2024-04-15 - TRAG Meeting Agenda/Minutes

Date

  • Monday 15th April 2024  -  13:30 - 17:00 (GMT) (13:30 - 17:00 UTC)

Room:  Bishopsgate & Chancery   (at the Andaz hotel, Liverpool street, London) 



Attendees

Apologies


Objectives

  • Briefly discuss each item
  • Agree on the plan to analyse and resolve each issue, and document the Action points
  • All those with Action points assigned to them to agree to complete them before the next face to face conference meeting

Discussion items



SubjectOwnerNotes & Actions
1Welcome!All

Thanks to our members for all of their help. Welcome to our observers!

INTRODUCTIONS...

We've got several topics that we've resolved and closed down

As always, we won't waste time going through them again in detail, but if you'd like to read through them they're listed below...  

I'll also run through them very quickly from a high level, and if you have any further questions/news on any of the discussions please let me know now and we can decide whether or not to re-open them...

2

Conclusion of previous Discussions topics

3Annotations - Release DatesALL

The release date depends on two factors:

  1. Firstly, the authoring platform being ready for annotations (which will be November 2023)
  2. Secondly, content authored for annotations. Language tags only involve about 8 concepts under 900000000000506000 |Language type reference set (foundation metadata concept)|. The attribution could be done by technical batch changes.

Because of the change to release date (to the 1st of the month), it is therefore unlikely to be possible to prepare everything in time for the December 2023 release. We are therefore currently aiming for the January 2024 releases - as this will also provide the largest audience for these major new changes (as opposed to Feb/March which most users still do no consume).

  • Is everyone ready for these changes, and comfortable with the proposed release date of January 2024 onwards?
  • If so, we will publish the EMPTY files in the December 2023 release as a trail run, and then populate them with the first content in the January 2024 International Edition.
  • This will likely be closely followed by more content being introduced in the various Extensions over the next few months:
    • Anyone in the room intending to include any data in them anytime soon?
    • If so, have we covered off all necessary bases?
    • Any other considerations?
    • NO - Everyone happy with the proposed timelines
4Annotations - refsetDescriptor recordsALL

Once we've agreed the filenaming conventions, we also need to quickly confirm that everyone is happy with the Attribute Types + Descriptions that will be applied to them in the refsetDescriptor files - as this is all automated now, and so I need to verify that it creates the refsetDescriptor records with the desired attribute types, descriptions, etc 

  • Please let us know if we missed anything or if there are any perceived issues?
  • NO - ALL GOOD - Andrew Atkinson to use these in the Specs, and then onwards in the December 2023 International Edition Release onwards - COMPLETED
5Annotations - file naming conventionsALL

Now that we've got the Language Code approach confirmed, we need to agree the file naming conventions for the 4x new refset types that will be included in the International Edition going forwards (although only the 2x String Value refsets will now be introduced initially - see below).

The four planned refsets are as follows:

  • 1292996001 |Member annotation with component value reference set (foundation metadata concept)|
  • 1292995002 |Member annotation with string value reference set (foundation metadata concept)|
  • 1292994003 |Component annotation with component value reference set (foundation metadata concept)|
  • 1292992004 |Component annotation with string value reference set (foundation metadata concept)| 

So they will be held in the /Refset/Content /Refset/Metadata subfolders, and the initial naming convention would suggest something along the lines of:

  • der2_sscsRefset_MemberAnnotationComponentValueSnapshot_INT_[date].txt
  • der2_sscsRefset_MemberAnnotationStringValueSnapshot_INT_[date].txt
  • der2_scsRefset_ComponentAnnotationComponentValueSnapshot_INT_[date].txt
  • der2_scsRefset_ComponentAnnotationStringValueSnapshot_INT_[date].txt

However we're happy to take any feedback on these before finalising them?

FYI We've decided to release the first 2x definite refsets (as empty files only for now) into the December 2023 Release, in order to trial it and get people used to them - we may introduce the other 2x in future releases if required:

  • der2_sscsRefset_MemberAnnotationStringValueSnapshot_INT_[date].txt
  • der2_scsRefset_ComponentAnnotationStringValueSnapshot_INT_[date].txt


In addition to this, we need to roll out the new refsets to all SNOMED Products - for example, National extensions will create their own annotation attributes and values in addition to those we have covered in the annotation document, such as information about medicinal products.   Other examples include the category annotation attribute for LOINC, which could belong to the LOINC module. 

We would therefore be looking to use conventions like this for Extensions:

  • der2_sscsRefset_MemberAnnotationComponentValueSnapshot_[CountryCode + Namespace]_[date].txt
  • der2_sscsRefset_MemberAnnotationStringValueSnapshot_[CountryCode + Namespace]_[date].txt
  • der2_scsRefset_ComponentAnnotationComponentValueSnapshot_[CountryCode + Namespace]_[date].txt
  • der2_scsRefset_ComponentAnnotationStringValueSnapshot_[CountryCode + Namespace]_[date].txt

And conventions like this for Derivatives:

  • der2_sscsRefset_[derivative name]MemberAnnotationComponentValueSnapshot_INT_[date].txt
  • der2_sscsRefset_[derivative name]MemberAnnotationStringValueSnapshot_INT_[date].txt
  • der2_scsRefset_[derivative name]ComponentAnnotationComponentValueSnapshot_INT_[date].txt
  • der2_scsRefset_[derivative name]ComponentAnnotationStringValueSnapshot_INT_[date].txt

(eg)

  • der2_sscsRefset_OrphanetMemberAnnotationComponentValueSnapshot_INT_20240131.txt
  • der2_sscsRefset_OrphanetMemberAnnotationStringValueSnapshot_INT_20240131.txt
  • der2_scsRefset_OrphanetComponentAnnotationComponentValueSnapshot_INT_20240131.txt
  • der2_scsRefset_OrphanetComponentAnnotationStringValueSnapshot_INT_20240131.txt
  • Again, any concerns or suggestions?
  • NO - Andrew Atkinson to write these up in Comms to go out to community in Release Notes - COMPLETED
6The possibility of updating inactive contentAll

MSSP-1670 - Getting issue details... STATUS

Please see the ticket above for full explanation - in brief:

  • Descriptions in the 20220731 International edition snapshot description file appear to contain ASCII Character 160 for Non-breaking space, when the character should be ASCII 32 for a standard space. ASCII Character 160 could potentially create issues with ETL processes.
  • The suggestion is that issues caused by non-printable ASCII / UNICODE / UTF-8 characters need to be covered under their own policy because simple inactivation does not resolve the issues caused by these characters in ETL and interoperability processes.
  • Unfortunately removing these characters from inactive content contravenes our current policy, which is to only update inactive content (whether this be via the AP or via a back-end fix by the tech team) where a "critical issue" has been found. The term "critical" is used specifically to clearly denote only those issues which present risks such as clinical patient-safety or legal liability, for example.  Therefore, in order for us to flag up these inactive records as a clinical safety issue, we'd need evidence of reports from users explaining how they present such a risk to their patients.  

  • Confirmed by the content team that validation for non-breaking spaces is in place already for active content, and so no improvement to validation is required.
  • From what we can tell, many of these have been in the release for years now, but we have not received any feedback that it has caused an issue thus far. This is therefore not a "critical" issue - however we'd appreciate community to confirm if there would be any issues with making the fixes directly on inactive descriptions?
  • The following Descriptions in the 20220731 International edition snapshot description file were found to contain ASCII Character 160 for Non-breaking space, when the character should be ASCII 32 for a standard space. ASCII Character 160 creates issues with many ETL processes.

  • All of these issue are in inactive descriptions:

  • ID Column Issue
    2869833013 [term] Code:160, Position:27
    2870804019 [term] Code:160, Position:27
    2871691013 [term] Code:160, Position:16
    2880511019 [term] Code:160, Position:21
    2880958016 [term] Code:160, Position:118|Code:160, Position:149
    2881152012 [term] Code:160, Position:118|Code:160, Position:124
    2882107012 [term] Code:160, Position:118|Code:160, Position:149
    2882999016 [term] Code:160, Position:118|Code:160, Position:124
    2884068015 [term] Code:160, Position:21
    3030804017 [term] Code:160, Position:30
    3030901012 [term] Code:160, Position:30

  • The suggestion is that "issues caused by non-printable ASCII / UNICODE / UTF-8 characters need to be covered under their own policy because simple inactivation does not resolve the issues caused by these characters in ETL and interoperability processes. Given the amount of inactive SNOMED content present in the data stream, it would be best if these characters could be removed entirely from even inactive descriptions. While working in healthcare implementations, the presence of ASCII Character 160 (non-breaking space) in the LOINC descriptions broke the entire ETL process between the data warehouse and Research databases and required me to jump through some programming hoops to remove these characters from the LOINC descriptions."
  • Whilst we appreciate the impact that these characters might have on ETL processes,  from a content team perspective, this is not a critical issue.  All of the current issues are related to inactive descriptions and validations are in place to prevent this from occurring in the future. 
  • Unfortunately removing these characters from inactive content contravenes current SI policy, which is to only update inactive content (whether this be via the AP or via a back-end fix by the tech team) where a "critical issue" has been found.  The term "critical" is used specifically to clearly denote only those issues which present risks such as clinical patient-safety or legal liability, for example.  Therefore, in order for us to flag up these inactive records as a clinical safety issue, we'd need evidence of reports from users explaining how they present such a risk to their patients.  

  • SI are always reluctant to change SNOMED CT history. However, there are situations where we have had to do that in the past. We are therefore bringing this to the TRAG for consideration...
  • A couple of people thought it might be easier to update the inactive content rather than getting repeated complaints over the years - however the vast majority disagreed, and thought that not only was it a waste of valuable resource to update inactive content, but more importantly actually contravened the spec at this level!  This is because the INT Edition specifies itself as a UTF-8 format, and the ASCII 160 characters are UTF-8 compliant!  Therefore where would we stop once we start excluding certain UTF-8 characters from the INT Edition? 
  • Instead, it should be the responsibility of the end implementations to exclude any characters that disagree with their ETL routines/programs.
  • Repsonse added to MSSP-1670 - Getting issue details... STATUS
  • TRAG RECOMMENDATION WAS TAKEN - our SI specs specify UTF-8 format, and as ASCII 160 characters in question are UTF-8 compliant, any changes would be contravening our own specifications.  Therefore all were agreed that no changes should be made in the content - instead it should be the responsibility of the end implementations to exclude any UTF-8 characters that cause issues for their ETL routines.
7Proposal to change the International Monthly release dates to the 1st of the monthALL

PROPOSAL:

  • We have had multiple instances recently of concepts being promoted to the International Edition before they were officially Published. This has then had the effect of introducing duplicates into the Extensions, as the concepts have been Published on the same date - for example on 31st of the next month, when both the local concept was Published in the Extension + the promoted concept was Published simultaneously in the International Edition, both with the same effectiveDate.
  • There is no way to extend the RVF validation to cover this scenario, as the two Releases are completely distinct, due to the relevant Extension releases being dependent on International Edition packages from far before the invalid promotion occurred.
  • We are, therefore, introducing manual validation at the point of Promotion, to try and catch any such invalid CRS requests at source, before they are promoted.
  • However, as this is a manual process it still has vulnerabilities, and so we are planning to move the International Edition releases to the 1st of each month, instead of the last day of each month.  This would prevent the vast majority of clashes with Extensions that are normally published on the last day of the month as well - the only remaining risk would be the USA which is published on 1st March and September each year.
  • We cannot predict any risks or potential downsides to moving to the 1st of the month, and so we will be moving ahead with this once we have sent out communications and given the community a reasonable notice period to prepare for the change.  Therefore, please let us know immediately if you can foresee any potential issues with this proposal, or have any valid business reasons why this change will have a negative impact?
  • October 2022 - EVERYONE ON BOARD!!!
  • HOWEVER, WE NEED TO ENSURE THAT IN ORDER TO PREVENT CONFLICTS, WE ARE NOT JUST MOVING THE DATE TO 1st OF EACH MONTH, BUT ALSO THAT THE SNAPSHOT CALCULATION INCORPORATES ModuleID CONSIDERATIONS AS WELL AS MOVING THE DATE 
  • April 2023:
  • Latest plan is to transition in August 2023, so the International Edition Release schedule would be:
    • 30th June 2023
    • 31st July 2023
    • 1st September 2023
    • 1st October 2023
  •  
  • Any issues with this plan?  Any other thoughts since we last spoke?
  • YES - the TRAG believes that we need to communicate to the community exactly which the new "Jan/July" Releases will be, so that all parties who are still only downloading INT Releases every 6 months are on the SAME version - helping interoperability + use of Derivatives that are baselined on these 2 milestone releases.
  • IN ADDITION:
    • The TRAG believe that the new "Jan/July" releases should NOT be those 1 day later (1st Feb/1st Aug) as it's too confusing to users to have the "Jan/July" releases published in different months!  
    • Therefore the NEW PROPOSAL is to:
      • Move all INT Edition Releases to the 1st of each month
      • Assign the "Jan/July" milestone releases to be:
        • 1st January
        • 1st July
        • ...each year, and ensure all International Derivative releases are dependent on these two releases.
      • This would mean that the proposed schedule would look like:
        • 30th June 2023
        • 31st July 2023                   ("July 2023" Release)
        • 1st September 2023
        • 1st October 2023
        • 1st November 2023
        • 1st December 2023
        • 1st January 2024             ("January 2024" Release)
        • 1st February 2024
        • ...etc
      • This is actually beneficial all round, as it gives the content team an extra couple of weeks each cycle to collaborate with the relevant external parties on each Derivative release.  This is especially useful in Summer when many stakeholders are on leave for most of August each year.
      • HOWEVER, this will require EARLIER deadlines for content submission to be agreed with stakeholders, to ensure that they get their content change requests submitted in time for each milestone (Jan/July) release + content SLA's met. Currently they are:
          • 15th April / 15th October each year
        • ....So this would be changed to:
          • 15th March / 15th September each year
        • All internal stakeholders agreed
        • THEREFORE WE NOW NEED TO WORK WITH Monica, Maria and Jane to get confirmation from all EXTERNAL STAKEHOLDERS that this is acceptable.
      • PLUS WE NEED TO TALK ABOUT MAPS, AND HOW MOVING TO 1st Jan / 1st July might impact DONNA and her team???
      • ONCE ALL DONE - we should then put out comms ASAP to the community to confirm the new schedule from September onwards....
  • Andrew provided confirmation that "January" Release moved to 1st January + "July" Release moved to 1st July each year - all in agreement
  • COMPLETE - no further requirements - we will close this issue as of next meeting
8LOINC Extension Alpha release

All

  • Feedback on the Identifier File changes was varied, but generally speaking there were no strong objections to the changes to the file.
  • HOWEVER, there were strong objections to the overrall plan to publish LOINC as a separate "Extension".
    • This is due to the additional Friction caused by having yet another component in a separate package.
    • Implementers would greatly prefer it to all be published in the same package as the International content.
    • Having spoken to Rory, this is a CONTRACTUAL issue - we cannot align the SNOMED CT licence with the LOINC licence in order to publish both types of content in the same package!
    • This is therefore the ONLY option - we have to publish both the LOINC Identifier file + the LOINC content itself in a separate Extension package, dependent on the International Edition.

The Alpha release of the new LOINC Extension was deployed by Regenstrief recently - has anyone used it yet?  

  • Any feedback is more than welcome on:
    • useability,
    • fitness for purpose,
    • format, etc
  • ALL FEEDBACK SHOULD REALLY GO THROUGH REGENSTRIEF AS IT IS THEIR PRODUCT, AS CONFIRMED BY RORY
  • COMPLETE - no further requirements - we will close this issue as of next meeting
9Community Consulation: Proposed changes to the RF2 Identifier File SpecificationAll

Full details can be found in:  SNOMED International Proposal to change the RF2 Identifier File specification

Main points for TRAG consideration:

  • Proposed Changes to RF2 - any issues with the proposal?

    The current column headers for this file are:

    identifierSchemeId alternateIdentifier effectiveTime activemoduleId referencedComponentId

    The new proposed format is:

    alternateIdentifier effectiveTime active moduleId  identifierSchemeId  referencedComponentId

    The data types will remain the same, as detailed in the current RF2 specification:  4.2.4 Identifier File Specification   

  • Perceived Impact - is this the case?

    This change is not expected to have any impact on implementers of existing systems, as SNOMED International are not aware of organisations who currently represent entities from other code systems directly in SNOMED CT, as opposed to mapping to it.   As such, consumption of the new file would only be required by organisations who have an interest is working with such content.

  • FEEDBACK - Walk through the feedback received so far and confirm if any further points?

Feedback requested:

  • Feedback on the File changes was varied, but generally speaking there were no strong objections to the changes to the file.
  • HOWEVER, there were strong objections to the overrall plan to publish LOINC as a separate "Extension".
    • This is due to the additional Friction caused by having yet another component in a separate package.
    • Implementers would greatly prefer it to all be published in the same package as the International content.
    • Having spoken to Rory, this is a CONTRACTUAL issue - we cannot align the SNOMED CT licence with the LOINC licence in order to publish both types of content in the same package!
    • This is therefore the ONLY option - we have to publish both the LOINC Identifier file + the LOINC content itself in a separate Extension package, dependent on the International Edition.
  •  
  • So we now need to go back to the intended changes to the Identifier file format, and confirm whether or not these are acceptable to everyone?
    • Initial feedback:
      • We're making it "look" like the other RF2 files, but it's not!  The Identifier column is NOT a primary key as you'd expect, as in other files with UUID's (even though they also technically have compound keys such as UUID+moduleID+active, etc)
      • We'd have to make the "ReferencedComponentID" field mutable, as otherwise when a mistake is made and we need to change this field to another ID, we have no other option than to create a DUPLICATE record which has everything the same except for active+ReferencedComponentID.
        • This shouldn't be too much of a problem though as we can make the ReferenceComponentID field mutable if we need to
      • Most people would prefer to use a Refset instead in order to be more flexible
        • We could have a unique primary key (like a UUID)
        • We could express one-one and one-many relationships, etc
        • URI attributes such as Concrete Domains coudl be a much more useful addition to the identifier file?
      • .
      •  
10Community Consulation: Proposed changes to the Spanish Edition delivery timelinesGuillermo / Alejandro

We are considering refining the delivery timelines for the Spanish Edition release. Currently it's published twice a year, on 30th April and 31st October.

We are considering various options, including (but not limited to):

  1. Early publication - retaining the dependency on the January/July International Edition content, but bringing the Spanish Edition release date forward to either
    1. 28th February and 31st August, or
    2. 31st March and 30th September
    3. Pros:
      1. This will reduce the version offset between the International and Spanish Editions, which may be the primary goal of the end users? (confirmation of this and in particular evidence as to why this is currently a problem for them would be useful in order to make this a priority....)
      2. This will also retain the standard January/July baseline on the International Edition content
    4. Cons:
      1. This would be dependent upon delivery to SI being completed by either a) 15th Feb and 15th August, or b) 28th Feb and 31st August respectively (at the latest), due to conflicting MS priorities in March/September.  The translation suppliers would therefore need to be comfortable with the ability to meet these timelines between the new monthly International release dates of 1st Feb + 1st August (for the Jan/July releases) and the end of the month.
        1. NOTE:  The timelines are shorted in the case of option a), as we have more capacity to drive the SE through in February/August than we do in March/Sept
      2. Significant increased risk to delivery timelines, due to March/September being extremely busy months for the Managed Service and Derivative releases.  Complex  and time-consuming releases such as US, NL, NZ, coupled with the build and validation of all Derivative releases in these months, make adding additional overhead to this month extremely risky.
      3. Significant increased risk to quality of content, as any issues found may be identified too late to be resolved in the current cycle, and would therefore need to be carried over  as Known Issues to be fixed in the next release.  This may be a concern for the end users.
  2. Retaining the dependency on the January/July International Edition content, retaining the April/October release dates for the Spanish Edition, but allowing more time for translation each cycle (this would therefore only require delivery to SI being completed by 31st March and 30th September respectively).
    1. Pros:
      1. This will provide more time time for translation suppliers to translate all International Content.
      2. This will guarantee delivery timelines, and content quality by providing enough time to resolve issues in the current cycle.
      3. This will also retain the standard January/July baseline on the International Edition content
    2. Cons:
      1. This will NOT reduce the version offset between the International and Spanish Editions, which may be the primary goal of the end users? (confirmation of this and in particular evidence as to why this is currently a problem for them would be useful in order to make this a priority....)
      2. This additional time may not be useful, as the Translation suppliers are already managing to deliver slightly earlier in the cycle.
  3. Retaining the April/October release dates for the Spanish Edition, but bringing the dependency of the Spanish Edition forward, allowing it to be baselined on a later International Edition - for example February and August.  
    1. Pros:
      1. This will reduce the version offset between the International and Spanish Editions, which may be the primary goal of the end users? (confirmation of this and in particular evidence as to why this is currently a problem for them would be useful in order to make this a priority....)
      2. This would be dependent upon delivery to SI being completed by 31st March and 30th September respectively.
      3. This would therefore still provide enough time to guarantee delivery timelines
      4. It would also ensure content quality by providing enough time to resolve issues in the current cycle.
    2. Cons:
      1. Changing the dependent International content may not be as palatable to the end users, as they would need to be careful as to which International Edition to download in conjunction with the Spanish Edition.

OPTIONS TO BE DISCUSSED AND ONE PROPOSAL TO BE AGREED, SO THAT WE CAN DISSEMINATE TO THE COMMUNITY AND TRANSITION AS SOON AS POSSIBLE.

  • OPTION 1 UNANIMOUSLY APPROVED
  • AAT Sent email to the new head of the Spanish Ministry of Health (Belen) on 11/04/2023, to double check that they are happy with the proposed changes -
    • ALSO NEED TO CHECK WITH HER THAT SHE'S HAPPY TO HAVE NO BETA FEEDBACK REVIEW PERIOD ANYMORE....(given that we haven't had any feedback at all for several Release cycles now)
  • Once we get confirmation:
    • AAT to send out planned changes notice to community, from September 30th 2023 onwards...
      • Deadline for objections End fo June??
    • Once deadline  passed, confirm with Guillermo new schedule for September onwards....
  • COMPLETE - no further requirements - we will close this issue as of next meeting
  •  
  •  
11Annotations - outcome of today's MAG discussions
  1. Language code to be removed from the implementation entirely - they're extraneous at present, and no valid use case is apparent at present.  Therefore the preference is to simplify the current implementation wherever possible, and manage any language considerations using the moduleID for now.
  2. Agreement on the distinction between data and metadata - for now we will use the new refsets to annotate metadata only, and data will be addressed using additional relationships.  Only remaining question will then be how to distinguish between what is technically data vs metadata!
12AttributeValue field immutability in the RF2 filesALL

Just a very quick one (especially for those who were in the MAG yesterday and have already heard this!) - the immutability of the valueID field is specified as being "depends on specific use" - see here:

The MAG are all happy to change this to "mutable", and so are we - however I just wanted to give those here who weren't in the MAG a chance to raise a valid objection in case anyone can identify a really strong reason why this field shouldn't be mutable??

No objections raised

13

Active Discussions for October 2023


14Welcome and thank you!

Welcome to new members!

15Member Nominations

Please let us know if anyone is interested (and who has the requisite domain knowledge and expertise) in applying for a seat on the TRAG - thanks!

We're looking for new members to take the place of some outgoing chairs - if you have any Nominations please let me know either this week or by email after.   Thanks!

16Association Relationship fileAll

In the MAG the requirement for the new Association Relationships (previously called "Additional Relationships") has been identified.

Although they will take the same form as the Inferred Relationships, and therefore be stored in the same format as the Inferred Rel's in the RF2 package, there was still a discussion on whether or not they should be held in the Inferred Rel's file or a completely separate file.

The arguments for retaining them in the Inferred File are:

    • The format is the same, and therefore it could be confusing to users for them to be in a separate file
    • Slightly smaller overhead to maintain and upload

The arguments for putting them into a separate file (with the same format as the Inferred file) are:

    • The precedent for implementing new types of content is to hold them in a separate file, in order to:
      • ...allow for backward compatibility (to allow users to continue to use the Inferred file standalone)
      • ...make it clear for users that this is a new type of content (even though it happens to be in the same format) 
      • ...prevent confusion for users who might not see them as different from the existing Inferred Relationships
    • The source of these Association Relationships (which are almost stated relationships) are different from the Inferred Relationships (which come from the classifier), and there is a potential for confusing systems by adding in a new source to the same file.
    • The maintenance of the ID's could therefore potentially be impacted by having them in the same file.
The arguments for the latter, therefore, appear to be more compelling, and this is the MAG's recommendation.
However, if anyone has any strong opinions either way then please raise them now?
  •  
17Association Relationship file naming conventionsAll

Once the above decision on the implementation of the Association Relationship records has been made, we then need to consider the naming and packaging conventions for any new files that are required.

The proposal would be to follow previous conventions, and therefore be something like this:

  • sct2_AssociationRelationship_Snapshot_INT_[date].txt
  • sct2_AssociationRelationshipConcreteValues_Snapshot_INT_[date].txt


  • However, these do make for long names, so any alternatives are welcome!

  • Also, are there any objections to hosting them in the standard Terminology folder (with the package structure)?

  • Finally, just to check that we want to standardise these files (even if they remain empty) across ALL SNOMED International products, rather than just retaining them in the International Edition? The assumption is that we would want to follow similar precedents (for OWL, Annotations files, etc) and replicate them across all products, but we wanted to make sure there were no contradictions to this before going ahead?
18Derivative product Release package formatsAll
  1. The SI Standards for Derivative packaging formats (and therefore the precedents set for all existing Releases such as MedDRA, GMDN, etc), are that we create packages that are inherently dependent on the relevant International Edition package (as per the MDRS). 

    These Derivatives are solely single refsets/maps, and so don’t mean anything to the end users without the supporting terms and other components from the International content. 

    This is why we have always created the metadata components (refset/module concepts, descriptions, relationships, etc) in the International content, and then made the Derivatives dependent on the relevant International Edition.

    Recently however, during the creation of the new EDQM maps, the question was raised as to whether or not we should change to include the metadata concepts in Derivative packages themselves, rather than in the International Edition.  This would not make them stand-alone (like the IPS sub-ontology for example), as they would still be dependent on the International Edition.

    However, as a Derivative with its own module there may be benefits of the package containing its own metadata concepts?

    The main benefit so far identified has been to avoid the situation experienced in the EDQM Alpha release:

    • the metadata for the EDQM product was published in the December 2022 International Edition,
    • and so the EDQM map content was upgraded in line with the December 2022 International content.   
    • the maps themselves however were not updated, and were still based on July 2022,
    • but the release itself was dependent on the December 2022 International Edition.  
    • this created a slight contradiction in terms of the map release which appeared to be based on December 2022, but actually the metadata itself was the only thing baselined on this release.  The content was only brought up to date with the July 2022 release.
    • Having said all this, the flip side is that if we just push the collaborators to request the metadata to be added to the International Edition at an earlier time, then this situation can also be avoided!

    HOWEVER, is it possible that the issue below in the RT2 release process could also be mitigated by moving the metadata into the Derivative packages themselves?  If we did this, could we potentially then retain the Derivative content in the Refsets' child branches and release from there?

    (eg) 

    • For GPFP we would maintain the content via the RT2 FE which would read/write to MAIN/Refsets/GPFP
    • Given that we would then also include the Module + other metadata in the same branch (instead of in MAIN),
    • ...Could we then version say into MAIN/Refsets/GPFP/2023-04-30, and Release straight out of that branch??


    Changing the way we do things currently would take some work, and so would require a strong business case in order to 

    a) Change our standards

    b) Incur the cost of making the technical + release changes

    Thoughts on the original decision to package them in this way?

    • Everyone comfortable that this was the right decision at the time, but not anymore.

    Thoughts on the benefits/risks of refining this standard?

    • Consensus is that moving the Metadata components into the Derivative packages brings benefits to both the maintainers (SI + NRC's) + also to the end users, as it's easier than having to pull the metadata down from the dependent International Edition.
    • It doesn't have a huge impact however, as the end users still need to download and consume the relevant International Edition when using the derivatives.
    • The big benefit however, comes from combining this change with the new way of managing refsets in RT2 (see below for full details).  The inclusion of this metadata in the Derivative branches in Snowstorm (instead of in the INT branch)allows us to move the Derivatives into their own codesystems, and thereby allow us to retain the different dependencies of the Derivative products on older version of the INT Edition than it would do otherwise in the new world of RT2
      • (as things currently stand the Derivatives would have to be rebased against the LATEST INT Edition content whenever we need to promote them up to MAIN to publish them.  This would force us to bring the Derivatives up to date with the very latest INT Edition content just before publishing the Production Derivative releases, which would be April/October.  All users have confirmed this would be a huge problem for them as they're not yet ready to take multiple monthly releases of the INT Edition, and so desperately want us to retain the dependencies on the Jan/July INT Releases) 
      • Therefore we can continue to Publish the Derivatives in April/October (which is the earliest possible date for most of them because of the delays in collaborating with the external entities), based on the Jan/July INT Edition releases, exactly as the users want.
    •  
    • If we agree on moving the module concepts to the Derivative package(s), do we also need to remove them from the International Edition, in order to avoid duplicates when users implement them in conjunction with the International content?
    •  
    • EVERYONE IN AGREEMENT - 
    •  
    • SO ON RELEASE OF EACH NEW DERIVATIVE IN 2024 we need to:
        • a) DEMOTE the various Derivative metadata components down from the INT Edition in the July 2023 Release
        •      (this would simply involve inactivating them all in the International Edition)
        • b) PROMOTE  them in the various Derivative packages in the Sept/October 2023 Derivative releases.
        •      (this would simply involve activating them in the relevant Derivative packages)
    •  
    • UPON FURTHER CONSIDERATION, WE REALISED THAT INACTIVATING THE INTERNATIONAL CONTENT IS UNNECESSARY, AND POTENTIALLY CONFUSING FOR END USERS.  This also removes the challenges involved with the timing of the demotions, which was going to be problematic either way - either creating active content in Derivatives first, or inactivating in INT first (which causes problems in the Browser)
    • THEREFORE THE NEW PLAN IS TO, ON RELEASE OF EACH NEW DERIVATIVE IN 2024:
      • a) LEAVE the various Derivative metadata components Active in the International Edition
      • b) ADD  the Active Derivative metadata components into the various Derivative packages in the 2024 Derivative releases
      • c) This results in covering off all use cases:
        • i) Users who just want to use the Derivative packages STANDALONE, have the relevant necessary Metadata in the Derivative packages
        • ii) Users who just want to query the International Edition can still see the Derivative metadata
        • iii) Users who want to continue combining the International + Derivative content before use, the Derivative Metadata records should naturally take precedence over the International records, due to the change of module + later effectiveTimes.
    •  EVERYONE happy with the new plan - only possible risk is that one set of the metadata (in either INT or the Derivative package) could potentially be updated without updating the other set and keeping them aligned.  This was agreed to be a very small risk however, as there is no reason to ever update this metadata without inactivating and recreating descriptions, etc
    •  
      • Andrew Atkinson TO IMPLEMENT ASAP AT THE SAME TIME AS MIGRATION TO RT2
        • TRANSITION BEGUN - PLEASE CAN EVERYONE REVIEW THE FIRST FEW PACKAGES CONTAINING THE NEW METADATA, IN ORDER TO ENSURE THAT IT'S IMPLEMENTED AS EXPECTED?
          • GMDN - January 2024
          • NCPT - January 2024
          • MEDDRA - April 2024 (to be published at end of April)
          • HPO - May 2024 (to be published at end of May)
          • EDQM - May 2024 (to be published at end of May)
          • ICNP - May 2024 (to be published at end of May)
          • GP/FP - May 2024 (to be published at end of May)
          •  
        • ****** WAS NOT POSSIBLE TO IMPLEMENT FOR THESE PRODUCTS AS THEY'RE STILL IN THE OLD FREESET FORMAT:
          • IHE freeset - Jan 2024
          • ERA Freeset - Jan 2024
          •  
          • SPANISH EDITION - Already contains 
          •  
        • ANY FEEDBACK ALREADY FROM ANYONE ON IMPLEMENTATION OF THESE DERIVATIVES?????
        •  
        •  
    • DEMO EXACT CHANGES MADE IN GMDN IN MARCH:
      • Records taken from International Edition:
        • Concept
        • Description (x2) 
        • OwlExpression
      • Records NOT taken from Internaitonal Edition:
        • Inferred Relationship
        • Simple Map (as this is just CTV3 - no need to take that???)
      • ****** SHOW EVERYONE ACTUAL RECORDS IN FILES, ENSURE THEY'RE HAPPY WITH THEM (inc. Inferred output in GMDN after classifying - should we actually take the INT Inferred record into the GMDN package?) *******
    • +++++++ NCPT IN APRIL:
      • Records NOT TAKEN from International Edition AS THIS IS A FIRST TIME RELEASE, AND THEREFORE THESE ARE ALL BRAND NEW COMPONENTS:
        • Concept
        • Description (x2) 
        • OwlExpression
        • Inferred Relationship
        • Language Refset
    • +++++++ MEDDRA IN APRIL:
      • Records taken from International Edition:
        • Concept
        • Description (x2) 
        • OwlExpression
      • Records NOT taken from Internaitonal Edition:
        • Inferred Relationship
        •  
    •  
    • QUESTIONS:
      • Any issues with the new approach??  (eg)  VERIFY THAT THE FOLLOWING IS EXPECTED:
        • 1. Reference of moduleID concept to itself (eg) MedDRA module concept (similar to how the Model Component Concept module is defined in the INT Edition) is part of it's own module:
          • id    effectiveTime    active    moduleId    definitionStatusId
            816211006    20240101    1    816211006    900000000000074008
        • 2. Change of effectiveTime to 20240101 (or later) for inclusion in the Derivative package (standard operating procedure for Extensions (which these Derivatives are now effectively treated as), as although content is the same, module is changing)
        • 3. Change of UUID's for components such as OWL records (eg) MedDRA OWL record changes from:
          • id    effectiveTime    active    moduleId    refsetId    referencedComponentId    owlExpression
          • 864e67df-6999-4aa8-819c-c4807b54ce6c    20200131    1    900000000000012004    733073007    816211006    SubClassOf(:816211006 :900000000000445007)
          • ...to 
          • id    effectiveTime    active    moduleId    refsetId    referencedComponentId    owlExpression
            c0d051d1-c830-4d0c-add8-772c8b4d42a8    20240101    1    816211006    733073007    816211006    SubClassOf(:816211006 :900000000000445007)
          •  
          • NO - UUID'S MUST BE RETAINED IN ORDER TO ENSURE CONTINUITY OF HISTORY!!!!
      • Are we happy with the approach for the NEW Derivative products (eg) NCPT ??
        • The current implementation is to ONLY add the metadata into the Derivative packages, and NOT add them into the International Edition
        • Whilst this is potentially slightly inconsistent, it also provides less confusion for users
    •  
19DescriptionType spec improvementsALL
  • Back in October 2023, the MAG agreed that increasing the DescriptionType spec to allow longer terms in Descriptions would be a good idea - see item 4 here: 2023-10-24/25 Full MAG Atlanta Hybrid Meeting 
  • FYI - In the meantime, NZ require a new limit for a handful of terms, and so we extended their DescriptionType in the April 2024 NZ release, in order to allow for slightly longer terms locally until the International spec has been updated.
  •  
  • Because the spec already allows us to increase the length of the field,  the concern is predominantly for impact to end implementers.

  • It’s mostly, therefore, a question of warning implementers that the status quo is going to change
    • We have therefore started a full community consultation in 2024, in order to garner feedback from anyone who may be impacted by the changes.
    • We will also ask if anyone has any issues with the length that we change it to, as we can foresee terms breaching 512 characters (with vaccine product with 10 ingredients for example) - so 1024 would be the next obvious target.  However, at that point it's not clear why we don’t just jump to 4096, given that we already have that configured for textDefinitions… otherwise we could end up having to extend it again within the next few years.
    • The potential problems are for end implementations who have local hard coding, or worse technical restrictions on imports, etc - but it feels like that’s going to be the same problem at 1024 as at 4096?
    • Therefore it would appear that the best plan would be to increase it from 255 to 4096?
  • Can anyone foresee any implementation issues? (other than providing a reasonable lead time to allow implementers to potentially change hard coded limits, etc?)
    • At the moment the only implementation issues we're seeing are that several countries are finding terms that contravene the 255 spec (both in the INT Edition + the MS terms) and so only positive reinforcement for increasing the limits (eg) https://ihtsdo.freshdesk.com/helpdesk/tickets/49593
    • But could we foresee, perhaps, any issues with implementers who might have
      • a) hardcoded the 255 limit and could take a long time to get it changed (especially given how long the limit has remained the same), or
      • b) still be running systems that can't actually cope with >255 characters even if the implementers want to increase the limit?
    • The reason we ask this is that if terms are concatenated (especially Drugs, etc) by out-dated systems, then this could cause Clinical Risks, which we want to avoid at all costs.
    • So perhaps we need a lengthy Community Consultation period (say 6-9 months) to socialise the change before we implement?
      • This would be okay for the current known offenders, as:
        • a)  The International terms have successfully been reduced down to comply with the 255 limit for now
        • b)  The MS customer who had longer terms specialised their DescriptionType format to 4096 in their own extension - the only issue here of course is global interoperability, but this is a lower risk for now than contravening our own specs.
  •  
  • WE ALSO NEEED TO INCLUDE THE SPANISH EDITION + ALL OTHER SI PRODUCTS IN THIS CONSULTATION!!  (as ALL our products would move to 4096)
20Proposal to deprecate the Concept Non-Current (CNC) IndicatorsALL

SOME REFINEMENTS TO THE proposal, for us to review and agree:

The Case For Removing Description Concept Non-Current Indicators

  • The key points of the proposal that are salient to our group are:
    • TODAY                                   = Discuss whether or not there are any known users still using the CNC indicators?
    •                                                  = Discuss whether there are any valid use cases still in existence to retain them? (whether in use or not)
    •                                                  = Are there any dissenting arguments against the assertion that CNC indicators are completely
    •                                                    obsolete, and that it's more efficient and reliable to determine the relevant Concept's state from the
    •                                                    Concept record, rather than from the AttributeValue record?
    •                                                 = Are there any dissenting arguments against the assertion that CNC indicators cause additional work
    •                                                    for all creators of SNOMED CT content, in terms of maintenance, packaging and validation?
    •                                                 = Are there any dissenting arguments against the assertion that the removal of CNC indicators 
    •                                                    will serve to simplify the understanding of SNOMED CT, + help to lower barriers to adoption?
    •                                                  = Discuss any impacts to the terminology, or to any users, when removing the CNC indicators?
    •                                                    (beyond our internal impact, which is restricted solely to removing/simplifying existing code)
    •                                                  = Discuss who, if anyone, we should specifically target for feedback on the proposal?
    •                                                 = Agreement in principle of the deprecation of CNC indicators by the TRAG.
    •  
    • PROPOSED TIMELINE (updated)
      • May 2024                               = Publication of an official Notice of Deprecation, and request for feedback -
                        • WHAT WOULD WE LIKE TO INCLUDE IN THIS TO ENSURE FULL VISIBILITY???
      •                                                     a)  Inclusion of this proposal in the "Early Visibility" notes????
      •                                                     b)  notes in the RF2 Specification?????
      • Just mark the specification as "this content is being deprecated" but keep the spec around for some time for those lagging...
      •                                                     c) the exact plan
      •                                                     d) proposed timelines
      •                                                     e) consultation period 
      •                                                     f) feedback channels, etc. 
      •                                                     g) Specifics for this deprecation - (eg) whether or not the final plan included complete removal of the 108mb of data after say 12-18 months after inactivation?
      •                                                    At this stage, no changes will be made to any products or systems.
      •                                                    Changes should be considered to Editorial Guidance and Educational Changes?

      • July 2024 INT Edition         = Inactivation of all existing CNC indicators,    
      •                                                          + Removal of all code creating new CNC indicators
      •                                                          + Removal of all code relating to the display and validation of CNC indicators
      • January 2025                       =  Removal of all code relating to the display and validation of CNC indicators, except in the most general structural tests for refset members eg that a referenced component id exists.
      •                                                     + Inactivation of the 900000000000495008 |Concept non-current (foundation metadata concept)| concept. 
      • Future                                     = We’re not at any point suggesting surgical extraction of the historical CNC indicators (using negative delta's or any other such mechanism!)  Just inactivation and keeping them static in perpetuity after that.
      • HOWEVER, given that they consume 108mb of the International Edition, is there an argument for complete removal?
        • YES, we can inactivate them for 6-12 months then REMOVE these records COMPLETELY (not AttributeValue files)
        • WE SHOULD ALSO REMOVE THE ENTIRE STATEDRELATIONSHIP FILES WHICH HAVE BEEN INACTIVATED FOR 5 years or so now
          •  
          • YES AGREED - LET'S MOVE IT INTO A STATIC PACAKGE ON MLDS AND KEEP IT SEPARATE.
          • WE SHOULD PROBABLY GIVE THE USERS 6 MONTHS NOTICE FOR COMPLETE REMOVAL
          •  
      • Andrew Atkinson  TO WRITE UP SOME COMMS AND SEND OUT ONCE TRAG HAVE FORMALISED PROPOSAL....
      •  
      • WE SHOULD ALSO DESIGN AND AGREE A TEMPLATE FOR FUTURE DEPRECATIONS - previously it's just been ad-hoc - but would be useful to always include the information that you consider critical for full visibility (eg)
          • Rationale (at least a summary paragraph) - or a link to the original Discussion which details the reasons behond it
            • But we need to consider document archiving in this respect as well, in order to keep current docuemntation clean.
          • Best early visibility notificaiton channels:
            • Member Forum Briefing Note - INITIAL statement to say "we have decided to deprecate this..."
            • Once MF confirmed okay - send confirmation out to:
              • Release Management email channels
              • Release Notes (early visibility for several months first)
            • Proposed timelines
            • Feedback channels (google form etc) for them to provide critical feedback if necessary
            • Feedback period needs to be formally cut off - say 2-3 months before implementation time, to allow us to take any action if required.
            • Documentation - Release, RF2, Ed guides, education etc
              • RF2 Spec can retain info on the components being deprecated, and state why they were removed
              • Can also provide a timeline for when they were inactivated + then subsequenetly removed
              • Can also provide a link to the new locatin where the Static data is being held forever
            • Potential Impacts to users:
              • (eg) If the Release Package suddenly becomes much smaller or larger - then tell people why so that they aren't suprrised and consider it to be an error
              • (eg) Changes to structure or format of the Release package - this could break hard coded upload routines
                • WE agreed NOT to leave empty files (with just headers) in the package as this is messy and also incurs an education overhead to explain to people why the files are there but empty!
            • Historical audit trail of changes 
              • Something that says "in 2018 we inactivated all Stated Rel's and created OWL files', in 2024 we intriduced new annotations files, etc 
              • (eg) like the Early visibility page but a historical trail of what DID happen and when
              • There may already be something like this in Appendix A of the Release File Spec which we could extend and use...
        •                                           
  • .
  • Any other Feedback?
  •  
21DEPRECATION METHODS:ALL
  • Multiple different use cases:
      • 1.  Transparency in allowing users to see what's being Validly removed from history due to mistakes
      • 2.  Obsolete content that wasn't a mistake, is just no longer relevant and we want to tidy up history (especially where we're talking about thousands of records (like CNC indicators)
      • 3.  Legal issues (such as licensing issues) - where you CAN'T retain hisotry ANYWHERE (even in a static folder) and so history has to be completely deleted and never seen again
      • 4.  UNSAFE data (ie) clinical risks, technical issues that cause dangerous content issues (duplicate ID's, etc) - that should again not be kept in a separate package that's available to users, in order to prevent them being loaded accidentally!
      •  
  • Method for 1 + 2:
    • Inactivate it all first for a certain period...
    • Remove it completely on agreed date
    • Put all removed data into its own separate package, in a "static package" in MLDS 
      • This allows users who absolutely CANNOT live without the deleted content to reload it into their extensiovs
      • We would need a spearate place in MLDS ??per product?? and also split between each use case above?? (so a repo for "removed content due to obsolescence" + a repo for "removed content 
    • Do we also then need to change status to something other than 0 or 1?
      • Or perhaps even move it to a new "trash" module or something?
      • OR do we retain each row in its exact state from the last Published state, as this gives users the opportunity to know exacty what needs to be deleted from their own extensions, etc (as the Triple index still exists as it would in Prod)
    • the Problem with this approach is whether or not the risk of someone then misinterpreting this "removed" package (and uploading it into their systems instead of using it to remove data!) is too high to keep the records in the same status?
    • OR perhaps we retain the info of which records to delete in the Annotations refset?  So we could add an Annotations record for each deleted record, which would contain the Triple (ComponentID + ModuleID + effectiveTime) so that users could know exactly which records need to be deleted...
    • ALSO NEED TO CONSIDER HOW TO PROVIDE THE USERS WITH A STANDARDISED METHOD 
    • Release Notes would also need link to MLDS static pacakge
    • Naming convention for the Static Pacakge needs to be OBVIOSU + content in the JSON and Readme files made clear to mitigate the risk


Discussions to continue in October 2024 meeting...

22Spanish Edition release dateSpanish Edition users

Now that we have proven that we can refine the timelines required to build, test and validate the Spanish Edition release packages, we now need to start the discussion regarding the Release Dates.

Recently we changed them to bring them forward to 31st March/30th September, in order to reduce the time between the dependent International Edition + the Publication of the Spanish Edition package.

Now that this has been trialled and confirmed, we should discuss what dates would be most helpful to the Spanish Edition users.

The end users can most likely benefit from moving our release closer to theirs (rather than moving them earlier and continuing using the "July" and "January" releases). For example, Argentina publishes November 30, Spain December 1st, Uruguay December 15th.  So we are considering moving the Spanish release to 1) October 30th, or mid-November 2024, or to a fixed date late in the month (e.g., November 25 to 27).  (see email trail with Guillermo 27/02/2024 18:45)

This would be with a view to socialising the plan for several months (assuming that we can agree on the best approach), and giving the end users time to adjust to the new schedule.  This would therefore likely be targeted for actual transition in 2025. 

  • WE NOW HAVE  A NEW REQUIREMENT AS THE SPANISH COMMUNITY AREN'T ABLE TO CHANGE THEIR RELEASE DATES TO BRING THEM FORWARD, in order to take advantage of the additional time gained by us releasing the Spanish Edition a month earlier!!  (they Release Nov/May)
    • So instead of continuing the refine the process down in order to release the Spanish Edition even earlier each year, should we instead:
      • Revert the Spanish Edition releases back to April/October
      • Just cut off the translations much later in the cycle, in order to allow us to use a much later monthly INT Edition as the baseline? (eg) Sept/March?
      • This would allow many more translations to get into each Spanish Edition release, but still allow the users to retain their own Release dates?
    • HOWEVER - IS THIS JUST A COUPLE OF CUSTOMERS, OR ALL OF THEM?????
    • NEED TO UNDERSTAND THE FULL USE CASES INVOLVED HERE, SO NEED TO HEAR FROM:
      • Guillermo
      • Spanish Extension NRC?
    • WHAT ARE OUR THOUGHTS?  ANY IMPACT ON ANYONE, OR SHOULD WE SOCIALISE WITH SPANISH COMMUNITY?

AAT to socialise a proposal to Change to:

  • May 10th + November 10th (based on INT Edition April 1st + October 1st) 
  • The first release on the new cycle would be targeted for 10th May 2025
  •  
23Spanish Edition frequency of deliverySpanish Edition users
  •  Guillermo initially confirmed that many Spanish Users are requesting more frequent delivery of the Spanish content.
    • Some ideas they have for addressing this are:
      • 1.  Allow Spanish users to build + publish their extensions based on the UNOFFICIAL preview release that we currently share with termMed - BUT this is a risk, and not great for interoperability
      • 2.  Allow Spanish users to version the content "locally" at ANY TIME, in order to baseline for their extensin - again not great for interoperability
      • 3. Move Spanish Edition to a monthly release 
        • BUT this is a significant overhead for termMed + SI, and so we asked for use cases to support this requirement...
  • Perhaps best would be a move to a Frequent Delivery of a Spanish Drugs extension, as this is the predominant use case Guillermo's users have for needing more freuqent delivery of Spanish contnet - and therefore trying to move the entire Spanish Edition (with it's rigid requirements for FULL translation of the INT Edition, etc) would be a large (and potentially unnecessary) overhead.
  • To be discussed in October 2024 meeeting...


24Differences between the format of Extensions and the SI SpecMatt/Dion to present

Australia have identified multiple differences between their Extension (which was valid from a Spec perspective), but different to other Managed Service extensions - would be great to discuss them through in APRIL 2024 and decide:

a) Should the spec be tightened?

b) Should the Validation (RVF, etc) be tightened to ENSURE alignment of extensions with the spec?


25MD5 Hash update

All

As we all know, our current MD5 uses the standard 128 bit encryption, giving a 32 digit hash.

However there are newer and more effective methods out there which we could in theory upgrade to, for example sha256Hash (which has been tested and proven already elsewhere in the community)

  • Do we think that this would be worth the effort to migrate over to?
  • Does any have any feedback on use (or non-use) of the MD5 files?
26Frequent Delivery for Managed Service

Whilst the overall MS move to Frequent Delivery won't be made available to MS customers until after the International Edition transition, we also don't want to diverge the code bases. 

Therefore, we need to consider and include configuration items within the code to allows the MS Projects to move through the new Frequent Delivery workflow WITHOUT moving to Frequent delivery (for example, we could just enable the basic mandatory automated SAC and nothing else?)

  • We have already had to introduce a small amount of change into the MS authoring processes, in order to ensure that the MS code base remains in line with the International code.
  • Comments and feedback welcome...
  •  
  • **** SI have now made the decision to standardise ALL of our Products in terms of the format of the packages
    1. This means that the MS packages are now being migrated over to Delta-less packages
    2. Any feedback on this?
    3. Same goes for the Derivative products - so far:
      1. GMDN
      2. MedDRA
      3. Have been migrated over - any feedback?
  • APRIL 2022 - only feedback was from Guillermo, who confirmed they are still creating extensions with Delta files - we assured him that we're not at the point of enforcing the new standards across ALL SNOMED Releases, just across all products published by SNOMED INTERNATIONAL - so he can continue to include/exclude the Delta files as required in his own extensions.
  •  
  • WE ARE IN THE PROCESS OF MIGRATING NOW - MORE FEEDBACK FROM USERS NOW??? NEW REQUIREMENTS???
    • Australia provided great example in October 2023 meetings, concluding that:
      1.  the key is in bringing as much validation up front to authoring point as possible +
      2. also managing scope of projects properly so promotion is efficient +
      3. making the Release packaging and validation processes as thin as possible (Release Management now happens at time of Promotion to MAIN)
    • HEAR FROM NORWAY IN 2024 TRAG MEETING WITH A FULL REPORT ON MIGRATING TO FRI IN THE MS?????????
27Annotations - Language Code ALL

Hi Matt Cordell Dion McMurtrie Michael Lawley Alejandro Lopez Osornio Mounir Bouzanih Patrick McLaughlin Mikael Nyström Stuart Abbott Gábor Nagy Reuben Daniels 

There are several options for managing the Language code -

  • see the options here:  Annotations review 
  • Plus also see the "Representation of annotation data type" section of the MAG proposal: SNOMED CT Annotations (this is because the other option was to include "@language" in the "annotationValue" field, which would be a problematic idea for implementations as the entire field would have to be parsed each time in order to extract the language code) 
  • Please provide feedback asap before the next TRAG meeting in October, so that we can try to unblock development.  thanks!
  • Decision made to use the "@[language]" (eg. "@en") in the "annotationValue" field
  • ***** BUT THEN THE MAG JUST MADE A NEW (unanimous) DECISION - TO REMOVE ALL LANGUAGE CODES FROM THIS IMPLEMENTATION (as they're extraneous at present, and no valid use case is apparent at present)
  • Any other major concerns with the decision made to remove the language code completely?
    • YES - Mikael has strong objections so we took a vote and adding a new Column (which would be empty (NOT null) when not required) won 8 votes to 5
  • Changes upcoming  (within next few months):
    • Dialect added to Language column
    • Changes to refsetDescriptor
    • Upcoming content in future INT Releases
28Annotations - Documentation for Refset File typesALL

The Primary Use Cases for Annotations have been provided as follows:

    • Attribution                             -  (eg)  AJCC vs. UICC tumor staging concepts
    • Editor notes                          -  (eg)  Reference to section of editorial guide when "nonconformance" is used as an inactivation reason
    • Authoritative reference        -  (eg)  Point to sources of truth such as UpToDate or Clinical key pages
    • Regulatory data for drugs   -  (eg)   approved uses, off-label uses 
  • All of the above examples appear to fall nicely within the new "METADATA" definition for Annotations...
  • Except, perhaps, for the last case??
  • Thoughts??

The new Annotations Refsets do not conform to any of the existing Refset types/patterns:

We likely therefore need to agree on a new type/format - this will be discussed first in the MAG in the morning and then in the TRAG in the afternoon, with the aim to agree new refset types in these meetings so that they can be used from the December 2023 International Edition Release onwards, and also to create the necessary documentation for the new Refset types in Confluence (as we did for the last new Refset type - the OWL Expression refsets:  

  • New types / formats agreed?
  • Do we need to DEPRECATE the earlier versions of the Annotations refset here  5.2.1.6 DEPRECATED: Annotation Reference Set ?
  •  
  • Refset Type formats:
    • Additional fields for the Member Annotation Refset (created to support annotations on members of any refsets):
      • refsetId                               - Identifies the reference set to which this reference set member belongs. In this case, a subtype descendant of |Member annotation type reference set|.
      • referencedComponentId - A referred the referencedComponentId in the referencedMember entry in a refset.
      • referencedMemberId       - A reference to the UUID of a member in a reference set. The entity to which the annotation is being applied.
      • Annotation                          - Any descendant of 900000000000459000 |Attribute type (foundation metadata concept)| in the metadata hierarchy.
      • .
    • Additional fields for the Component Annotation Refset (created to allow annotations to be assigned to any SNOMED CT component):
  • Documentation complete?
  • NO - Andrew Atkinson to complete proposed Specs and send out internally for review, before sending to TRAG for final review
29Annotations - Additional Relationship fileALL
  • Question - do we need to rush the Additional Relationship file into the December/January release urgently (in order to get Language tag in)? 
  • .
  • Or can we put this in a future release once we've got the refsets in now?
  • .
  • AAT to take this offline and put a proposal together to get the Additional Relationships file (same format as ConcreteValues file) + some technical content (for initial use cases like language tags etc - see Australia) in as soon as possible
    • TOPIC FOR THE MAG ON WEDNESDAY 
30Annotations - ValidationAll
  • What validation, if any do we need?
    • MUST BE UTF8 compliant (and we need to lock down what we mean by this as means different things to different people - see Peter)
    • Exsiting refset validation for COMPONENT ID's (or UUID's) - (doesn't have to be Active, just EXISTING component)
    • non -empty Annotation validation
    • Andrew Atkinson to write up in tickets and request Dev work ASAP
  • Anyone already have assertions they'd like to donate?
31

SNOMED Release Package causing file path length issues in Windows environments.


WEDNESDAY (MEETING 2) WHEN US NRC IS IN ATTENDANCE:

  • The base file name is 63 characters:  SnomedCT_ManagedServiceUS_PRODUCTION_US1000124_20230301T120000Z.zip
  • When the zip package is decompressed on a windows based computer using 7zip, the base folder name is the same length as the zip package file name:
  • Drilling down into the second level directory, we see that the base folder is duplicated:
  • The user must click through the duplicate folder before actually getting to the Full and Snapshot folders:
    •  
  • The duplicated folder is easily viewable when looking at the file path.
    • C:\Users\snyderjw\Desktop\SNOMED\
    • ...SnomedCT_ManagedServiceUS_PRODUCTION_US1000124_20230301T120000Z\...
    • ...SnomedCT_ManagedServiceUS_PRODUCTION_US1000124_20230301T120000Z
  • To access files in the release package, the SNOMED path and file name can reach up to 218 characters.
    • ..\SnomedCT_ManagedServiceUS_PRODUCTION_US1000124_20230301T120000Z\...
    • ...SnomedCT_ManagedServiceUS_PRODUCTION_US1000124_20230301T120000Z\
    • ...Snapshot\Refset\meta\
    • ...der2_cissccRefset_MRCMAttributeDomainSnapshot_US1000124_20230301.txt
  • The maximum file path length allowed in Microsoft windows is 260 characters. This leaves distributed file systems only 42 characters, which can easily be exceeded by simply placing the zip package in the following directory
    • “C:\Users\username\Documents\SNOMED\Downloads\USEdition\March2023\”
  • When attempting to copy / paste or work with the files, cause the windows operating system to display an error message to the user as follows:
    •  
  •  This error causes the user to move and unzip the package in a shorter directory path to work with the files, which is not always feasible. While the duplicated folder structure issue has always existed, it has been accentuated by the recent change in the zip package and upper level folder renaming which increased the length.

Solution Request:

While some windows server and client systems have been configured to allow file lengths greater than 260 characters, not all systems or local computers have been so configured.

The US NRC is requesting that the duplicate folder structure be removed from the zip package during the zip package generation process to minimize file path length issue in windows environments. 

ACTIONS

    • If I download the US Edition from March 2023, I don't get the duplicate base folder structure - albeit using a Mac!
    • PROVEN THIS IS A WINDOWS-ONLY ISSUE...
    • Has anyone else experienced this issue on Windows or anywhere else?
    •  YES!  
      • HOWEVER Mikael confirmed this is NO LONGER an issue with the native winzip program in the latest version of Windows!  So upgrading Windows resolves this issue.
      • Stuart confirmed that it worked for him too, and also if we change the format we would have to make EVERY package different for every user in the world - not feasible!
      • Gabor had checked and it is a configuration item that you can change in the Windows Registry, even on older versions
    • THEREFORE ONLY ACTION IS FOR SNOMED International to add some guidance for Windows users - perhaps to the Readme files?
    • ALSO AAT to check Release Packaging Conventions doc, as Gabor said that our MS PAckages contravene OUR OWN CONVENTIONS for the 4th Element (eg) "_US1000124_", etc ????????
    • NOTE:  Everyone agreed that the TRAG should occasionally review ALL of these RELEASE DOCS and confirm that they're still up to date, as things change quite frequeently so we should have a formal ACTION in place to review and update where needed at least once per year!!
    • .
32IPS Terminology ProductAll

Quick run through of the changes that we're proposing to make in the final Production release in Q4 2022, as compared to the BETA release

(ie) discussion of the feedback that we accepted and have implemented in the Production release:

  1.  INCLUSION OF THE “EML” (new Drugs refset) IN THE FEEDER FOR THIS PRODUCT FROM 2022 ONWARDS
  2. IPS Terminology URI:

         *** PLEASE SEE SECTION E here for final solution:

ACTIONS:

  • Reminder that this is a SNOMED International product, but NOT a SNOMED CT product, which means it's non conformant to many of our normal standards
    • "RF2-like", purely from a structural point of view
    • HOWEVER, it will NOT be a full, formal RF2 package
    • It will contain nothing but SNAPSHOT data, because it's going to be re-generated every year based on the latest data, rather than authored from release to release
    • This means NO HISTORICAL mechanism will be provided - users will need to create their own if required
  • Another reminder that this product is NOT for members, it's only useful for non-members (mostly those new to SNOMED)
  • Questions on any changes planned?
  • OCTOBER 2022: Any final feedback before finalise first Production release?
    • YES!!! Following feedback received:
    • a)  FHIR and others have problems with the format - they have to add extra functionality for their non-member countries to use a new format - in addition, the use base is very diverse, across members and non members - this is because entities like HL7 are trying to support different users across these domains.  This means that whilst the intention was only ever to target non-members with this product, this hasn't been the practical reality.... THEIR REQUEST IS TO THEREFORE:
    • b) Various users therefore require the MDRS file to be included, in order for this product to be more usable across both types of users.
    • c) It has also been requested that we consider turning this product into an EDITION!  This would mean including all of the historical information and potentially other content, in order to turn it into a "mini SNOMED", however this was never the intention of the original product, and so is not likely to be accepted. 
    • d)  The problem with using the IPS FREESET is that the Freeset contains only 8000 concepts, whereas the IPS SUB-ONTOLOGY expands everything to about 16,000 concepts!! 
    • It was therefore suggested that perhaps in order to address this requirement instead, we could scale up the IPS RF2 Refset product, to include all concepts in the IPS Terminology product?  (currently there are nearly double the amount in the IPS Terminology product due to the expansion of the sub-ontology). This would then allow the users to get the historical info from the IPS RF2 Refset product instead...
    • e) Michael Lawley raised the following query: 

      I know that IPS is "NOT SNOMED" and thus maybe doesn't need an update to the SNOMED URI spec?!?, but the following is not documented in that spec and again creates cost for venders to do custom support for IPS rather than just re-using the existing http://snomed.info/xsct/... approach – it's not really clear what the value of using /ips/... is?

  • AAT to discuss with the business and come back to everyone with potential solutions on Wednesday...
    • We can include the MDRS, just with a circular reference to itself (as it's supposed to be a standalone product, not dependent on INT or any other package!)
    • With respect to the history requests, there is no appetite to include these in the IPS Terminology release format.
    • However, we have one potential compromise - how about adding the additional content from the IPS Terminology scope into the IPS RF2 Refset release?  That way you naturally get both the MDRS + Histroy mechanism included?
      • Only drawback we can see is that removal of parents etc in the calculation of the sub-ontology, would not then be perfectly represented in the RF2 inactivations, and so we'd have to all be happy that there may be concepts that are removed each cycle because of the unusual circular mechanism involved in
        • a) firstly calculating the sub-ontology based on the original scope of the IPS Freeset, then
        • b) using that wider scope to feedback into a new Refset in the Refset tool, and finally
        • c) basing the IPS RF2 Refset Release on this new refset in the tool
        • (otherwise if we just feed it straight back into the original IPS RF2 Refset in the tool, it will grow exponentially, because the next cycle of sub-ontology calculation will start from the 16,000+ scope and then expand it again from there! 
      • So this won't really work!
  • So we agreed to trial a new version of the IPS Terminology format:
    • MDRS file to be added to the package
    • IPS RF2 Freeset file to be added to the package
    • Change URL spec to "xsct" as per Michael Lawleys' recommendation in the TRAG meeting...
    • Extra step in calculating the subontology Snapshot FROM 2023 ONWARDS (as no history required for this first 2022 Prod Release):
      • Add in any concepts that had "previously" been in the IPS Terminology package, BUT check they are no longer, either because:
        1. They're now inactive, or
        2. The modelling has changed and these concepts are no longer in the scope of the sub-ontology
  • NOVEMBER 2022:
    • We published the Production release package, with the agreed improvements:
      • MDRS file added to the package (with circular self-reference!!)
      • IPS RF2 Freeset file added to the package
    • THOUGHTS????
  • APRIL 2023:
    • ANY FEEDBACK FROM USING IT IN PRODUCTION SYSTEMS???
    • YES!
      • Previous changes to the file format addressed the issues that they had - so that's good
      • People were however unhappy that this is being published separately, 
        • ...and via a different mechanism to the usual MLDS distribution method
        • This creates more work for implementers and NRC's to consume
        • MLDS is already full of historical non-SNOMED CT content (Resources, etc)
        • The use-case for Members using the IPS Terminology product (that was originally designed specifically for non-members to use as an intro to SNOMED before getting full SNOMED licence), is that they want to be able to create queries (FHIR value sets, etc) that work for BOTH Members and non Members, allowing Members to transfer data to and from non-Members.  Therefore in order to make this happen, and to be able to test the end to end, they need to be able to test them against not only the FULL SNOMED (that Members are using) but ALSO against the IPS Terminology scope (that non-Members are using).
      • HAVING DISCUSSED THIS INTERNALLY WE WOULD BE HAPPY TO PUBLISH IPS TERMINOLOGY VIA MLDS (as well as the IPS part of the SNOMED website) - WOULD THIS RESOLVE THIS ISSUE??
      •  
      • IN ADDITION, some people are unhappy with the separate IPS URI (eg) "http://snomed.info/ips/999991001000101"
        • HAVING DISCUSSED THIS INTERNALLY WE WOULD NEED A REALLY STRONG USE CASE TO CHANGE THIS AT THIS POINT - CAN ANYONE PROVIDE ONE, OTHER THAN THAT IT'S A BIT IRRITATING?
        • .
  •  
  •  
  • 2023 - ROB TO PROPOSE ADDITIONS TO THE IPS TERMINOLOGY SCOPE...to include 14 structural concepts
  •  
    • AAT TO TALK TO DEV TEAM TO GET THESE ADDED (Kai + Rory) IN TIME FOR THE NOVEMBER 30th 2023 RELEASE - COMPLETE
    •  
  • AAT to start publishing IPS Terminology on MLDS AS WELL as on the IPST download site, to allow easier access for Members.
  • Request was also made for the URI to change from http://snomed.info/ips to something more standard
    • This was initially rejected internally, as the entire point of this was to distinguish IPST from other SI products
    • However, Australia then confirmed that Ontoserver CANNOT consume this type of API. 
    • Peter Williams also suggested that maybe Snowstorm and/or the Browser might not consume it either...
      • If this is the ALSO the case then we would have a stronger business case to change the URI 
      • Peter will therefore confirm shortly and we will decide from there...
  • ONCE ALL DECISIONS MADE WE NEED TO
    • a)  Inform the community if any changes to be made, and 
    • b)  Update the SI URI Spec (again if any changes are to be made, or even if we're keeping it as .../IPS/... as this isn't in the spec??
  •  
33Documentation

All

Question:  Do we need to update the release file specification to reflect the new practice of not including the delta release file type in the International Edition release package?

  • As we know, the delta format is still "valid", but it is no longer provided as part of the International release package.
  • Also we now provide a tool to generate delta files.
  • We've updated the Delta file specifications (3.2 Release Types) to specifically mention the removal of Delta files from the International Edition:
    • Please note : 

      • Delta files have been removed from the SNOMED International release package, but a Delta Generation Tool is available for those who need it. The Delta Generation Tool allows users to create their own Delta between two fixed release dates - you can find it here: https://github.com/IHTSDO/delta-generator-tool/releases.
    • BUT this doesn't include ALL Extensions + Derivative products - does it need to??
    • It also states at the top that :
  • ALSO the RELEASE PACKAGE CONTENTS page is definitely out of date:
    • 3.4 Release Package Contents
    • UNLESS we consider this to still be useful info for historical packages that still contain DELTA files? (or other extensions outside of SI control that still include them??)
  •  
  • If we need to do this, let's walk through it in the Release File Spec docs...
  • Andrew Atkinson to implement changes in the Documentation??????
34Refset  processes in the post-RT2 world

All

Options to be discussed (see local Notes "RT2 New Process")

MAIN POINTS:

  • The International Derivative releases have always been dependent on Jan/July, in order to align with the fact that most end users still only take the Jan/July releases, and not the other monthly releases.
  • The new RT2 integration with snowstorm branches greatly improves the quality, because it allows the authors to run full validation against the new derivative content BEFORE promoting, thereby allowing identification + fixing of most issues before they hit the Release cycle. (eg)
    • MAIN/Refsets/GPFP,   MAIN/Refsets/ICNP,  etc
  • However, in order to actually RELEASE these derivative products, we’ll need to Promote the Refset content up to MAIN/ (as the metadata content is in the International Edition, and we can’t currently export content from multiple snowstorm branches into SRS for the same release, just from one branch)
  • Before you’re allowed to promote in the AP, you HAVE TO re-base and validation FIRST

    • The re-base process will pull the content through from the LATEST International content in MAIN, which may include monthly content from later releases than the recent JAN/JULY release that we originally wanted to base the Derivative release upon!

  • This makes it inherently less flexible in terms of preventing re-basing against later monthly International releases, and therefore extremely difficult to retain dependency on JAN/JULY releases.

OPTIONS:

  1. BEST option appears to be to allow the Derivative refsets to be dependent on the month prior to that in which they're Published (eg) March/September for most derivatives.
  2. However, is it possible that if we were to make a different decision on the item above, then this issue in the RT2 release process could also be mitigated by moving the metadata into the Derivative packages themselves?  If we did this, could we potentially then retain the Derivative content in the Refsets' child branches and release from there?

    (eg) 

    • For GPFP we would maintain the content via the RT2 FE which would read/write to MAIN/Refsets/GPFP
    • Given that we would then also include the Module + other metadata in the same branch (instead of in MAIN),
    • ...Could we then version say into MAIN/Refsets/GPFP/2023-04-30, and Release straight out of that branch??
  3. The final option is moving to Monthly releases for Derivative products as well - however:
    1. This is problematic from a capacity/practical point of view, and
    2. This would require significant discussions with all of our collaborating entities to sign off on new agreements (for those who have tangible inputs into the process), including monthly deadlines, etc - This could not be achieved quickly so would need to be discussed with 2024 in mind at the earliest. 
      1. The alternative to this would be to move just SOME of the derivatives (the straightforward refsets for example which don't require much/any external collaboration) to monthly schedules, and keep the others on annual/6 monthly schedules.
      2. However, this would be a significant operational issue, as the processes are already complex enough without introducing further complexity in terms of different derivatives runing on completely different processes.

We should discuss options and agree the best way forward for retaining quality within the Release process vs impact to the users.

  • Option 1
    • No-one is in agreement with this option!
    • This would cause real problems for NRC's (let alone end users) who would struggle to keep up with downloading and consuming multiple monthly releases.  In addition, they wouldn't be able to then publish multiple releases of their own to the end users, containing the usual Jan/July changes + then extra releases for each month that is a dependency for the Derivative releases.
    • Finally, many of the entities doing Translations are struggling enough to keep up with the pace, without adding additional stress and complexity.  This option would therefore completely prevent them from consuming any of the Derivative products.
    • This Option is a non-starter.
  •  
  • Option 2 
    • The Pro's are far greater here - as all of the users who can't keep up can continue to download just the Jan/July INT Edition releases, and then consume whichever Derivatives they need.
    • Andrew Atkinson  to put forward this proposal, which would be to:
      • a) MOVE all of the Derivative content in Snowstorm from the INT Edition branch into their own Codesystems (checked with Rory and Terance and should not be a problem)
      • b) CHANGE RT2 to use the new individual codesystem branches for reading + writing each Derivative content to and from RT2 (checked with Brian and Rick and should not be a problem)
      • c) DEMOTE the various Derivative metadata components down from the INT Edition in the July 2023 Release
      •      (this would simply involve inactivating them all in the International Edition)
      • d) PROMOTE  them in the various Derivative packages in the Sept/October 2023 Derivative releases.
      •      (this would simply involve activating them in the relevant Derivative packages)
      • e) THEN EACH CYCLE WE WOULD:
        • i)  Upgrade each Derivative Codesystem to the relevant Jan/July INT content
        • ii) FREEZE the content in each of those "in flight" codesystems, to prevent any more re-basing until the Release cycle is complete
        • iii) VERSION in each relevant Derivative Codesystem
        • iv) RELEASE from each relevant Derivative Codesystem
    •  
35Update to the .JSON file metadata - addition of "Package Composition" data

ALL

Now we've used this file for several months, do we have any suggestions for improvements?

  1. Andrew Atkinson to put together proposal to include following New fields:
    • URI that identifies the package being published
    • PackageType (ie) Edition or Extension or Derivative
    • List of modules used
    • Default Namespace 
    • Default module to start authoring
    • Country tag
    • Custom tag
    • ALL INFORMATION FROM THE README FILE (which is neither human nor computer readable)
      • MANIFEST INFO
      • Licencing info
    • JSON SCHEMA for this JSON file
      • (to allow computer readable version of how to read the JSON file)
    • .
    • ANY OTHERS????
    • .
    • JUST TO CHECK WE STILL NEED THIS GIVEN ANNOTATIONS IMPLEMENTATION??
    •  
    • TRAG TO REVIEW THIS PROPOSAL IN OCTOBER 2024 + IF RATIFIED WE'LL IMPLEMENT SHORTLY AFTER
  1. Removed fields:
    • ANY TO REMOVE???
    • .
    • .
    •  
36

Computer readable metadata


* MAG crossover

Andrew Atkinson

  1. Suzy introduced the topic for discussion...


    Suzy would like to raise the question of creating computer readable metadata, and raise questions such as whether or not to include known namespace & modules? 
    Or just the current metadata for the files in a machine readable format? 


    CAN WE PLEASE REQUEST THAT PEOPLE SHOUT NOW IF THEY HAVE ANY FURTHER REQUIREMENTS FOR THE METADATA PROJECT??

    WE NEED TO FORMALISE THE SCOPE IF WE'RE GOING TO BE ABLE TO ADD THIS INTO THE WORKPLAN FOR 2024 - PLEASE SUBMIT REQUIREMENTS TO ME BY 30th September OTHERWISE THEY MAY NOT MAKE IT INTO THE SCOPE OF THE FIRST PHASE OF THIS PROJECT...

    Suzy Roy to provide an update on progress:

    • All agreed that whilst this is a large topic, we should start somewhere, and get at least some of the quick wins in (then request the change to content via the CMAG):
    1. Check where the progress with the namespace metadata has got to - can we progress this?
    2. Code systems (and versions) of the map baselines
    3. Common strings such as boiler plate licence text etc
    4. Description of use cases for the various refsets (using the text definition of the Refset concetps themselves) - either json or markdown representation of multiple pieces of info within the same field.
    • Michael Lawley to provide an update from the related MAG topic...
    • TRAG agreed that this should be incorporated into the discussions with the continuous delivery, in order that we can plan the changes here in line with the transition to more frequent releases. To be continued over the next few months...
    • Michael Lawley to kindly provide an update on his work with David to help design and implement the solution - this will now be in the second TRAG meeting of the April 2019 conference, after they have met together....
    • Ideas:
      • Some human readable metadata could potentially live as descriptions (which can then be translated)? David to discuss further...
      • David will mock up something in Json...
    • Michael + David + Harold agreed to create a straw man to put up in the next meeting and take this further...
    • This should now be combined with the Reference set metadata topic, to address all updated metadata use cases - Human readable, Machine readable, etc
      • We need to setup a JOINT Working group to deal with this!
      • Dion kindly volunteered for this group
    • We've added a new machine-readable file to the International Edition this cycle, which can be refined for future usage:
    •  
    • Suzy Roy kindly volunteered to run a Project Group later in 2021 to refine and improve this data as needed going forward:
      • Volunteers confirmed in October 2021 TRAG meeting:
        • Dion, Mikael + Alejandro
        • + Andrew + Peter from tech team
        • + need 2 volunteers from MAG (as SMT decided we need wide range of views)
      • Suzy to setup meetings once we have MAG volunteers confirmed...
    • This will be rolled into the holistic discussions on Metadata in the new Metadata Working Group... Working Group: Refined Metadata 
      •  
      • Plus new requirements from other discussions:
        • HOWEVER, WE'RE STILL MISSING THE IDENTIFICATION OF THE ACTUAL MAP PRODUCT ITSELF, AND THE VERSION OF THAT ENTITY
          • (eg) "ICNP version Jan 2019" should exist as metadata somewhere within the ICNP map product package...
          • + possibly even the direct URI?
          • SUGGESTION IS TO USE THE JSON FILE FOR THIS - Andrew Atkinson  to take this forward in the Metadata working group...
          •  
        •  ANOTHER DISCUSSION POINT FOR THE JSON FILE:
          • Are the "DeltaToDate" and "DeltaFromDate" fields in the JSON file now misleading in the new world of Frequent Delivery where we have no Delta files in the INT package itself?!
            • "deltaFromDate" : "20210930",
              "deltaToDate" : "20211031",
          •  
          • FINAL DECISIONS:
            • Agreed that these fields should ONLY be available in packages with Delta files
            • Monthly International Releases going forward, should instead just have:
              • EffectiveTime
              • PreviousPublishedPackage (that the current release is based upon)
              • Any retracted releases + their replacements
        •  
      •  
      •  Examples of extending this metadata:
        • .json format 5 ?? (Please see Michael Lawley's comments on 16/04/2021 here:  Re: Working Group: Refined Metadata)
        • Namespace data
        • Individual external Refset data
        • ranges of permitted values
        • mutability, etc?
        • Package Name? (Please see Michael Lawley's comments on  20/04/2021 here:  Re: Working Group: Refined MetadataYes, regarding the "Name" entry, it would be ideal if it could be used to populate the "Product Name" field in a list of available packages (and other required and relevant fields for MLDS).  Then the zip contents would be sufficient to automatically populate MLDS (or an ATOM-based Syndication feed))
        • WE'RE STILL MISSING THE IDENTIFICATION OF THE ACTUAL MAP PRODUCT ITSELF, AND THE VERSION OF THAT ENTITY
          • (eg) "ICNP version Jan 2019" should exist as metadata somewhere within the ICNP map product package...
          • + possibly even the direct URI?
          • SUGGESTION IS TO USE THE JSON FILE FOR THIS - group to provide examples of how this would look to the TRAG for review...
        •  
        • ANYTHING TO SUPPORT FREQUENT DELIVERY USEFULLY???? 
      • Also create 2 new pages -
    • ALL AGREED NO OTHER REQUIREMENTS CURRENTLY, BEYOND THOSE NOW COVERED OFF BY EITHER:
      1.  Extension of JSON file metadata, or
      2. Annotations, or
      3. Additional Relationships file
      4. .
      5. THEREFORE WE'LL HOLD THIS TOPIC OPEN ANOTHER MEETING OR TWO, AND CLOSE DOWN IF NO NEW REQUIREMENTS COME IN
      6. JUST TO CHECK WE STILL NEED THIS TOPIC GIVEN ANNOTATIONS IMPLEMENTATION??


37Run other (non Managed Service Extensions) through our RVF etc to see what differences are out there between their Extensions and the spec

This should help prove what barriers to adoption some of our implementors might face 

Andrew Atkinson  to Discuss with Alejandro and Kai to see if they can help - as this might be a good implementation team task?

38Appetite for front end for RVF configuration and building!

Not enough outside of the Managed Service - however a Service where people could feed a package into RVF and get results out would be useful 

Discuss further in 2024?  Maybe spec out the new service?

39Potential move towards EditionsALL

MAIN POINTS:

  • Over the past couple of years we've noticed a trend towards requests for Edition packages containing multiple combined modules, rather than individual extensions/derivatives that are dependent upon other packages.
  • In addition, some of our Managed Service work (in particular wrt the Common French + Common German content) is driving us in this direction as a natural part of the products' evolution.
  • We'd therefore like to open the discussion on whether or not we should start moving towards producing more Editions, with an eventual aim of publishing most of our products in Edition format.
    • Would this make things easier for yourselves as consumers?
    • Would it make things easier/more difficult for smaller users such as affiliates and licensees?
    • What are the benefits / drawbacks of such a move?
  • Spain is another example:
    • The Articles of Association appear to specify nothing, but one of our country contracts state that SNOMED International need to "Provide at least twice-yearly updated versions to the international release of SNOMED CT, including the English and Spanish editions" -
    • However it does NOT specify format or structure.... So perhaps this allows us to change the Spanish Edition to a true Edition??

FEEDBACK SO FAR

  • National Extensions should move to Editions in order to remove blockers for end users:
    • Knowing which International Edition to download in conjunction with the Extension
    • Knowing how to combine Extension + INT packages to make something useable
    • ESPECIALLY as this all needs to be done consistently across all countries and users, in order to make the final results useable and compatible for interoperability purposes.
    • Edition packages also remove the ambiguity around modules that have been included in a package that aren't part of the MDRS - composition versus dependency.
  • International Derivatives should remain as dependent Extensions
    • Surely the same benefits for end users apply as with the National Extensions? (ie)
      • Knowing which International Edition to download in conjunction with the Extension
      • Knowing how to combine Extension + INT packages to make something useable
    • HOWEVER:
    • As they are mostly Refsets, having an enormous Edition (500mb+)  for one tiny refset (10kb!!!) seems redundant and a massive overkill
    • Many users want multiple derivatives, and so combining Editions then becomes extra-complicated! 
    • Derivatives (maps and reference sets, even language translations) don't typically incur the same level of risk as Extensions (wrt module dependencies etc) as they don't modify components declared in upstream modules.
    • ANOTHER OPTION:
    • Would be for SI to create a "Super-Edition" containing INT content + ALL derivatives, but we moved away from this several years ago for many reasons:
      • Most Users don't want all derivatives, just one or two
      • All derivatives are on different maintenance schedules, so no matter when we published this we'd be out of date with several of them.
      • If something goes wrong with just one derivative, it holds up the release of ALL derivatives.
  • What are the thoughts on the current proposal?
    • .
  • Any further feedback?
    • QUESTION - IS IT WORTH PUSHING EVERYTHING (and all Extension owners, both MS and external) TO EDITIONS, given that we're also driving towards Service-based delivery in the long run?  What's the benefit of having 2x major transitions instead of just 1???
  • Any comments on the feedback received so far?
    • Mikael would also like International Derivatives to be left as Extensions and NOT Editions (too fat for such small releases, too complex to combine Editions (and they often want to combine Derivative releases into one package), etc)
    • Stuart confirmed the UK have clinical Edition + their Drugs Extension (monthly because their users don't want so much data, and the Drugs extension is over 1GB for the Snapshot on its own!)
      • So they want to choose what components to download
      • + they want to releases some components annually, and others monthly, so this is another vote for EXTENSIONS (certainly for EXISTING Extensions - maybe NEW Extensions could be moved to Editions and leave existing as they are?)
    • General suggestion from the TRAG is that "going forward" we should always promote Editions, BUT existing Extensions are too invested in Extensions to want to move, unless we can provide a better business case!
      • However this doesn't increase efficiency in MS management as we would still have to spec-up our internal systems to build and validate Editions better than is currently the case, so this approach doesn't improve anything.
    • Gabor thinks we are worrying about just one perspective - we should be concerned with machine-readability as well as human consumption.  So just because some users make mistakes downloading and combining Extensions together, doesn't mean we should get rid of Extensions (which are more machine-readable and faster to consume in an automated way).  Maybe instead we should just
      • a) improve human training, and 
      • b) improve our upload tools to work better with Extensions? (allow automatic combinations, etc)
    •  
  • If we approve the proposal, should:
    • a) All Managed Service Extensions be transitioned to Editions?
      • .
    • b) Does that even include Translation-only Extensions?
      • .
    • c) Should NRC's not using the MS be required to create Editions instead of Extensions?
      • .
    • d).Without unity and consistency across all NRC's, does it help to move to Editions, or create a larger interoperability blocker?
      • .


    •  release.... 
40Redesign of the Map Reference Set formatsAll

Please find below a proposal for redesigning the map reference sets to support maps in either direction:

https://docs.google.com/document/d/14bmRaVQYI7-Kz2EPgv00muGqdO6wRrMycCPCJqp5W2s

  • This proposal was signed off, ready to take to the MAG on 20/10/2021...
    •  
    • APRIL 2022 - Review and sign off of final formats:
      • An opportunity has been identified to improve the format of the SNOMED International Map Reference Set products.  This will apply to all types of simple and complex Map Reference Sets going forward, including (but not limited to) the SNOMED CT MedDRA Simple Map package, first released back in April 2021.  

      • The existing SNOMED CT map reference sets were originally designed for maps in the direction from SNOMED CT to another code system, manifested by the use of a ‘mapTarget’ string attribute used to represent the code in the other code system.  The new and improved map reference set patterns will be introduced with a ‘mapSource’ attribute, in order to more accurately represent maps from other code systems to SNOMED CT. 

        The refined format provides users with more clarity when using maps of either direction, as well as additional map metadata representing the new refset patterns and correlation values.  Users will also benefit from clearer and more predictable naming of the map refsets, as the map reference set concepts have been reviewed and updated to follow the refined description patterns.  Please see the links below for the updated technical details including the improvements:


      • The first product to be improved using the new designs will be the SNOMED CT MedDRA Simple Map package.  After in-depth discussions with the communities’ expert advisory bodies, the users confirmed that their preference was to retain the historical data from April 2021.  


      • It was therefore agreed that the 2022 SNOMED CT MedDRA Map package will be published as follows:

        • …with all new 2022 content in the improved format 
        • …with all relevant historical MedDRA data (from April 2021) also in the new format
        • …with the historical April 2021 map records that were in the original format inactivated (in order to retire the relevant UUID’s) - the inactivations would likely be published a) in the new package in the new format, and b) in a separate file/package in the original format.  However this is still to be confirmed.
        • All of this means that the 2022 file will appear as if the original April 2021 MedDRA release was actually published in the new format.  Therefore, the 2022 MedDRA Release will be published as a complete, consolidated package, with all original data from 2021 plus all new inactivations/changes from the latest cycle presented in the new and improved format.
    •  
  • To be taken forward in metadata working group:
  • HOWEVER, WE'RE STILL MISSING THE IDENTIFICATION OF THE ACTUAL MAP PRODUCT ITSELF, AND THE VERSION OF THAT ENTITY
    • (eg) "ICNP version Jan 2019" should exist as metadata somewhere within the ICNP map product package...
    • + possibly even the direct URI?
    • EXAMPLES FOR MEDDRA??
    • SUGGESTION IS TO USE THE JSON FILE FOR THIS  - Unless we need to discuss now, we will take this forward in the Metadata working group...
  •  CONFIRMED THAT WE WANT THE FOLLOWING FIELDS ADDED TO THE .JSON FILE FOR RELEVANT DERIVATIVES :
    • External MapSource (or MapTarget) - (ie) If we're publishing a map from SNOMED TO GMDN then we should state that this is from 
        • SNOMED CT version Jan 2022 to 
        • GMDN Version 2019
      • If we're publishing a map from MedDRA to SNOMED CT we should state:
        • from MedDRA version 2023 to 
        • SNOMED CT Version July 2023
    • Directionality of the map - Some people would like the Directionality to be explicitly stated so that it's machine-readbable, instead of just implied in the Map Package naming convention
    • (ie) If we're publishing a map from SNOMED TO MedDRA then we should state that this is 
      • Direction:  FROM SnomedCT TO MedDRA
    • (ie) If we're publishing a map from MedDRA to SNOMED CT then we should state that this is 
      • Direction:  FROM MedDRA to SNOMED CT
      •  
  • Simple Map transition complete and Documentation Published:
  • Additional Metadata now included in following 2023 Releases:
  • ANY ISSUES WITH THIS, OR IMPROVEMENT SUGGESTIONS???
    • YES:  
      1. The JSON Metadata file can be further refined to be more useful:
        1. Should be machine readable
        2. Can use SNOMED URI's to denote SNOMED components, and 
        3. Perhaps use FHIR URI's for the non-SNOMED parts?
      2. The scope of this file was discussed in great detail, and it was agreed that it was still useful to target having package-specific metadata ONLY in this file.  Everything else can and should be put into Annotations instead, so that it's all machine readable in the content itself.
      3. We may need to increase the breadth of the package-specific metadata - to cover Composition elements as well as the current nominal scope - see the ECRS discussions for further use cases...
      4.  We could make the directionality of map products machine-readable by including an array of metadata (eg)
        1. <conceptID (of the Map)>
          1. <Parent (of the Map Concept)> - i.e. Simple Map from SNOMED type, or Simple Map to SNOMED...
          2. etc...
        2. Discuss with Peter W as he has good ideas on this...
        3. Then run the final Proposed formats past the Australian NRC, as they have good use cases and can not only feedback but also test thoroughly...
    •  AAT to discuss further and come back with new proposals for refined format...
    •  
41IMPROVEMENTS TO THE RELEASE FORMAT

42a) Proposed deprecation of the CTV3 Identifier simple map

Due to it coming to the end of its useful life, SNOMED International would like to propose planning for the deprecation of the CTV3 Identifier simple map (that currently resides in the RF2 International Edition package) as of the January 2020 International Edition. 

Some Member countries have already identified the reduction of the effectiveness of the product, and have already put plans in place to withdraw support for the CTV3 Identifiers from 2020 onwards. 

The TRAG therefore need to discuss whether or not there are any apparent problems with the proposed deprecation, and if so how they can be mitigated. 

We must also discuss the most effective method to pro-actively communicate out announcements to the community to warn them of the upcoming changes, in order to ensure that everyone who may still be using the Identifiers has plenty of notice in order to be able to make the necessary arrangements well in advance. 

Finally, we will need to decide on the best method for extricating it from the package, in order to ensure the smoothest transition for all parties, whilst remaining in line with the RF2 standards and best practices. 

  • AAT CHECKED THE PREVIOUS IMPLEMENTATIONS OF DEPRECATION OF BOTH ICD-9-CM and RT Identifiers, AND AS THOUGHT BOTH WERE IN THE CORE MODULE, AND REMAINED IN THE CORE MODULE IN THE STATIC PACKAGES - SO ANY ISSUES WITH DOING THIS AGAIN?
  • So the plan would be to follow the same deprecation process as we did with ICD-9-CM (ie)
    • move all of the content to a Static Package in July 2020, and inactivate all of the content
    • publish the reasons for inactivation in the historical associations
    • Release Notes similar to ICD-9 = SNOMED CT ICD-9-CM Resource Package - IHTSDO Release notes
    • CREATE A STATIC PACKAGE FOR CTV3 BASED ON THE JULY 2019 MAP FILES AND PUBLISH ON MLDS (and link through from Confluence link as well). ALSO LIFT THE CTV3 SPECIFIC DOCS FROM THE Jan 2020 RELEASE NOTES TO INCLUDE IN THE PACKAGE.
    1. Date of the files should be before the July 2020 edition (so say 1st June), in order to prevent inference of dependency on the July 2020 International edition
      1. So we set the effectiveTime of the Static package to be inbetween the relevant international edition releases (eg) 1st June
      2. This is to ensure that it's clear that the dependency of the Static package will always be the previous International Edition (here Jan 2020), and not continually updated to future releases
      3. It cannot therefore have an effectiveTime of July 2020 (as we would normally expect because we're removing the records from the July 2020 Int Edition) as this would suggest a dependency on the July 2020 content which doesn't exist
      4. It also can't have an effectiveTime of Jan 2020 as we need to distinguish between the the final published content which was Active in Jan 2020, and the new static package content where everything is Inactive.
    2. Inside the files should be all International edition file structures, all empty except for:
      1. Delta ComplexMap file needs to be cleared down (headers only), as no change in the content since the Jan 2020 files, so no Delta
      2. Full and Snapshot ComplexMap files exactly as they were in Jan 2020 release (including the effectiveTimes)
      3. ModuleDependency file needs to be blank, as CTV3 was in the core module (not in its own like ICD-10 is), and therefore the dependency of the core (and therefore the CTV3 content) module on the Jan 2020 edition is already called out in the Jan 2020 ModuelDependency file, and therefore persists for the static package too.
      4. Date of all of the files inside the package should be the new date (1st June)
      5. But all effectiveTimes remain as they were in Jan 2020
      6. Leave refsetDescriptor records as they are in the International edition
      7. RELEASE Notes Should describe all of the thinking we went through when creating this package, why the moduleDependency file remains blank, and why we’ve wiped the Delta, etc (see above)
  • AND ALSO COMMS SAME AS WE DID WITH THE RT IDENTIFIER REFSET DEPRECATION:
    • RT Identifier Refset deprecation:

      We need additional comms around the July 2017 release, in addition to the usual Release Notes wording, in order to confirm what is happening and the rationale behind it.

      To re-iterate what was discussed on the previous call, Legal counsel confirmed that from a legal perspective, he doesn’t consider that it’s either necessary (or even advisable) for us to send CAP any further communications on this matter.  Legal counsel is confident that the informal discussions that we’ve already had with them (in order to remind them about what they need to do), are sufficient to cover our legal obligations, given that the licence is theirs and not SNOMED International's.  Therefore we no longer need to send a formal letter to CAP.

  • Has anyone identified any issues with the proposed deprecation?

    • If so what?

  • Is everyone still in favour of the refined process to use to deprecate??

  • If all good then Andrew Atkinson to begin formal deprecation process

43b) Proposal to remove the Stated Relationship file completely

Link to proposal

Inactivated all records in July 2019 - long enough now for everyone to be on Axioms?

  • Thoughts?
44Continual Improvement to the Frequent Delivery process - Presentation on Frequent Delivery

In our last TRAG meetings several people confirmed that many people within the community were asking for more information on our transition to Frequent Delivery - therefore it was requested that we create a presentation on how the migration went, benefits realised, lessons learned, etc

  • Maria and Andrew to Present findings on our transition to Frequent Delivery:
  • Processes transitioned
    • This is the benefits of the transition so far
              - [ ] 1.  These are the issues we faced
                  - [ ] a)  This is how we resolved them
              - [ ] 2.  This is how we see the future going - improvements + benefits
  • Lessons learned
  • Questions?
  • We could setup a blog post with Kelly (similar to Jim's on collaborative authoring - https://www.snomed.org/news-and-events/articles/embracing-collaborative-authoring) that would be based on this presentation...
    • Would this be helpful to people? 
  • FEEDBACK ON PRESENTATION:
    • Would be useful to add Example monthly cycle for Authoring team in terms of Dates for cut off's, delivery, etc
    • Would be great to clarify how often the authors have to "unpromote" concepts from MAIN because of conflicts, etc?
    • Mapping - no impact moving to keeping up with monthly cycles - useful to specify this so people aren't guessing?
  1. USER DOCUMENTATION
    • Several end users have contacted Guillermo to request more information on the transition to more frequent delivery (and/or more frequent updates to the dependent content of both extensions and derivatives).
      1. It would be great if we could provide people with a white paper or presentation (both from a Content and Technical perspective) on 
        1. How the transition went
        2. Benefits realised
        3. Lessons learned
        4. Risks
        5. etc
    • This should be targeted at both the Supplier level + the end users level for max effect
    • Does the presentation myself and Maria gave cover this?  Or could we add an area on the website??
    •  
  2. RELEASE NOTES
    • Can translators please have more detailed release notes - automated to the extent of having EACH component change listed out?
    • We need to be able to automate the generation and publishing of the Release Notes -
      1. this work is still underway, but will take quite awhile for the Dev team to complete....
    • NEW REQUIREMENTS FOR SONJA:
      1. Option for detailed release notes as well as the standard level for all Releases (as per Guillermo's requirement above) - either in the RNMS (preferable) or in the Delta Generation Tool?
      2. It would be great to also link each Component change to the relevant high level change note in the official Release Notes as well (eg)
      3. Release Notes March 2023:
        1. Drugs Changes:
          1. Component 1 changed
        2. Anatomy changes:
          1. Component 1 added
          2. Component 2 removed
          3. Component 3 changed
        3. Quality Initiative:
          1. Component 1 changed
          2. Component 2 inactivated
      4. INFRA-8739 - Getting issue details... STATUS RAISED
        1. RNMS-65 created to track development
      5.  
      6. Explicit annotations in the Release Notes to that each component change in the Delta period is linked to a specific Template
      7. INFRA-8740 - Getting issue details... STATUS RAISED 
        1. MAINT-1958 created to track development
  3. DELTA GENERATION TOOL
    • Has anyone trialled the Delta File Generation Tool as yet?  Any feedback?
    • YES GABOR HAS TRIED IT AND FED BACK ISSUES TO PETER - PETER IS STILL WORKING ON IMPROVEMENTS SUCH AS THE Snowstorm issue whereby if there are multiple different states for the same component withint the Delta period, snowstorm loses the history of all those changes and just spits out a (random) one line state!  So if a concept has started active, been inactivated and then reactivated in the Delta timeframe, snowstorm might decide to spit out active or inactive as the latest state!  It will also lose those 3 changes and only export one change!
    • UPDATE ON THIS WORK:
      • "...the problem here is more with the Terminology Servers not being able to deal with deltas that contain more than one state for the same component than it with with the DGT itself.   

      • However we added a flag to the tool (see https://github.com/IHTSDO/delta-generator-tool/releases/tag/1.2.0 ) so that you can generate output that will contain multiple effective times, but only the most recent effective time for each component.   This is a workaround that means your TS does not end up with the correct Full file representation.

      • So really the only additional work would in theory be in Snowstorm so that it can treat deltas as successive updates to the Full file and generate release branches as it needs to.  However so far this has not been raised as a requirement by the community, and so is not planned work...

    • DO WE NEED FURTHER ENHANCEMENTS, OR NO APPETITE FOR THIS?? 
      • a)  Delta's to be generated from any point in time to any other point in time
      • b)  Metadata to be included somehow (to be discussed further in the Metadata Working Group) to record critical information, such as which Dates the Delta is from + to, which Modules are incorporated, etc
      • c)  Compound Delta's (including ALL changes since the relevant date, including ALL changes in the dependent release package(s), rather than just the latest state - so these are "Full file to Full file" Delta's, as we are used to) are favoured so far, however we should continue to assess any potential use cases for Atomic Delta's (effectively "Snapshot file to Snapshot file" Delta's) as we go along, in case it becomes apparent that there is a valid Business Case to ensure that the new Delta generation tool can provide either or both of these Delta file types...
      • d)  It needs to support the future requirements for Service Based delivery, once we transition over
      •  
  4. VALIDATION advances:
    • OWL testing - anyone worked on this as yet?

    • Template validation - thoughts?

    • Implementation testing feasible? (see Implementation Load Test topic below)

    • Need to identify Modelling areas that need improving - for example where concepts have 2x parents, this is usually an indication of areas that need re-modelling
    • Need automation of the QA system itself - so some quick way to validate RVF + DROOLS Assertions, both old + especially new!
    • Whitelisting - API required?
    • Specific extensions to the automation Validation scope (eg)
      • New idea for an RVF assertion regarding the ordering of OWL records (based on first concept) with disjoints:
    •  
  5. Critical Incident Policy update
    • We need to refine the Critical Incident Policy:
      • Need to ensure categorisation is solid (as otherwise requests may be made for minor issues to be fixed immediately as "Critical Incidents" just because it impacts one institution (but not Internationally))
      • Currently Content Team critical incident policy states:
        • If it's a Clinical Risk then it has to be fixed
        • OR if it's not a Clinical Risk but impacts certain number of members etc then still Critical, etc
    • April 2023
    • What other criteria do we need to use?
    • How strict should we be with the criteria?
      • We need to balance the risk of NOT fixing an issue vs the risk of impact to a stable Release candidate from the fix...
    • As discussed yesterday, we should keep the policy flexible on the solution that will need to be implemented in order to resolve any critical incidents:
      • The best solution is simply to mark the Release in question as "Invalid" and advise all users to download the next stable Release
        • However, can we reliably contact all users who've consumed a Release, given all the possible end users who've downloaded it via NRC's as well as direct from MLDS?
      • We should only use Negative Delta files and other potentially confusing and destructive techniques if there is no other option (eg) Critical Legal Incidents.
    • Any useful lessons learned from anyone else's Critical Incident Policies?
45Continual Improvement to the Frequent Delivery processAll

Potential Improvements:

  1. USER DOCUMENTATION
  2. RELEASE NOTES
  3. DELTA GENERATION TOOL
  4. VALIDATION advances:

  5. Critical Incident Policy update
46NNF GenerationEssentially it is about what is considered redundant in the NNF generation, and the implications that has for ECL. At the moment things that are more specific than statements inherited from further up the ancestry replace the more general statements in the NNF calculation, which makes sense.However I introduced equivalence axioms which created necessary conditions that were equivalent - not more or less specific. This resulted in the NNF calculation removing (seemingly arbitrarily) one of the two sets of conditions - this is kind of right because they are "redundant" in the sense that you don't need both, however they also aren't redundant in the sense that they are both necessarily true and neither is "more specific" than the other. Which is picked will affect how ECL works and is evaluated.I'm pushing the boundaries here having equivalence axioms with expressions on both sides, but that should be theoretically possible and I suppose what we need to determine is if that's to be supported what should the NNF look like. Presumably a deterministic selection of one of the axioms or a merged set of all the necessarily true conditions may be more useful for ECL.There's a related point with property chains which I can demo with ECL too to explain and provoke discussion.
47RVF improvement discussions

CSIRO have been working on improvements to the RVF, and would like to report on and discuss some of the results with us...

  • Dion to Present current status + plan...
  • Comments and feedback welcomed...
    • Plenty of feedback and so further discussions required as we move through the project...
  • The main feedback for the past few months has been the RVF failures for the new MDRS assertions, which appear at first glance to be false positives.  However, they have been proven to be valid failures, as long as you consider that the MDRS format itself is (and has always been) inherently flawed.
  • The closure of this topic is therefore dependent on the outcome of the discussions on the Proposal for a complimentary file to the MDRS - the "ECRS" ("Edition Composition Reference Set")
    • If this concludes that we need to change the MDRS, then this RVF topic can be closed down.
    • If, however, we decide to retain the MDRS format, then we need to revisit these RVF assertions...
  • We need to use the new planned changes to .JSON metadata file:  Update to the .JSON file metadata - addition of "Package Composition" data in order to fix the RVF assertions and remove the false positives...
    • FRI-169 - Getting issue details... STATUS
  •  
  • QUESTION FOR DION/MICHAEL - CAN WE JUST REFINE THE .JSON FILE (as per the proposals here:  Update to the .JSON file metadata - addition of "Package Composition" data)  IN ORDER TO ALLOW THE MDRS ASSERTIONS TO WORK PROPERLY FOR NOW????
  • YES, but the question is how best to do this?
  • NEED TO ADD EXAMPLES OF EACH USE CASE + SAMPLE MANIFESTS - This will not only help with MDRS assertions, but also Syndication info...
48Refset containing the semantic tags?

This topic was closed down by the TRAG a few years ago due to the lack of requirements vs the complexity of finding a robust solution.

However, new requirements and a potential solution from Ed Cheetham have now been submitted for our review and discussion - please see here for details: Refset containing the semantic tags?

We will discuss in detail in the next TRAG meeting in April, however please feel free to contribute to the online discussion in the above link in the meantime.

  • Slide deck here for advanced review:
  • Feedback from the group:
    • Excellent identification of issues that need addressing
      • The first target should be to discuss the application of the Validation that Ed has kindly brought to us, both in the AP + Release validation stages.
      • The second sim is to bring the discussions on the potential Formalisation of the Semantic tags to the relevant AG's for furhter consideration
  • Yong has kindly agreed to add this to the agenda for the next MAG meeting, to be discussed further.....
  • UPDATES FROM THE MAG???
49Extension Management in the new world of Frequent Delivery
  • With the change in release cycle to monthly, extension management has become intractable and merits consideration for tooling enhancements or procedural change on the part of SNOMED International. 
  • Since extension modules have dependencies on one or more other modules, periodic reconciliation with their parents is a requirement if they are to support interoperation of their content. 
  • Multiple dependencies for an extension creates opportunity for parent modules with dyssynchronous release cycles, introducing further complexity.
  • Since it is seemingly unrealistic to require alignment of versioning and release schedules between independent institutions, the situation calls for tooling support that would compare modules for reconciliation and prepare a systematic step-by-step workplan for the content manager to follow to achieve expedited systematic reconciliation that will validate and classify.  The tooling would ideally execute the workplan to guide the manager in the process.
  • Potential extended requirement for the Delta Generation Tool??
  • Any new thoughts on this since October?
  • .
50Dependent Releases for Derivative ProductsAll

To be discussed in April 2022, in time to make a final decision before the 2022 Derivative cycle begins shortly afterwards...

  • The original intention of more frequent delivery was to continue using the January + July Releases as the dependent INT Editions for all derivatives. This was to ease users through the transition, by allowing them to continue using the Jan + July releases indefinitely, rather than moving to individual monthly releases.

  • However, this causes a potential conflict with the July Derivative cycle, as if we don't start the (many) feeder derivatives for the September GPS product until 1st August (instead of starting on 1st July as we did last year because we had the luxury of cutting off the July 21 editing cycle in May 21), not only do we reduce the amount of time that everyone has to migrate the refsets + get external reviews completed, but more importantly we clash with the European holiday season in terms of getting reviews signed off by the key external stakeholders, who are often away during August.

  • We are in the process of discussing this with the relevant stakeholders, to see if they will be available in August 2022, but if not we are wondering if it would be acceptable for the 2022 Derivatives (including GPS) to be based on the May or June 22 release (instead of July 22)? Whilst this may initially seem inconvenient, it would have the benefit of increasing the quality of these derivative products by allowing thorough internal + external reviews before publishing.
  •  Feedback?
  •  
  • As Matt mentioned, another option is to try to feed the derivative authoring process with monthly updates, thus reducing the necessary workload in the final Release cycle. 
    • However, in order to have the desired effect, this would also require us to not only author new changes more frequently, but also to migrate each derivative multiple times per year, in line with each monthly release.
    • Whilst this could resolve the time crunch in August, it would necessarily introduce an additional overhead to the workload of the authors throughout the year,
      • ...as even though they'd technically migrate the same number of concepts over 6 monthly migrations as they would in one large migration per 6 months, the process is cumbersome enough to have an impact on capacity
      • ...this could (in theory) have a slightly positive effect however, as it would mean that authors get to know the migration process more intimately, if having to do it every month instead of every 6 or 12 months!
      • We need to discuss with WCI to ensure that the tool would support this however...
        • ...for example, we'd almost certainly need a new Delta generation process in the Refset tool, in order to enable it to provide roll-up Delta files for the past 6 or 12 months' worth of migrations in one file...
  • The vast majority of the group are in favour of retaining the Jan + July releases as the dependent releases for all derivatives, mostly because of the comms that we sent out confirming that most users won't be impacted by the Monthly Releases if they don't want to be, as they can continue to use only the Jan/July releases for the foreseeable future.
  • This is especially true for NRC's like Sweden, who Mikael says are using quite a few derivatives to package up different products for their users, and so having a conflict between the dependent releases of their extensions and thos of the derivatives will be very unhelpful for them
  • We need, therefore, to explore different options, such as 
    • a) Updating the refsets monthly (though this is confirmed as an overhead for the team by Maria)
    • b) Removing the review stage for all derivatives (except those which are brand new), s most feedback on BAU derivatives finds nothing of use nowadays...
    • c) Postponing the final delivery of the refsets impacted by lack of people to review  in July/August to November say, so the reviews can take place in September and work can continue after that.  This si probably the most popular option in the group, but then not many people in the group are dependent on the derivatives releases...
    •  
  • REVIEW AGAIN IN 2023 TO SEE IF THE APPETITE TO REFINE THIS IS NOW THERE, BASED ON USERS' EXPERIENCES OF BASING EXTENSIONS ON DIFFERENT MONTHS, ETC??
51NEW DEPRECATION PROCESS!

Link here (if JMI completed in time - if not push this to 2023)

  • 2022
  • We will shortly be refining the deprecation process for SNOMED CT Products, especially derivatives such as Nursing Activities + Nursing Health Issues.
  • If you have any pre-emptive ideas of how we can improve this process, please let us know now, as this is the time when we can easily impact the final solution?
  • For example:
    • Communication improvements?
      • Comm out as far and wide as possible...
    • Changes to the way we leave (or don't leave) the deprecated packages in MLDS?
      • Some suggested leaving on MLDS for a short period (1 year?) then removing to keep MLDS clean
      • Most others prefer to ALWAYS leave the latest (in this case Final Deprecated) version on MLDS permanently, so people know
        • HOWEVER, this should be accompanied by clear labellling on MLDS to state
          • a) That the product is deprecated
          • b) the reason for deprecation (no longer used vs INVALID vs Dangerous, etc!)
          • c) And keep the packages in a separate folder in MLDS marked "Deprecated" to make it very clear to only use them if you know what you're doing
      •  
    • Changes to the way in which we deprecate the RF2 records?  (inactivation, just leave them active but static, etc)
      • This should be optional depending on the Reason for Deprecation (ie)
        • a) If it is just no longer being maintained, then everything should remain Active, with a note clearly stating that there is no longer ACTIVE MAINTENANCE being done on this Product, and so should be used with caution as it's definitely out of date
        • b) If the content is "WRONG" or "UNSAFE" then it should be inactivated and flagged as Unsafe for use
        • c)  etc 
    • Changes to the way we deal with the metadata? (inactivating refsetDescriptor records, module records, etc?)
      • Metadata can never be "unsafe" in and of itself, and so refsetDescriptor and Module records ashould always remain active in all cases
      •  
  •  
  • 2023
  • Confirm if everyone is happy with the new process?
  • Confirm if they are then also happy with applying the new process to all following planned deprecations:
    • 2x Nursing Refsets
    • Old FORMAT MedDRA Maps (but not entire Product)
    •  
52Proposal for a complimentary file to the MDRS - the "ECRS" ("Edition Composition Reference Set")

The TRAG had discussions a couple of years ago to clarify the best application of the Module Dependency Reference Set (MDRS) - some background reading is here: 

  1. Re: 4.2.1.0 Using SNOMED CT with FHIR
  2. Proposal for a complimentary file to the MDRS - the "ECRS" ("Edition Composition Reference Set")
  3. Miscellaneous Documents


Michael and Dion then walked through the proposal and answered questions, but Michael and Linda both confirmed that the use case was not a critical priority at the time, and therefore didn't need to be actively discussed until new cases were proposed...

WE THEREFORE CLOSED THE DISCUSSION DOWN AT THE TIME DUE TO A LACK OF MULTIPLE USE CASES, AND SO THIS WAS DE-PRIORITISED UNTIL SUCH TIME AS MORE USE CASES CAME TO LIGHT.

We have now identified more use cases for this proposal, as the new automated MDRS validation picks up what appear at first to be false positives, but which are actually valid failures due to the historical shortcomings of the MDRS format.

  • We therefore need to discuss and agree an approach that allows us to both express the correct moduleDependencies + the new module composition (to express which modules comprise the Edition package, for URI + validation purposes).
  • This should then be used to properly validate the MDRS and moduleDependencies within the Edition and Extension packages.
  • There was a lot of feedback on the original proposal - however in this meeting we should:
  • a) Ask Dion/Michael to walk through the proposal in person to ensure that everyone's on the same page (and remembers the original discussions)
  • b) Answer the feedback (plus any new feedback in light of new situations and/or use cases)
  • c) Agree what the final proposal should be, and what are the next steps we need to take in order to get it signed off (MAG, design authority, etc?)
  • Michael, Dion and Reuben were going to create the Australian version as an example, in order to include that in Michael's updated version of the proposal document - did this happen?
    • New proposal for representing the ECRS information in the .JSON Metadata file will be kindly brought to the table by Dion + Michael tomorrow, for further review
      • This will include an example of how the INT Edition might look...
  •  
  • As part of the discussions on this topic, we need to decide what to do about the transitivity of dependencies in the MDRS - Linda will kindly present the background and options to discuss... 
    • Initial discussion were had on 18th October 2021, leading to a provisional decision that the best course of action might be to:
      • State that transitivity is the primary method, but that
      • Explicit statement of all moduleDependencies (even though that could be inferred through their transitive inclusion) would remain an option in all cases, to be used whenever the transitive dependencies would lead to potential confusion or conflict, for example in the case where two different components (eg. ICD-10 map + IPS refset) of an Edition (eg. Pangea Edition) were themselves dependent on two different versions of the same product (eg. the July 2021 INT Edition + the October 2021 INT Edition respectively).  In this case the MDRS in the Edition which incorporates the modules would explicitly state the dependencies of all it's constituent modules, and therefore resolve the conflict that would otherwise have arisen -
        • so in this example, the  Pangea Edition would explicitly state that both ICD-10 + IPS modules were dependent on the October 2021 INT Edition
          • NB  the curator of the Pangea Edition would first be responsible for testing and confirming that the ICD-10 maps (which were implicitly dependent on the July 2021 INT Edition rather than October) worked cleanly with the October 2021 release as well, before publishing the Pangea Edition.
    • However, the one drawback raised in response to this option was that we need a strong use case to warrant changing the RF2 spec.  So we need to decide if we're happy that the use cases in the proposal are strong enough for that (ie) 
      1. Resolving issues with pre-existing Editions that did not originally spec out the URI with this in the mind
      2. Enabling more comprehensive targeted automated validation of the MDRS files
        1. This is currently not possible without resolving the transitivity question, and 
        2. The imminent transition to Frequent Delivery brings this to the forefront of our current considerations, as without the necessary breadth in the automated validation, we cannot guarantee the quality of the monthly releases.
    • FINAL DECISIONS:
      • a)  We will use the new JSON data on Package Composition to resolve the issues with the false positive results in the current MDRS RVF assertions, by having the assertions check the new JSON data to confirm whether or not the modules that are not explicitly called out in the packages' MDRS file (as its an extension or similar), or that have conflicting versions.
      • b)  We will use the new .JSON data to allow correct resolution of URI's
      • c)  We will NOT change the RF2 spec to move to transitive dependencies in the MDRS. 
        • 5.2.4.2 Module Dependency Reference Set - currently states 

          "Dependencies are not transitive and this means that dependencies cannot be inferred from a chain of dependencies. If module-A depends on module-B and module-B depends on module-C, the dependency of module-A on module-C must still be stated explicitly."

        • Despite this being a valid theoretical stance (as dependencies are inherently transitive), the weight of historical data across all products for the past many years means that introducing a new approach whereby all dependencies are assumed to be transitive unless there's a problem and are therefore stated, could result in confusion when taken in the context of all previous releases where stated dependencies are NOT only there if there's a problem!   We will therefore continue to review this use case in future TRAG meetings, to see if the case for changing the spec becomes strong enough to warrant a change to all our products, plus a change that runs contrary to all historical releases.
      • New planned changes to .JSON metadata file:  Update to the .JSON file metadata - addition of "Package Composition" data
      • FEED INTO THE METADATA WORKING GROUP DISCUSSIONS...
53

Reference set metadata

* MAG crossover

Replacement of the Refset Descriptor file with a machine readable Release Package metadata file

See David's proposal here: Reference set metadata (plus sub page here: Potential New Approach to Refset Descriptors)

  • Everyone confirmed no issues with the proposal in principle, in April 2018
  • However, do we consider this to just be relevant to refsets in the International Edition release package?
    • Or to all derivative products as well?
    • Both refsets and maps?
  • Also, are we talking about only human readable descriptive information, or also machine readable metadata such as
    • ranges of permitted values
    • mutability, etc?
  • Michael Lawley to kindly provide an update on his work with David to help design and implement the solution - this will now be in the second TRAG meeting of the April 2019 conference, after they have met together....
  • Michael + David + Harold agreed to create a straw man to put up in the next meeting and take this further...
    • Michael Lawley - where are the discussion on this currently?
    •  Michael confirmed (20210420) that this straw man was never created, and so we should use the published .json file as the straw man for future discussions... 
  • Can we link this in to the .JSON file above? (Computer readable metadata) - yes, done!
  •  
  • IN FACT, are there any requirements for machine-readable or human-readable metadata that can't be addressed with extensions to the new .JSON file in the release packages?
    • No, not that people can foresee!
    •  
  • This will be therefore be rolled into the holistic discussions on Metadata in the new Metadata Working Group...
  •  
  • ANY UPDATES FROM THE MAG???
54Refset Descriptor InactivationMatt Cordell

Question here is whether or not RefsetDescriptor records themselves should remain active for retired reference sets?

TRAG to decide on correct policy and feedback to Matt...

  • The consensus so far is that we should keep the RefsetDescriptor records themselves active, which has been the precedent for all cases in RF2 history so far, with the exception of the Non-human refset which was physically removed from the International Edition package.
  • The UKTC and others have previously requested these RefsetDescriptor records to be inactivated ( ISRS-112 - Getting issue details... STATUS , etc) - for consistency purposes, but the corollary of this is that the refset structure itself (which the refsetDescriptor describes) remains valid and active, despite the refset itself having been inactivated.
  • TRAG TO DISCUSS AND AGREE BEST SOLUTION...
    • Then propose an addition to the TIG to provide clear guidance on this for all users...
    • AGREED:
      • Happy to leave the RefsetDescriptor Active for all normal circumstances
      • If we're removing the Refset entirely from the Extension/Edition, we should 
        • a) if it's just for space or something, then leave refsetDescriptor record in place
        • b) if it's for CRITICAL INCIDENTS ONLY (and even then only certain subsets of this - most likely only legal issues), we'll remove RefsetDescriptor completely
      •  
      • Matt Cordell  to write up and send to all of us for review.... confirmed on 20/04/2021 that Matt will write this up and present to the TRAG in future meetings
      • FINAL DECISIONS:
        • Matt Presented - no contentious points, so Matt is ready to take this proposal further...
        • UPDATES FROM MATT???
55Implementation Load TestAll

RVF has now been open sourced to allow people to contribute towards it more easily, so that Implementation issues can be reverse engineered into the assertions. All of the NRC validation systems should remain separate, in order to ensure as great a coverage across the board as possible.

However, it makes sense to ensure the critical tests are included in all systems, in order to ensure that if, say, one NRC doesn't have the capacity to run Alpha/Beta testing for a certain release, we don't miss critical checks out. We are working on this in the Working Group, and also in the RVF Improvement program, where we are including the DROOLS rules, etc. These are also being incorporated into the front end input validation for the SCA.

TRAG to therefore discuss taking the Implementation Load test forward, including the potential to incorporate key rules from NRC validation systems into the RVF. So we should discuss the tests that are specific to the Implementation of vendor and affiliate systems, in order that we can facilitate the best baseline for the RVF when agreeing the generic testing functionality in the Working Group.

  • Matt Cordell will promote some useful new ADHA specific rules to the RVF so we can improve the scope... report back in October 2019
  • Chris Morris to do the same - get the RVF up and running and then promote any missing rules that they run locally.... report back in October 2019
  •  
  • THIS NEEDS TO BE CONSIDERED AS PART OF THE OVERARCHING Shared Validation Service PROJECT GROUP
  • Anything we can add to the Shared Validation Service going forward?
  •  


56

Versioning Templates

* MAG crossover

* EAG crossover


The EAG have proposed the need to version templates in some way, and potentially even make them "Publishable" components (with all of the reletive metadata that goes along with that). Also the potential to make them language sensitive.

They would then also need to be automatically validated themselves, as well as then being used in the automated validation of the International Edition!

  • Keep an eye on EAG + MAG discussions on this topic an
  • Ensure that the decisions are fed into our Continuous Delivery proposal
  •  
  • October 2021 TRAG meeting:
    • Peter confirmed no longer being discussed in EAG or MAG
    • Instead, Linda confirmed that the templates are still being developed internally, and once the final proposal is ready they will share it with the TRAG and MAG for review+ for decisions such as how best to publish them, in what format, etc.
    • So one to revisit in future conferences...
    • UPDATES FROM THE MAG???
57

Release packaging conventions and File Naming Conventions

All

TRAG to review and provide final feedback.

Reuben to provide feedback on progress of the URI specs + FHIR specs updates...

  • Document updated by Andrew Atkinson in line with the recommendations from the last meeting, and then migrated to a Confluence page here: SNOMED CT Release Configuration and Packaging Conventions
  • To be reviewed in detail by everyone, and all feedback to be discussed in the meetings. AS OF OCTOBER 2017 MOST PEOPLE STILL NEEDED TIME TO REVIEW THE DOC - Andrew Atkinson INFORMED EVERYONE THAT THIS DOCUMENT WILL BE ENFORCED AS OF THE JAN 2018 RELEASE AND THEREFORE WE NEED REVIEWS COMPLETED ASAP... so now need to check if reviews still outstanding, or if all complete and signed off??
  • AAT to add in to the Release Versioning spec that the time stamp is UTC
  • AAT to add the trailing "Z" into the Release packaging conventions to bring us in line with ISO8601
  • AAT to add new discussion point in order to completely review the actual file naming conventions. An example, would be to add into the Delta/Full/Snapshot element the dependent release that the Delta is from (eg) "_Delta-20170131_" etc. AAT to discuss with Linda/David. Or we hold a zero byte file in the Delta folder containing this info as this is less intrusive to existing users. Then publish the proposal, and everyone would then take this to their relevant stakeholders for feedback before the next meeting in October. If this is ratified, we would then update the TIG accordingly.
  • AAT to add in a statement to the section 4 (Release package configuration) to state that multiple Delta's are not advised within the same package.
  • AAT to add in appendix with human readable version of the folder structure. Done - see section 7
  • IN ADDITION, we should discuss both the File Naming convention recommendations in the Requirements section (at the top of the page), PLUS Dion's suggestions further below (with the diagram included).
  • Dion McMurtrie to discuss syndication options for MLDS in October 2018 - see hwat they've done (using Atom) and discuss with Rory as to what we can do. Suzy would be interested is this as well from an MS persepctive. UK also interested. This shouldn't hold up the publishing of the document. Discussions to continue in parallel with the creation of this document...
  • Reuben Daniels to raise a ticket to update the fhir specs accordingly
  • Reuben Daniels to talk to Linda to get URI specs updated accordingly.
  • URI Specs to be updated and aligned accordingly - Reuben Daniels to assist
  • EVERYONE TO REVIEW TONIGHT AND SIGN OFF TOMRORROW
  • ONLY outstanding point from earlier discussing was Dion's point from the joint AG where he talked about nailing down the rules for derivative modules... -
  • Dion McMurtrie to discuss/agree in the October 2018 meetings - REPORT FROM DION??
  • Everyone is now happy with the current version, therefore Andrew Atkinson to publish - we can then start refining it as we use it.
  • Andrew Atkinson to therefore agree all of the relevant changes that will be required as a result of this document internally in SNOMED International, and publish the document accordingly.
  • FIRST POINT WAS THEREFORE TO have it reviewed internally by all relevant stakeholders...
    • This has been completed and signed off
  • Do we consider anything in here needs to be incorporated into the TIG?
    • or perhaps just linked through?
    • or not relevant and just separate? YES - NOT RELEVANT!!
    • the litmus test should be whether or not implementers still use the TIG, or whether people now use separate documentation instead?
      • ??????????
  • We also need to make a decision on the final Freeset distribution format(s), as I want to ensure we only have a MAXIMUM of 2 distribution formats - RF2 + the agreed new Freeset format (whatever that may be)
    • YES everyone is happy with this!
    • Add this into the Release Packaging Conventions and publish
  • APRIL 2021 - DO WE NEED TO MAKE ANY REFINEMENTS IN ORDER TO PREPARE FOR CONTINUOUS DELIVERY? Did ADHA need any formatting changes when moving to monthly?
    • No, nothing beyond the new .json file and refinements to that 
    • We really need to tackle the Delta from and to release version in the Delta file naming, and possibly package file naming. At the moment it is impossible to know what a Delta is relative to making it hard to safely process it. Perhaps beyond the scope of this document, but quite important

  • THIS NEEDS TO BE CONTINUALLY REFINED OVER THE NEXT YEAR WHEN WORKING TOWARDS MORE FREQUENT DELIVERY:
    • Once all happy, the document will be published and opened up to anyone to view.
    •  
  • Everyone was invited to either join the Working Group, or contribute ideas towards it - we will therefore continue to report back on how this is going...
  •  
58Community ContentAll
  • COMMUNITY EDITION(s)

    1. What should the criteria be that differentiates between what goes in each Edition:
      1. SNOMED CT Core
      2. SNOMED CT International Edition
      3. SNOMED CT Community Edition
    2. What level of quality do we allow into the Community Edition? 
      1. Any quality (quick and sharable) vs validated (slower but better)
      2. One suggestion is that instead of certifying the content, we could certify the authors themselves - so we could differentiate between projects which are authored by newbies, vs those who have say passed our SNOMED CT authoring certification level 1, etc
      3. Another suggestion is that whoever delivers content to the Community content would have to provide the MRCM to support it, + conform to editorial guidelines, etc
        1. So a list of “quality indicators” could be automated against each project (eg):
          1. MRCM compliant
          2. Automated validation clean
          3. Authors have SNOMED CT certification
          4. Peer reviewed
          5. Release Notes
          6. Etc
        2. And then people can make their own minds up about which projects to use based on comparing the quality indicators between projects
    3. SOME AGREEMENT TO SUPPORT AND MAINTAIN BY @SOMEONE@ AT LEAST…
      1. For example, what happens if we change something in the core which breaks someone way down deep in the Community Edition?  (Which we can’t possibly test when we make the change in the core)
      2. The idea here would be that whoever creates the branch in the Community Edition then manages and maintains it - so everyone maintains their own branch, and is therefore responsible for resolving the conflicts coming down from the core, etc
      3. Versioning also becomes important, as whoever creates it needs to specify which Versions of each dependency their work is based on - (eg) they would state that their work is based on the 20190131 International Edition, and therefore any impact we have on the downstream community content would only happen when the owners of that content decided to upgrade their dependency(s) to the new version
    4. Promotion criteria important - thoughts?
    5. Do we remove the need for local extensions, as they can then simply become part of the Community Edition, with any local content just existing in a “country specific” edition within the Community Edition
      1. This also provides some level of assurance of the quality of the content in the Community Edition - as these would be assured by the NRC’s (and SI in some cases) and therefore provide a good baseline of high quality content for people to then start modelling against
    6. ModuleDependency is going to be important - 
      1. perhaps we answer this by making the entire Community Edition part of the same module - therefore it will all classify as one entity?
      2. However a lot of people will ONLY want to cherry pick the things that they want to take - so we need a method for taking certain modules (or realms or whatever we call them) and allowing people to create a snapshot based on just that content instead of the entire community edition
    7. Dependencies need to be properly identified:
      1. Could the CORE be standalone and published separately?
      2. Or would the CORE need to have dedpendencies on the wider International Edition, etc?
    8. HOWEVER, how do we classify the entire Community Edition when there could be different projects dependent on different versions of the dependencies (such as the international Edition)?
59

IHTSDO Release Management Communication Plan review

All

This document was reviewed in detail and all feedback was discussed and agreed upon - new version (v0.3) is available for review, attached to the IHTSDO Release Management Communication Plan review page.

AAT has added in details to state that we'll prefix the comms with "Change" or "Release" in order to distinguish between the type of communications. See version 0.4 now - IHTSDO Release Management Communication plan v0.4.docx

Once we've collated the feedback from the revised comms processes that we've implemented over the past year (in the items above), we'll incorporate that into the final version and discuss with the SNOMED International Executive Lead for Communications (Kelly Kuru), to ensure that it is aligned with the new overall Communication strategy. Once complete, the Release Management comms plan will be transferred to Confluence and opened up for everyone to view.

We have publicised the Release Management confluence portal to both NRC's and the end users to get people to sign up as and when they require the information. Do we know of anyone still not getting the information they need?

We also agreed last time that the community needs more visibility of significant, unusual changes (such as bulk plural change, or case significance change). These changes should be communicated out not just when they're assigned to a release, but actually well in advance (ie) as soon as the content team start authoring it, regardless of which future release it will actually make it in. I have therefore created a new Confluence page here: January 2020 Early Visibility Release Notices - Planned changes to upcoming SNOMED International Release packages

I've left the previous items up (from the July 2017 International Edition) because there are no examples yet from the Jan 2018 editing cycle - so please take a look and provide feedback on whether or not this is useful, and how it can be improved.

  • ACTION POINT FOR EVERYONE BEFORE OCTOBER 2018: (Dion McMurtrie, Matt Cordell, Orsolya Bali, Suzy Roy, Corey Smith, Harold Solbrig, Mikael Nyström, Chris Morris)
    The final version of the communication plan needs to be reviewed by everyone and any comments included before we agree the document internally and incorporate it into our communication strategy
  • Suzy Roy will discuss the end use cases of her users with them and come back to use with feedback on the practical uses of SNOMED CT and any improvements that we can make, etc 
  • We may now also need to add a new section in here wrt the comms for the TRAG, so that this is standardised and agreed with the community? Or is it outside of the scope for the Release Communication Plan? This was felt to be out of scope, and should this be restricted only to communication related to actual releases of products.
  • Everyone is now happy with the current version, therefore Andrew Atkinson to publish - we can then start refining it as we use it.
  • Andrew Atkinson to therefore agree all of the relevant changes that will be required as a result of this document internally in SNOMED International, and publish the document accordingly.
  • AAT MIGRATED THE DOCUMENT FROM WORD TO CONFLUENCE, AND THEN SENT IT TO THE EPS Team for first review.....
  • The feedback has been incorporated and the document refined accordingly.
  • https://confluence.ihtsdotools.org/display/RMT/
  • SNOMED+CT+Release+Management+Communication+plan
  • Andrew Atkinson has now sent to the relevant members of the SMT for final sign off....
    • This has now been signed off and is ready for publication
  • Do we consider anything in here needs to be incorporated into the TIG?
    • or perhaps just linked through?
    • or not relevant and just separate?
    • the litmus test should be whether or not implementers still use the TIG, or whether people now use separate documentation instead?
  •  
  • THIS NEEDS TO BE CONTINUALLY REFINED OVER THE NEXT YEAR WHEN WORKING TOWARDS FREQUENT DELIVERY:
    • Do we need more Communications over the first few months to ensure that everyone knows what's going on? 
    • Or do we actually need LESS now that we have regular, monthly releases?
    • Once all happy, the document will be published and opened up to anyone to view
    •  
60What constitutes a true RF2 release?

Harold would like to introduce this topic for discussion...

  • Language refset conflicts are not yet resolved - Linda has been discussing this in terms of how to merge Language refsets or dictate whether or not one should override the other in cases of multiple language refsets - in the UK they combine them all into one but this is not ideal either. In translation situations they use the EN-US preferred term as the default where there is no translated term in the local language. Perhaps we need to do a survey on the members and who's using what how.
  • Suzy Roy (or Harold Solbrig) to get Olivier's initial analysis and come back to us on what worked and what didn't, and we can take it from there.
  • Suzy would like to ask Matt Cordell if he can share his ppt from his CMAG extensions comparison project.
  • Matt Cordell will distribute this to everyone for review before the April 2019 meeting.....
  • Harold to continue analysis and report back with the results of reviewing the specific examples that Olivier identified in the next meeting....

  • Can you please present the revisited presentation Matt Cordell ?
  •  
61

Modularisation of SNOMED CT


* MAG crossover

All

Dion McMurtrie completed the Alpha release - did anyone have chance to review it? (I haven't had any requests for access to the remainder of the package)

The subject of Modularisation needs to be discussed between the various AG's who are considering the topic, before we can proceed with the Release-specific sections.


We need to discuss any red flags expected for the major areas of the strategy:

  1. Modularisation
  2. Members who want to abstain from monthly releases, and therefore need to use delta's with mulitple effective times contained within.
  3. Also need to consider if we continue to hold the date against the root concept - works perhaps still for 12 monthly releases, but not necessarily for continuous delivery daily!
  4. THIS NOW BECOMES CRITICAL TO THE STRATEGIC DIRECTION WE DISCUSSED IN TERMS OF MODULARISING OUR CONTENT, AND IMPROVING THE WAY THAT THE MDRS WORKS, IN ORDER TO ALLOW RANGES OF DEPENDENCIES. THIS WILL ALLOW THE "UNIT" OF RELEASE TO BE REFINED ACCORDING TO THE RELEVANT USE CASES.
  5. Understand the Use cases thoroughly, and refine the proposal doc to provide people with more real information - Dion McMurtrie TO PROVIDE THESE USE CASES FOR Andrew Atkinson TO DOCUMENT
  6. Does the POC allow for concepts to be contained within multiple modules? NO - BUT DION CAN'T THINK OF ANY CONCRETE EXAMPLES WHERE THIS WOULD BE NECESSARY
  7. What about cross module dependencies? Michael Lawley's idea on having a separate Module purely for managing module dependencies
  8. IN THE FINAL PROPOSAL, WE NEED TO CREATE A NESTED MDRS TO MANAGE THE INTER-MODULE DEPENDENCIES (as per Michael's comments)
  9. NEED TO PROVIDE GOOD EXAMPLES AND WHITE PAPERS OF THE USE CASES FOR MODULARISATION IN ORDER TO ENGAGE OTHERS...

  10. AFTER SIGNIFICANT DISCUSSION AND CONSIDERATION, THERE ARE NO VALID USE CASES LEFT FOR MODULARISATION. IT CAUSES A LOT OF WORK AND POTENTIAL CONFUSION, WITHOUT ANY TANGIBLE BENEFIT.
  11. THE PERCEIVED BENEFIT OF HAVING A WAY TO REDUCE THE SIZE/SCOPE FO RELEASE PACKAGES IS BOTH a) invalid (due to everyone's experience of being unable to successfully do anything useful with any small part of SNOMED!), and b) easily answered by tooling that using the ECL to identify sub-sections of SNOMED to pull out for research purposes, etc.
  12. THEREFORE AS OF APRIL 2018 THE FEEDBACK FOR RORY AND THE STRATEGY TEAM WAS THAT MODULARISATION SHOULD NOT BE IMPLEMENTED UNLESS A VALID USE CASE CAN BE IDENTIFIED.
  13. HOWEVER, KNOWING THE HISTORY OF THIS ISSUE, THIS WASN'T NECESSARILY GOING TO BE THE FINAL WORD ON THE MATTER, SO IS EVERYONE STILL SURE THAT THERE ARE NO KNOWN USE CASES FOR MODULARISATION?? (eg) linking modules to use cases, as Keith was talking about with Suicide risk assessment in Saturday's meeting,etc??
  14. This topic came up several times again during other discussions in the April 2019 meetings, and it was clear that people had not yet given up on the idea of Modularisation - we therefore need to discuss further in October 2019....
  15. Agreed to see where the linked discussions in the MAG etc end up going, and then discussing the proposals rather than just in abstract....
  16. UPDATES FROM THE MAG???
62"Negative Delta" file approachAll

This approach was successfully implemented in order to resolve the issues found in the September 2017 US Edition - is everyone comfortable with using this approach for all future similar situations? If so we can document it as the accepted practice in these circumstances...

  • NO! Everyone is decidedly uncomfortable with this solution! In particular Keith Campbell, Michael Lawley and Guillermo are all vehemently opposed to changing history.
  • The consensus is that in the particular example of the US problem, we should have instead granted permission for the US to publish an update record in the International module, thus fixing the problem (though leaving the incorrect history in place). This would have been far preferable to changing history.
  • ACTION POINT FOR EVERYONE FOR OCTOBER 2018: (Dion McMurtrie, Matt Cordell, Orsolya Bali, Suzy Roy, Corey Smith, Harold Solbrig, Mikael Nyström, Chris Morris
    We therefore all need to come up with potential scenarios where going forward we may need to implement a similar solution to the Negative Delta, and send them to AAT. Once I've documented them all, we can then discuss again and agree on the correct approach in each place, then AAT will document all of these as standard, proportionate responses to each situation, and we will use these as guidelines in future. If we have issues come up that fall outside of these situations, we'll then come back to the group to discuss each one subjectively, and then add them back into the list of agreed solutions.
  1. Preference now is to retain EVERYTHING in the Full file, regardless of errors - this is because the Full File should show the state at that point in time, even if it was an error! This is because there is not an error in the Full file, the Full file is accurately representing the error in the content/data at that time.
  2. The problem here is that the tools are unable to cope with historical errors - so we perhaps need to update the tools to allow for these errors.
  3. So we need the tools to be able to whitelist the errors, and honestly document the KNOWN ISSUES (preferably in a machine readable manner), so that everyone knows what the historical errors were.
  4. The manner of this documentation is up for debate - perhaps we add it to a new refset? Then we could use something very similar in format to the Negative delta, but instead of it actually changing history retrospectively, we simply document them as known issues, and allowing people to deal with the information in their own extensions and systems in whatever way they feel is appropriate.
  5. Only situation we can think of where we couldn't apply the above gentle response, would be copyright infringement - whereby if we discovered (several releases after the fact) that we had released content that was in direct infringement of copyright, then we would potentially have to revoke all releases since the issues occurred. However, this would raise a very interesting situation where patient safety might be compromised - as if we remove all historical content that contravened the copyright, then we run the risk of patient data being impacted, thus potentially adversely affecting decision support. This is simple to resolve when the problem is in the latest release (simply recall the release), but if found in a 5 year old release for example, it could be very problematic to recall 5 years' worth of content and change it!
  • October 2018 - Guillermo proposed a separate possibility, which is to introduce a new Status (eg) -1 whereby if you find this status in the latest snpashot you would just ignore it - this doesn't however address the use case where there is a legal contravention and you need to physically remove the content from the package - the use case where you would have something that contravenes RF2 paradigm, you can't use the RF2 format to correct something that is RF2 invalid! So this is unlikely to work...
    • Nobody is on board with this idea, as it's too fragile and introduces unnecessary complexity such as we had with RF1...

  • April 2019
  • If we're still all in agreement with this, then steps 1-5 above should all be documented and disseminated to get confirmation of approval from everyone??
  • Did everyone read through everything? Has anyone got any further scenarios that we can include in the documentation?

  • The EAG raised this issue again on 08/04/2109 - Peter to try to make it to the next TRAG to explain the use case that was raised today and elaborate on the new proposal...
  • The TRAG discussed this issue at length, and came to the conclusion that we cannot address ALL potential use cases with a standard, generic, solution (certainly not any of those offered above).
    • Instead the solution in each case should be agreed on given each specific use case that comes up each time
    • So INSTEAD we should update the Critical Incident Policy to very clearly define the process to be followed each time we need to remove something from the Published release(s):
      • Which group of people should make the decision on the solution
      • Perhaps we also provide examples of how each use case might be resolved:
        • For Legal/IP contraventions, we should either remove content from history entirely, or redact it (leave the records in place, but remove all content from fields except for UUID, effectiveTime, moduleID, etc - thus allowing traceability of the history of the components, without including the offending content itself)
        • For Clinical risk issues, we can remove it from the Snapshot, but leave the Full file intact to leave a historical audit trail whilst ensuring that the dangerous content shouldn't get used again (as most people use the snapshot) - see Full file steps 1-5 above, etc
      • How to communicate it out to the users, etc
  • OCTOBER 2019 - DISCUSSION RE-OPENED AS PART OF THE MAG:
  • ONCE FEEDBACK OBTAINED FROM MAG:
  • Andrew Atkinson to update the Critical Incident Policy with
    • the various use cases that we've identified so far
    • the governing bodies who should be the deciding entities
    • the process for making the decision in each case
    • including the critical entities that need to be collaborated with in each case (all NRC's, plus 3rd party suppliers (termMed etc) who represent some of them), to ensure the final solution does not break outlying extensions or anything
    • the process for communicating out those decisions to ALL relevant users
    •  
  • UPDATES FROM THE MAG???


63

Potential for adding a "withdrawn" reason for inactivated content


* MAG crossover

All

Discussions around the future strategy for SNOMED CT have included the potential for adding new statuses for content. 

In particular, many people have suggested that problems are created for those either mapping or translating from content that's still "in development". If (as is often the case) they use Daily Builds etc as input data, they can often get tripped up by content which is created but then withdrawn before it's versioned and officially released. It would be extremely useful to those users to have access to traceability data describing the reasons behind why they were removed, in order to support accurate mapping/translation. 

In another use case, there's the possibility that content needs to be formally withdrawn from the International Edition AFTER it's been officially released. This would be the case if, for example, content has unintentionally been published that breaks the RF2 paradigm, or contravenes licensing laws, etc. In this case mere inactivation is not sufficient, the content instead needs to be completely withdrawn from the releases and sometimes even from history. 

The TRAG needs to discuss all of this and be ready with recommendations if these proposals are taken forward.

  • ONE OF THE POTENTIAL SOLUTIONS TO THE ISSUE ABOVE: "Negative Delta" file approach
  • Use cases:
    • undo a historical issue (that break RF2 paradigm, etc) but don't want to pretend it never happened - in this case we should use the Negative Delta approach - but only used in EXTREME circumstances
    • Legal contraventions - in this case we should use the Negative Delta approach - but only used in EXTREME circumstances
    • Dead on arrival components - it should be okay to have these, and have them openly dead on arrival and therefore inactive to not map to them etc. However it's useful to be able to see these (even though they'd been activated + inactivated within the same release cycle) - so for those people who need to map/translate etc DURING the release cycle, they have to rely on the Daily Build and use live data still in development. Therefore if those concepts disappear by the time of the International Edition it causes problems for those maps/translations already including those concepts.
      • Therefore the best answer is for us to move to having 2x Daily Builds - the existing one + a separate true Daily Builds - where each Daily Build is built relative to the previous Day, and NOT to the previous Published release. This new Daily Build could then be properly relied upon by mapping and translation projects.
      • Can we align this with the transition to the more Frequent Releases?
  • HAS ANYONE HAD ANY MORE THOUGHTS ON THIS SINCE OUR LAST DISCUSSIONS??
  • MAG to discuss tomorrow (30/10/2019)
  •  
  • UPDATES FROM THE MAG???
  •  
64Clean modularizationAll

There are 22 module concepts, that are on the 900000000000012004|SNOMED CT model component| module.

I don't think it's documented anywhere, but we (AU) have made the assumption that the concept for a module, should be on itself. I suspect we've started to discuss this before, but can't recall how accepted this position was. The 22 concepts below (including the core module) aren't part of the core release, but clutter up the heirarchy. We also get enquiries about this content, some of which is non-existant/available.

  • Thoughts please from everyone on whether or not this proposal would have any impact (negative or positive) on the International Edition?
  • Ready to close down?
65Proposal to increase the level of metadata available for authors to log decisions made during content authoring

Jim Case +

Suzy Roy

This is a subject that would be helpful to include Jim in the discussions, as he has some definite opinions on how to improve the metadata in this area. 

Some suggestions would be to make more detailed information available for authors to describe their reasons for inactivation (especially in those areas where currently they are forced to use inactivation reason codes that aren't completely representative of the reasons in that instance).

Adding Jim Case - for further discussion later...

66Discussion on the conflict between Extension content and International content

All

Jim Case

The answer to this may be quite simple:

  1. If extensions promote content via RF2 delta, we just need to retain all ID's, and only change the ModuleID and effectiveTime, and therefore it is all managed by effectiveTime.
  2. If IHTSDO reject content this is also managed
  3. The only issue then comes if IHTSDO want to change the FSN, then we need a way to manage the change of the meaning of the concept without creating 2 FSN's - as then we need a feedback loop to ensure that it's also corrected at source in the extension as well as in the International edition.

TRAG to continue the discussion and come to a conclusion that will work for all.

  • Has this been answered in its entirety by Jim's new agreed approach? (link here to his final position)
  • Most people consider that Jim's approach covers this under most circumstances. We also need to ensure that we follow the approach listed to the left - so we should confirm all of this has been working in practice since April 2018, and if so close down?
  •  
  • OR, do we have any new requirements here in order to ensure that Promotion/Demotion works efficiently once we move to more frequent delivery?
  •  
  • In addition to this, we have had several issues with Promotions recently, with concepts being promoted without the related components (descriptions, relationships, etc) - so perhaps it's worth writing a full process document on exactly how, when and why content should be promoted + all related tasks that must take place at the same time in order to ensure a smooth and accurate promotion?
67AG Declarations of InterestAllCould each of you please go in and update your information? If there has been no change, then you can simply update the last column with the date. 
68Any other questions / issues?All