1 Introduction

SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.

The International Health Terminology Standards Development organisation (IHTSDO^®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.

2 Background

This document provides a summarized description of the content changes included in the May 2019 release of the SNOMED Clinical Terms^® Managed Service Sweden Extension package.

It will also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.

This Sweden Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® January 2019 International Edition release.

2.1 Scope

This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.

3 Content Development Activity

3.1 Summary

Content from the SNOMED CT® January 2019 International Edition release has been translated and additional concepts and synonyms for use in Sweden have been added. The main areas for which new concepts and synonyms have been added are:

• Reasons for encounter
• Alert information
• National list of prescriptions
• Laboratory medicine
• Cancer and pathology
• National knowledge base for reasons for prescription
• The national information structure
• Assessment scales (for use in the SUSSA regions)

3.2 New and Updated Content

Concept statistics

New concepts: 236

Table 1 New concepts by hierarchy

Inactivated concepts from the Swedish extension: 6
Changes to existing concepts in the Swedish extension: 15

Descriptions statistics

New synonyms added: 598
Inactivated descriptions: 377
New translations: 12 486

Some concepts have not been translated into Swedish. The reasons for non-translation can vary and include concepts not relevant in a Swedish context and concepts were the name in Swedish and English is equivalent (e.g. the Latin names of organisms).

Table 2 Non-translated concepts by hierarchy

Reference sets

Two reference sets for the Inera laboratory medicine specifications published in November 2018 have been given new identifiers and have moved from the Swedish release center namespace to the Inera namespace. The new reference set ids are 500121000057102 |urval provtyp laboratoriemedicin| and 500091000057101 |urval anatomisk lokalisation laboratoriemedicin|.

4 Technical notes

4.1 Known Issues

Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented.  This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.  

For the SNOMED CT Managed Service - Sweden Extension May 2019, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:

4.2 Technical notes

Combination of two new refsets - OWLAxiom and OWLOntology

In line with the January 2019 International Edition release, it was agreed to combine the two OWL refset files into one "OWL Expression" file, which now contains both OWL Axiom + OWL Ontology refsets in the same file, in each section of the International Release package (Full, Snapshot and Delta):

• sct2_sRefset_OWLExpressionFull_SE1000052_20190531.txt
• sct2_sRefset_OWLExpressionSnapshot_SE1000052_20190531.txt
• sct2_sRefset_OWLExpressionDelta_SE1000052_20190531.txt
  

The decision was taken to place the files in the "Terminology" folder in the release package (as opposed to the "Refset" folder), because these files are designed to eventually replace the Stated relationship files, and therefore contain core content which needs to be included in the Terminology folder.