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The terminology server will accept CTU expressions matching the following pattern:

  [[+ (<  71388002 |Procedure|  ) @procedure]]:
      
272741003 |Laterality|   = [[+ (< 182353008 |Side|  ) @side]]  
The transformation of expressions following this pattern will include the following steps:

  1. Copy the defining properties and role groups of the focus concept (as present in the NNF) to the classifiable form expression

  2. Replace the value of the |Procedure site| attribute (or any of its subtypes / @siteAttribute) with a nested expression:

    From: @siteAttribute = @bodySite

    To:  @siteAttribute = (@bodySite:  |Laterality|   = [[+ @side]] )

Important Notes

The terminology server will only accept expressions complying to this pattern where the focus concept has the following characteristics:

  • The focus concept
    • includes only one role group with a @siteAttribute 363704007 |Procedure site| attribute (or any subtype of 363704007 |Procedure site|) OR
    • includes two or more role groups with a 363704007 |Procedure site| attribute (<< 363704007 |Procedure site|) WHERE
      • the @bodySite value is the same for all procedure site attributes
    • includes no attributes with values that are lateralized anatomical structures
  • The value of the procedure site attribute is a member of the 723264001 | Lateralizable body structure reference set|
    • i.e. the associated body structure is lateralizable, and
    • the associated body structure does not already state a laterality

Transformation of bilateral procedures

When applying the concept 51440002 | Right and left| as the value for the  272741003 | Laterality| attribute, the transformation should be done in accordance with the modeling applied to the content in the International Edition of SNOMED CT. 

This means that the transformation steps described above should be applied twice; one for each lateral half, as illustrated in the example below.

Examples

Table 5.3.2.5-1: Examples of CTU expressions and their evaluation at level 1.

CTU expressionAccept/rejectNotesClassifiable form
AcceptThe value of the |Procedure site - direct| attribute (i.e. 344001 |Ankle region structure|) is lateralizable
Accept

The values of the two  |Procedure site - direct| attributes of the focus concept is the same concept and this is lateralizable

RejectThe value of the |Procedure site - direct| attribute (59441001 |Structure of lymph node|) is not lateralizableN/A

N

A

/

N

RejectThe focus concept includes two groups with a  |Procedure site - direct| attribute in each. The attribute values are not the same concept.N/A

N

A

/

N

52734007 |Total replacement of hip| 272741003 |Laterality| = 7771000 |Left|

288228002 |Myalgia/myositis - forearm (finding)|

Accept

The focus concept includes one group with a  |Procedure site - Direct | attribute, and another group with a  |Procedure site - Indirect| attribute. 

The value of the two different procedure sIte attributes are the same (i.e. 182201002 |Entire hip joint|) and this is lateralizable

RejectThe value of the |Procedure site - direct| and the |Procedure site - indirect|
attribute (i.e. 735264009 |Entire right knee joint|) is defined with a laterality
N/A



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