concepts not inheriting the necessary attribute from the parent concept

Children of concepts with the "Has active ingredient" attribute must also have that attribute. The following concepts are not inheriting the necessary attribute from the parent concept:

 

RULEIDSCTIDDETAILSTERMLIST
107316943005Parent: 423714001316943005: Compound magnesium trisilicate 250 mg tablet (product)
423714001: Aluminum hydroxide + magnesium trisilicate (product)
107326342007Parent: 412256008326342007: Ethinylestradiol+norethisterone 35micrograms/1mg tablet (product)
412256008: Product containing ethinyl estradiol and norethisterone (medicinal product)
107329167003Parent: 421178007329167003: Calcium compound 400mg effervescent tablet (product)
421178007: Calcium carbonate + calcium lactate gluconate (product)
107329168008Parent: 421178007329168008: Calcium compound 1000mg effervescent tablet (product)
421178007: Calcium carbonate + calcium lactate gluconate (product)
107329297004Parent: 424828009329297004: Vitamin B compound tablet (product)
424828009: Niacinamide+riboflavine+thiamine (product)
107347900004Parent: 421774002347900004: Sodium chloride 1.5% compound mouthwash (product)
421774002: Sodium bicarbonate + sodium chloride (product)

RESOLUTION:  UKTC confirmed that after further investigation this issue was specific to the UK extension, and therefore requires no action for the International Edition.  Issue therefore closed without action.

2017-jun-21
ISRS-227Unknown FSN postfix values occurring as children of other FSN postfix values

Postfix metamodel rule: Only known FSN postfix values may occur as children of other FSN postfix values. The table below gives the issues from the International content.  In the details column the child is the first code and the parent the second.

RULEIDSCTIDDETAILSTERMLIST 
187677701000119107677701000119107 (finding) : 75971007 (disorder)677701000119107: Subretinal neovascularization of right eye (finding)
75971007: Choroidal retinal neovascularization (disorder)
Removed 3330639017
Added new FSN with semantic tag (disorder)
Removed parent  6984966024; replaced with new IS A = disorder
1871621920100011910116219201000119101 (finding) : 26929004 (disorder)16219201000119101: Behavioral disturbance co-occurrent and due to late onset Alzheimers dementia (finding)
26929004: Alzheimer's disease (disorder)
Removed 3447208014
3447209018 and 3447210011 replaced with new FSN (disorder) and 2 new synonyms. 
187733465009733465009 (substance) : 14103001 (product)733465009: Naldemedine (substance)
14103001: Opiate antagonist (product)
Removed IS A - Opiate antagonist (product) 6996256024
and replaced with IS A = Opiate agonist (substance)
187733342000733342000 (finding) : 609411003 (disorder)733342000: Ischemic contracture of kidney (finding)
609411003: Traumatic and/or non-traumatic injury of anatomical site (disorder)
No action required as new FSN (disorder) will correct this inference. 
187677671000119106677671000119106 (finding) : 75971007 (disorder)677671000119106: Subretinal neovascularization of left eye (finding)
75971007: Choroidal retinal neovascularization (disorder)
Removed 3326522013 replaced with new FSN (disorder)
1874190600241906002 (finding) : 118940003 (disorder)41906002: Drug withdrawal seizure (finding)
118940003: Disorder of nervous system (disorder)
No action required:118940003: Disorder of nervous system (disorder) will go away as it is inferred from IS A = drug withdrawal which has been removed. 
1874190600241906002 (finding) : 363101005 (disorder)41906002: Drug withdrawal seizure (finding)
363101005: Drug withdrawal (disorder)
Removed IS A = Drug withdrawal 6904370024 
187733342000733342000 (finding) : 709978007 (disorder)733342000: Ischemic contracture of kidney (finding)
709978007: Contracted kidney (disorder)
Removed 3499255013 FSN (finding) replaced with 3512941013 FSN (disorder)

 

RESOLUTION:  All relevant descriptions and Stated Relationship amended as per the noted in the table above.

 


ISRS-228Delete 9 born inactive historical associations

RVF failure:

"assertionText": "New inactive states follow active states in the ASSOCIATION REFSET snapshot file.",

"failureCount": 9,

"firstNInstances": 

[{"conceptId": "157379003","detail": "ASSOC RS: id=a0e20ebe-a5dc-4cb6-a226-a3b4441b0dc8 is inactive but no active state found in the previous release."},{"conceptId": "157379003","detail": "ASSOC RS: id=c03e2672-3d0e-4e5a-b61e-d43021b90810 is inactive but no active state found in the previous release."},{"conceptId": "287103000","detail": "ASSOC RS: id=d4f62913-bdbb-467c-811f-0f8250a7661d is inactive but no active state found in the previous release."},{"conceptId": "157379003","detail": "ASSOC RS: id=df96b92e-76b1-42f3-aa6f-01e3a9a8c0eb is inactive but no active state found in the previous release."},{"conceptId": "413138007","detail": "ASSOC RS: id=e806ed49-531d-41ed-bebf-2ec69995b0aa is inactive but no active state found in the previous release."},{"conceptId": "287103000","detail": "ASSOC RS: id=fc1cc179-f30c-49f7-b1c2-954955c78c2c is inactive but no active state found in the previous release."},{"conceptId": "397967003","detail": "ASSOC RS: id=006bbe0f-3d34-4ca8-9b94-bf97d44ca4a1 is inactive but no active state found in the previous release."},{"conceptId": "397967003","detail": "ASSOC RS: id=58121ca7-6b7d-4c9a-916f-d6d70df9b7c5 is inactive but no active state found in the previous release."},{"conceptId": "287103000","detail": "ASSOC RS: id=65d450af-36ef-47e5-a29b-fd0c82a27a0b is inactive but no active state found in the previous release."}

RESOLUTION: The relevant Association refset components removed accordingly.


ISRS-229Fix assertion (1852b9d6-38cf-11e7-8b36-3c15c2c6e32e) validation issue

RVF failure:

"assertionText": "Previously published historical association components should not be modified.",

"failureCount": 1,

"firstNInstances": 

[

{"conceptId": "413138007","detail": "Association refset id=84eb1cc8-23b9-5112-8ad1-9a075becd413 has historical association components changed since the previous release."}

],

RESOLUTION:  Association Reference record fixed as folllows:

id effectiveTime active moduleId refsetId referencedComponentId targetComponentId
84eb1cc8-23b9-5112-8ad1-9a075becd413 0 900000000000207008 900000000000527005 413138007 68525005
2120b5b4-5a52-11e7-8261-3c15c2c6e32e 1 900000000000207008 900000000000527005 413138007 571611000119101


ISRS-230MRCM regression failure - attribute group contains multiple records for the same attribute

According to the attribute group rule there should not be more than one attribute per group as it is [0..1] group.  This one only exists in the stated relationship but not in the inferred view: 

id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid

[4428858023|tel:(442)%20885-8023] 20090131 1 900000000000207008 438595008 417992006 1 118168003 900000000000010007 900000000000451002

7111885023 20170731 1 900000000000207008 438595008 367643001 1 118168003 900000000000010007 900000000000451002

RESOLUTION:  Stated Relationship inactivated as follows, to leave only 1 relationships in the group:

4428858023 20170731 0 900000000000207008 438595008 417992006 1 118168003 900000000000010007 900000000000451002


ISRS-2313 MRCM failures for multiple Stated Relationship records per group

The following 3 born inactive Stated Relationship records have failed the MRCM tests:

id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
6937579029 20170731 1 900000000000207008 1542009 371520008 2 116676008 900000000000010007 900000000000451002 
6937585020 20170731 1 900000000000207008 18735004 371520008 2 116676008 900000000000010007 900000000000451002 
6937613027 20170731 1 900000000000207008 72951007 371520008 1 116676008 900000000000010007 900000000000451002

RESOLUTION:  The three Stated Relationship records in question were removed by the SNOMED International Content team.


ISRS-254Issue found with new Stated Relationship

SNOMED International’s continuous Content quality review identified a change within the terminology that requires wider consideration - namely the addition of the following Stated Relationship:

6842860029 20170731 1 900000000000207008 80400009 3898006 0 116680003 900000000000010007 900000000000451002

RESOLUTION:  This Stated relationship and the related Inferred relationships have therefore been removed pending further review, to ensure that the impact of this change within the hierarchy is fully communicated with appropriate consultation with the wider community of practice.


ISRS-255RVF Assertion failure: 89ceaf00-79b9-11e1-b0c4-0800200c9a66

"assertionUuid": "89ceaf00-79b9-11e1-b0c4-0800200c9a66",

"assertionText": "All stated relationships inactivated in current release must have been active in the previous release.",

"failureCount": 1,

"firstNInstances": [{"conceptId": "80400009","detail": "Stated relationship: id=6842860029 is inactive in the current release but no active state found in the previous snapshot."}

RESOLUTION:  Born Inactive record was removed accordingly.


ISRS-256Unexpected control characters in TextDefinition records

The following textDefinition records have been found to have unexpected control characters contained within the text (just before the number of degrees in each case):

3476134011 20170731 1 900000000000207008 733525007 en 900000000000550004 Left anterior fascicular block is characterized by all of the following: Left-axis deviation with frontal QRS axis between 45° and 90°; Q wave in lead aVL; rS in inferior leads; QRS duration is 120 ms. 900000000000017005
3476135012 20170731 1 900000000000207008 733525007 en 900000000000550004 Left anterior fascicular block is characterised by all of the following: Left-axis deviation with frontal QRS axis between 45° and 90°; Q wave in lead aVL ; rS in inferior leads; QRS duration is 120 ms. 900000000000017005
3476139018 20170731 1 900000000000207008 733524006 en 900000000000550004 Right-axis deviation with frontal QRS axis between 90° and 180° rS in leads I and aVL and qR in inferior leads (Q waves 40 ms).;QRS duration 120 ms; Exclude other causes of right-axis deviation. 900000000000017005

RESOLUTION:  The 3 textDefinition records have been updated accordingly, to remove the special characters. 

3.3 Actualizaciones técnicas

3.3.1  Convención para la denominación del paquete de RF2 

Se mejoró la convención para la denominación del  fichero zip del paquete de RF2, para reflejar la versión del paquete de publicación en el estándar ISO8601. Por lo tanto, se agregó un sufijo "Z" al nombre de este paquete (pero no a los nombres de archivos internos) y en el futuro se agregará a todos los nombres del paquete de publicación. De este modo se asegura que la fecha en el nombre del paquete de publicación se establece en el contexto correcto, es decir, UTC. En este caso, en vez de denominar al paquete de publicación de la Edición Internacional de julio de 2017 como

  • SnomedCT_InternationalRF2_Production_20170731T120000.zip

Se ha denominado:

  • SnomedCT_InternationalRF2_Production_20170731T120000Z.zip

3.3.2 Actualización de la asignación de relevancia para el uso de mayúsculas y minúsculas, de acuerdo con la especificación de RF2

Se corrigió la asignación incorrecta de la relevancia en cuanto al uso de mayúsculas y minúsculas de acuerdo con la especificación de RF2. EL problema se debía a que el valor de 900000000000448009 |uso de mayúsculas y minúsculas sin relevancia para la totalidad del término (metadato del núcleo)| no se había utilizado debido a la migración de datos desde RF1 y limitaciones de las herramientas de autoría. En realidad, la mayoría de las descripciones de SNOMED CT deberían calificarse como 'uso de mayúsculas y minúsculas sin relevancia para la totalidad del término'. Estos términos pueden utilizarse indistintamente en mayúsculas o minúsculas sin influir sobre su significado. Por lo tanto, se realizaron cambios técnicos masivos en el valor de relevancia del uso de mayúsculas y minúsculas para resolver el problema. Para mayores detalles, se puede consultar el documento IHTSDO-950 Update of case significance assignment following the RF2 specification.

3.3.3  Agregado de conjunto de referencias de MRCM al paquete de la Edición Internacional

Los conjuntos de referencias de MRCM, que se publicaron como versión preliminar (beta) en febrero de 2017, ahora se incluyeron en el paquete de publicación de la Edición Internacional. Los cuatro archivos siguientes se incorporaron a la carpeta de Metadatos, que es una subcarpeta de la carpeta de Conjuntos de Referencias en el paquete de la Publicación: 

  1. der2_sssssssRefset_MRCMDomainDelta_INT_20170731.txt
  2. der2_cissccRefset_MRCMAttributeDomainDelta_INT_20170731.txt
  3. der2_ssccRefset_MRCMAttributeRangeDelta_INT_20170731.txt
  4. der2_cRefset_MRCMModuleScopeDelta_INT_20170731.txt

3.3.4  Mejoras en el fichero RefsetDescriptor

Se mejoró el fichero refsetDescriptor para incluir descriptores para los tipos de conjuntos de referencias predefinidos. Ahora también incluye registros del refsetDescriptor. A partir de la Edición Internacional de julio de 2017, ahora también se incluyen registros de refsetDescriptor para describir los cuatro nuevos conjuntos de referencias de MRCM. Véase los detalles adicionales de estos conjuntos de referencias en la sección 3.3.3.

3.3.5  Agregado de un nuevo conjunto de referencias SEP al paquete de la Edición Internacional

Este conjunto de referencias se agregó para colaborar con la solución preliminar para las relaciones no definitorias adicionales y también para mejorar aún más nuestros procesos de Aseguramiento de la Calidad. Véanse los detalles del nuevo Conjunto de Referencias propuestos en la página  SEP maps and refset.

3.3.6  Remoción del conjunto de referencias de identificadores RT de SNOMED CT, previamente incluido en el paquete de la Edición Internacional 

Como se comunicó previamente (en diversos foros) en los últimos años, la Asamblea General de SNOMED International de 2009 decidió que, a partir del 26 de abril de 2017, Snomed International ya no autorizaría el uso de trabajos previos de SNOMED. Esta decisión recibió el apoyo clínico de la Asociación Mundial de Sociedades de Anatomía Patológica y Medicina de Laboratorio debido a que habían identificado los mismos riesgos. Por lo tanto, desde la fecha mencionada Snomed International ya no mantiene las versiones previas de SNOMED, incluyendo SNOP, SNOMED, SNOMED II, SNOMED International (3.x) y SNOMED RT. Debido a que tanto las ciencias médicas como la terminología han evolucionado considerablemente desde su desarrollo, el uso de estas versiones más antiguas podría implicar un riesgo para los pacientes y problemas de seguridad.

SNOMED International no puede ser responsable de este riesgo y por lo tanto, en el anuncio original se instaba firmemente a los usuarios de estas versiones anteriores a migrar a SNOMED CT tan pronto como fuera posible.

Como parte de este proceso, el conjunto de referencias de identificadores previos de SNOMED será retirado y ya no estará disponible en la Edición Internacional.

Con el fin de proporcionar un recurso compartido y una fuente unívoca de verdad sobre estos problemas precedentes, hemos reunido un conjunto de preguntas frecuentes disponibles en nuestro sitio web SNOMED International:

https://ihtsdo.freshdesk.com/support/solutions/folders/4000013539 

3.3.7 Formato del paquete de RF2

Para referencia futura, la convención para el paquete de ficheros RF2 establece que contiene todos los ficheros relevantes, independientemente de que incluyan registros en cada publicación en particular. Por lo tanto, el paquete contiene una mezcla de archivos, con filas tanto de encabezado como de contenido, y también ficheros que intencionalmente están en blanco (cuyo contenido sólo incluye un registro de encabezado). El motivo para no eliminar estos ficheros del paquete es establecer una distinción clara entre

  1. ...ficheros obsoletos (y que por lo tanto han sido retirados del paquete por completo), debido a que el contenido ya no es relevante para RF2 en esta publicación o en publicaciones futuras y
  2. ...ficheros que sólo no contienen datos en esta publicación en particular (y que por lo tanto se incluyen en el paquete pero quedan en blanco sólo con la fila de encabezado), pero que aún son relevantes para RF2 y podrían contener datos en publicaciones futuras.

Esto permite que los usuarios distingan fácilmente entre los ficheros que han sido que se han eliminado adrede o no, ya que de lo contrario si los ficheros mencionados en la opción 2 fueran excluidos del paquete esto podría interpretarse como un error y no como una falta de contenido intencional en esa edición.

3.3.8 Visibilidad temprana de un cambio inminente en la Edición Internacional de enero de 2018

 Véase la siguiente página para consultar los detalles de los próximos cambios planeados para la edición de enero de 2018: Early Visibility - Planned improvements to upcoming SNOMED International Release packages



Aprobaciones

 

Versión final

Fecha

Aprobado por

Comentarios

1.00

12/10/2017

Guillermo ReynosoApproved
1.00

12/10/2017

Alejandro Lopez OsornioApproved

 

 

 

 

Descargar el .pdf aquí:

 

 



Borrador del Historial de Cambios

 

Versión

Fecha

Editor

Comentarios

0.120170510Monica HarryPrimer borrador para revisión y comentarios
0.2 20170517 Donna Morgan Actualizacioón del contenido relacionado con Referencias Cruzadas
0.320170629Andrew AtkinsonVersión final de Problemas resueltos y actualización de Problemas Conocidos después de la finalización de la publicacin
0.420170719Andrew AtkinsonActualización con tres nuevos tickets resueltos, que se corrigieron en el paquete actualizado de la Publicación para los Miembros (antes de la publicación para el público). También se reemplazaron enlaces que estaban bloqueados en el repositorio de Contenido para acceso interno solamente) incluyéndose, en cambio, texto relevante, provisto por Monica y Yong
1.020171008Alejandro Lopez OsornioUpdated in line with all of the changes required due to the namespace changes for this Spanish release.

 


 

 

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