SNOMED CT Editorial Advisory Group

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Inactivation ReasonAssociationDefinition

Duplicate 

SAME_AS

This combination of inactivation reason and association type explicitly states that the inactivated concept (A) semantically represents exactly the meaning of the remaining active concept (B). Implicitly it also means that (A) SAME_AS (B) always, by definition implies (B) SAME_AS (A).

The definition includes the requirement to ensure any analysis expressed in terms of (A) returns the same subtypes as would have been present had the concept (B) been substituted into the query logic, and vice versa.

Please note that the meaning of the concept is based on the FSN.

Guidance
  • Inactivate non-synonymous synonyms
    If any of the concept’s synonyms are considered to be non-synonymous, these should first be inactivated and re-assigned to either the concept that matches the meaning or if not available a new concept created.
  • Specify target concept
    The target component identifies the active concept that this concept duplicates.
    Note: The choice of which concept should be inactivated should be based on keeping the concept that has the most compliant and specific Fully Specified Name.
  • Annotation
    Provide evidence/reference to support the concepts are duplicates
  • Additional notes:
    • The requirement to ensure any analysis expressed in terms of (A) returns the same result as it would if the same logic was applied to (B) is contingent on both concepts being modeled correctly.
Equivalent FSNs but different semantic tags

If the pair of semantic tags are within the following permitted pairs then an inactivation reason of "Duplicate" may still be used:

  • Disorder and Finding
  • Procedure and Regime/Therapy
  • Finding and Situation
  • Procedure and Situation
  • Procedure and Observable 

Examples

Semantic meaning the same but FSN different

Duplicate concepts:

Resolution

Note: Both concepts had an effective date of 2002-01-31 and so the decision was based on current clinical usage and the retained concept already had a synonym of Perinephric abscess.

Identical FSN but different semantic tag

Duplicate concepts:

Resolution

Resolving sequences of Historical Associations

The intention is that functionality to resolve sequences of Historical Associations will normally be seamlessly integrated into the tooling so as to present to the user the appropriate updated historically association to be allocated.

Whenever an already stated “SAME_AS” target itself also becomes inactive - whether at the same release or later, identifying the replacement for the original concept, should follow the combinatorial logic stated below.

Combinatorial Logic

(A) SAME_AS (B) and (B) SAME_AS (C) implies (A) SAME_AS (C)

(A) SAME_AS (B) and (B) REPLACED_BY (C) implies (A) REPLACED_BY (C)

(AIntEd) SAME_AS (BIntEd) and (BIntEd) MOVED_TO (CNRC) implies (AIntEd) MOVED_TO (CNRC)

(A) SAME_AS (B) and (B) POSSIBLY_EQUIVALENT_TO (C OR D) implies (A) POSSIBLY_EQUIVALENT_TO (C OR D)

(A) SAME_AS (B) and (B) WAS_A (C AND D) implies (A) WAS_A (C AND D)

Note: Once MOVED_TO the NRC we (SNOMED International) have no knowledge of what has happened to BIntEd

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5 Comments

  1. James R. Campbell

    "Please note that the meaning of the concept is based on the FSN."  Please see my comment on main page.

  2. Cathy Richardson

    • Inactivate non-synonymous synonyms
      If any of the concept’s synonyms are considered to be non-synonymous, these should first be inactivated and re-assigned to either the concept that matches the meaning or if not available a new concept created.

    This guidance is used by a range of users and would be tooling dependent. The key point should be the need to manage the both the concept and synonym inactivations. Given synonyms remain active on an inactive concept (unless inactivated) the order isn't relevant. 

    With the current authoring platform functionality there is a need to inactivate the concept first and then manage the non-synonymous synonyms. 

    1. Paul Amos

      Cathy Richardson

      Logically it would be more sensible to deal with the non-synonymous synonyms first. Part of the next phase of the work will be to look at the concept inactivation workflow and discuss with Technical/Content teams how it can be improved.

  3. Cathy Richardson

    The guidance section above states:

    • 'Note: Where possible consider keeping the concept with the oldest effective date as this is likely to have had the most usage." and
    • "The choice of which concept should be inactivated should be based on keeping the concept that has the most compliant FSN, complete and correct modeling, and/or synonyms" 

    This gives potentially conflicting guidance. 

  4. Paul Amos

    Cathy Richardson

    We will update this part of the guidance to make it less confusing.