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Inactivation ReasonAssociationDefinition

Non-Conformance to Editorial Policy

REPLACED_BY

ALTERNATIVE

No suitable replacement identified

The inactivation reason “Non-conformance to Editorial Policy” explicitly states that the inactivated concept does not comply with a specific Editorial Guideline valid at the point of inactivation.

From time to time editorial policy may change, either to revise what is considered to be within scope for the International Edition of SNOMED CT, or to support changes in modeling practice and thereby bring greater consistency to existing content. In the latter scenario, the necessary refactoring or remodeling of content can change the meaning of existing SNOMED CT concept FSN’s or the implied meaning of their logical definitions.

Guidance
  • Compliance with existing Editorial Guidance
    Where an existing concept is found to be non-compliant with existing editorial guidance (we might presume it to be a legacy of older editorial guidance or an artifact from the original merger of CTV3 and SNOMED RT) an assessment of the impact of bringing the concept into line with the editorial guidance should be made. Where the change results in a potential change to the meaning of the concept, then the legacy concept should be inactivated and replaced.
    • Specify the target concept
      • The target concept should represent as closely as possible the new meaning of the inactivated concept and an association of REPLACED_BY used.
      • If no suitable existing SNOMED CT concept exists, one should be created.
    • Annotation
      • The Editorial Policy that gave rise to the inactivation should be stated and if possible a link provided to the Editorial Guide
  • Compliance with new Editorial Policy
    Where new Editorial Policy is developed the Editorial Guide should be updated along with guidance as to how non-compliant content is to be updated. The development of a new Editorial Policy may impact a number of concepts and in some circumstances, and in agreement with EAG/Community of Practice it may be possible to change the FSN without inactivation of the concept.
    • Specify the target concept
      • The target concept should represent as closely as possible the original meaning of the inactivated concept and an association of REPLACED_BY used.
      • If no suitable existing SNOMED CT concept exists, one should be created.
      • Where a change in FSN alone is agreed upon, the legacy FSN should be inactivated as "Non-conformant to Editorial Policy"
    • Annotation
      • The editorial policy that gave rise to the inactivation should be stated and if possible a link provided to the Editorial Guide
      • Where only the FSN has been inactivated and replaced a note should be added that refers to the editorial policy and agreement to change only the FSN
  • Editorial Policy that results in the inactivation of content that is now deemed out of scope for SNOMED CT
    When concepts fall entirely out of scope for SNOMED CT due to a change in Editorial Policy this will have been notified and agreed with the EAG and Community of Practice. The Editorial Guide will have been updated with guidance on how inactivated content should be handled. Policy changes of this type often involve bulk updates and may relate to medicinal products, substances, and devices.
    • Specify the target concept
      • The target concept should represent as closely as possible the original meaning of the inactivated concept; however, the closest available target concept still within scope of SNOMED CT may often be significantly less specific than that original meaning.
      • The briefing and editorial guidance should state whether it would be appropriate to create a new SNOMED CT as a replacement with closer meaning to that of the original concept.
      • Where the replacement target is a high-level concept that is significantly less specific than the inactivated concept use "ALTERNATIVE" as the historical association. Otherwise, if the meaning is close (e.g. the difference is unlikely to be clinically significant), use REPLACED BY.
      • Dropdown list   (Where no replacement is appropriate)
        • No suitable alternative concept identified
        • No suitable replacement concept identified
    • Annotation
      • The editorial policy that gave rise to the inactivation should be stated and if possible a link provided to the Editorial Guide

Examples

Non-Conformance to Editorial Policy - no alternative replacement provided

Non-Conformance to Editorial Policy - content out of scope for SNOMED CT: 

Proposed change to FSN without inactivation of the concept

Non-Conformance to Editorial Policy: Update of FSN to comply with Editorial Guidance: The use of "and" which has the implied meaning of "and/or"

Editorial guidance on conjunction and disjunction states that the use of "and" in structural groupers has an implied meaning of "and/or" and therefore the FSN is to be updated to make the inclusive disjunction implicit with the use of "and/or". While this technically represents a change in meaning, as this is both a structural grouper and with the agreement of the community of practice, change of the FSN alone is supported.

  • 767270007 | Iron and iron compound (substance)|
  • Inactivate the FSN as "Non-conformance to Editorial Policy":
  • Replace the FSN with: "Iron and/or iron compound (substance)"
  • Annotation:
    Briefing note for MF June 2021, Link to Editorial Guidance - Conjunction and Disjunction 

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 “REPLACED_BY” 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 - REPLACED_BY

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

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

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

(A) REPLACED_BY (B) and (B) POSSIBLY_EQUIVALENT_TO (C, D) implies (A) POSSIBLY_EQUIVALENT_TO (C, D)

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

Whenever an already stated ALTERNATIVE 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 - ALTERNATIVE

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

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

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

(A) ALTERNATIVE (B) and (B) POSSIBLY_EQUIVALENT_TO (C, D) implies (A) ALTERNATIVE (C, D)

(A) ALTERNATIVE (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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2 Comments

  1. Drop down list:

    • No suitable alternative concept identified
    • No suitable replacement concept identified

    Is there a difference? When do you pick one over the other? 


    The guidance "if possible link to Editorial guidance" - this would add a maintenance burden:

    • with broken links and
    • if the guidance is in the process of being added at the time the inactivation occurs.

    Would information on the specific policy and version of guidance used be easier?


    The examples above reference 'MF briefing notes'- will this guidance be updated when information added to the guide? This suggests briefing notes are also an acceptable source- thats not stated in the guidance above.


  2. Hi Cathy Richardson,

    I suspect the subtle differences between "No suitable alternative concept identified" and "No suitable alternative concept identified" in this context confers little benefit to the end-users understanding of our thought processes and so it would be reasonable not to provide an option.

    What is possible and how we provide links to Editorial Guidance and other material used is open to discussion with the technical and content teams. At the moment, we are simply stating the requirement that a mechanism for providing this information needs to be achieved.