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Overview of Current Notices

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

ItemsProposed improvement

Planned Release date

(*this is provisional only and is subject to change)

1LOINC timeline changes - please refer to Roadmap link here LOINCJuly 2018 and potentially other future releases.
2

Revision of IS A relationships for anatomy concepts 

The new anatomy concept model has implemented the new Description Logic features, e.g. reflective and transitive property, general concept axioms, for consistent logical modeling. However, the new model cannot be implemented in production because these DL features currently are not available in production. The implementation of them will depend on the enhanced logic profile for SNOMED CT which is under development by the Modeling AG. Yet, the inferred IS A relationship from the OWL anatomy ontology can be reviewed and implemented in the production. This will utilise the outcomes of the new anatomy model as well as evaluate the design of the new model. In particular, it is important to review the changes of IS-A relationships in anatomy for quality assurance and minimise impact to other hierarchies, such as disorders, procedures, observables, situations etc.

The first subject area for revision is the sub-hierarchy of skin structure. The majority changes have been made in the January 2018 release. The rest will be completed in July 2018 release.

For July 2018 release, the subject area for revision of IS A relationships will be determined and updated in the following confluence page.


July 2018 International Edition
3

Summary of Drugs changes

New hierarchies 766940004 | Role (role) and subhierarchy 766941000 | Therapeutic role (role) created with additional subtypes to be added in future releases

New semantic tags (role)

Attribute types New attributes created:

  • 766953001 |Count of active ingredient (attribute)|
  • 766954007 |Count of base and modification pair (attribute)|
  • 766952006 |Count of base of active ingredient (attribute)|
  • 763032000 |Has unit of presentation (attribute)|
  • 766939001 |Plays role (attribute)|

Grouper concepts representing disposition, intended site, and/or structure Grouper concepts representing disposition, intended site, and/or structure sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈550).

New high level grouper concepts created as an incremental improvement with additional subtypes to be added in future releases:

  • 766779001 |Medicinal product categorized by disposition (product)|
  • 763760008 |Medicinal product categorized by structure (product)|
  • 767102007 |Medicinal product categorized by chemical element (product)|

Product role concepts Concepts representing product role relocated as stated descendants of 763087004 | Medicinal product categorized by role (product) with definition status = primitive and attributes inactivated (n≈ 400)

For further details see Briefing Note Use of Additional Axiom Functionality and Remodeling Product Roles

Medicinal product (MP) concepts - MP-containing concepts sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈ 3750). Includes the following attributes:

  • Has active ingredient (n≈4650)

Medicinal product form (MPF) concepts - MPF-containing concepts sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈2100). Includes the following attributes:

  • Has active ingredient (n≈2400)
  • Has manufactured dose form (n≈2150)

Clinical drug (CD) concepts - CD-containing precisely concepts sufficiently defined by modeling to proximal primitive concept, adding defining attributes, and updating descriptions per editorial guidelines (n≈ 4850). Includes the following attributes:

  • Count of base of active ingredient (n≈4850)
  • Has basis of strength substance (n≈5600)
  • Has concentration strength denominator unit (n≈1450)
  • Has concentration strength denominator value (n≈1450)
  • Has concentration strength numerator unit (n≈1450)
  • Has concentration strength numerator value (n≈1450)
  • Has manufactured dose form (n≈4850)
  • Has precise active ingredient (n≈5550)
  • Has presentation strength denominator unit (n≈4750)
  • Has presentation strength denominator value (n≈4750)
  • Has presentation strength numerator unit (n≈4750)
  • Has presentation strength numerator value (n≈4750)

Documentation Notification for Briefing Notes, Editorial Guidelines, and other documentation updates are posted on the project group website as they become available; see Drug Model Working Group - Directory for details

Briefing

Briefing note - Use of Additional Axiom Functionality and Remodeling Product Roles.pdf

Briefing note - Implications of describing liquid dose form product concepts using presentation strength.pdf

July 2018 International Edition
4Summary of Substances Changes


Top Level

  • Dietary subhierarchy. To remove context of use from the substance concepts and manage the situation where substances can be both a pharmaceutical ingredient and a foodstuff 80 substances that had a tag of “- dietary” in the Fully Specified Name (FSN) and the Preferred Term (PT) were inactivated. Replacement concepts concept without  "-dietary" in the FSN and PT were created. The top level concept "Dietary substance (substance)" has been inactivated and replaced with a new concept "Edible substance (substance)".
  • Radioactive isotope substances. These concepts have been remodelled and the terming normalised to provide consistent representation without the use of carats.
  • Cancer related substance. The subhierarchy has now been removed. Some concept have been inactivated. Some have been moved within the substances hierarchy.


Substance groupers including Disposition, Structure and Combined groupers have been remodelled and additional grouper concepts created as required. The inactivation of role groupers in the substances hierarchy has been initiated.


Disposition groupers

  • Disposition groupers within the substance hierarchy have been modelled as fully defined concepts. The creation of the new top level substance concept of "Substance categorised by disposition" will allow these to be modelled by proximal primitive authoring.
  • Existing disposition grouper concepts in the substances hierarchy have been retained where appropriate and have been remodelled to conform to SNOMED CT Editorial policy. Examples as below.
    •  Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)
    •  Substance with beta-1 adrenergic receptor agonist mechanism of action (substance)
    •  Substance with phosphodiesterase inhibitor mechanism of action (substance)
  • Currently there are in excess of 200 disposition groupers in the substances hierarchy that have been remodelled.
  • Work to remodel existing substance disposition groupers is ongoing.
  • New concepts will be added as identified.

Role groupers

Role groupers within the substances hierarchy are being inactivated where this is possible without creating disruption in other hierarchies. At the start of this work there were approximately 600 role groupers. Currently in the region of 100 role grouper substance concepts have been inactivated or remodelled.This work is ongoing.

Many of these role grouper concepts remain in the substances hierarchy pending a solution for the roles concepts within the terminology as a whole and so will still be present in the July 2018 release.

Structural groupers

Structural groupers within the substance hierarchy have been modelled as primitive concepts.

Existing structural grouper concepts in the substances hierarchy have been retained where appropriate and have been remodelled to conform to SCT Editorial policy.

New structural grouper concepts have been added.

Groupers that identify X or derivatives where X is a specific substance will be inactivated. Some of these concepts have already been inactivated. As the implementation of the IS Modification attibute is carried out the remainder of these concepts will be inactivated.

Structural groupers that reference a chemical group will be retained.

e.g. Amides and derivatives (substance)

Where the structural group name also refers to a specific chemical the grouper has been re-termed “Substance with X structure” 

e.g. Substance with tetracycline structure (substance)

Combined groupers

Combined groupers that include a role will be inactivated where this is possible without causing disruption in other hierarchies. Inactivation of some of these concepts in the substances hierarchy is waiting on a solution for the roles concepts within the terminology as a whole and so will still be present in the July 2018 release.

Groupers of disposition + structure will be retained in the substance hierarchy. Existing concepts have been remodelled to conform to SCT Editorial policy. Examples as below.

Antimony compound with antiprotozoal mechanism of action (substance)

Quaternary ammonium compound with anticholinergic mechanism of action (substance)

Piperidine derivative with histamine receptor antagonist mechanism of action (substance)

New concepts will be added as required.

Use of the Is Modification attribute

To date, we have added n≈1200 new S Modification attribute. This number will most likely increase by the end of the release. This has achieved a flattening of the substance hierarchy. Priority has been given to the remodelling of substances associated with the definition of medicinal products.

The following guidelines have been developed.

1. Substances may have zero to many Is modification attribute(s). e.g  Iodine (131-I) labelled monoclonal antibody (substance) has 2 IS MODIFICATION attribute values.

2. Salts have a IS MODIFICATION relationship to the base e.g. Doxepin hydrochloride (substance) IS MODIFICATION of Doxepin (substance)

3. Hydrates have a IS MODIFICATION relationship to the unspecified salt e.g. Caffeine hydrate (substance) IS MODIFICATION of Caffeine (substance)

4. Anhydrous salts have a IS MODIFICATION relationship to the unspecified salt e.g. Theophylline anhydrous (substance) IS MODIFICATION of Theophylline (substance)

5. Stereoisomers are subtypes of the unspecified substance. e.g.. Dextrothyroxine IS A thyroxine. 

6. There is no IS MODIFICATION relationship between stereoisomers.

Further guidelines will be added to the published documentation as they are developed.

The initial population of the IS MODIFICATION attribute is still subject to manual authoring input to ensure compliance to Editorial guidelines and so some areas of content may appear to be non-conformant in the Alpha release data.

July 2018 International Edition
5

Internal QA

Test and procedure status: Inactivated 143 concepts in the Situations and Findings hierarchies with pattern "Test/procedure OFFERED" and "Test/procedure NOT OFFERED" as these represent an administrative status.


6

Internal QA

Inactivation of Agencies and organizations (qualifier value) and subtypes: moved to UK extension i.e. 66 concepts inactivated.


7

Improvement to the Release package naming convention

In order to ensure that the status of each package is correctly identified, we will be capitalising the third element of the naming convention. For example therefore, instead of the January 2018 International Edition release package being called:

SnomedCT_InternationalRF2_Production_20180131T120000Z.zip

It will instead be called:

SnomedCT_InternationalRF2_PRODUCTION_20180131T120000Z.zip

Alpha/Beta releases will be called:

SnomedCT_InternationalRF2_ALPHA_20180131T120000Z.zip

SnomedCT_InternationalRF2_BETA_20180131T120000Z.zip

This should have no impact on most users, this is provided for visibility of anyone who's upload routine might be case-sensitive.

January 2018 International Edition - COMPLETE
8

Improvement to the Release file naming convention for the Asssociation Reference file

In order to improve the description of this file, we will be updating the file naming convention from:


'der2_cRefset_AssociationReferenceSnapshot_INT_*.txt'

to:

'der2_cRefset_AssociationSnapshot_INT_*.txt'

....as of the January 2018 International Edition

January 2018 International Edition - COMPLETE
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