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 November 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® July 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® July 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
• National medication list
• Medical alerts
• National knowledge base for reasons for prescription
• The national information structure
• Surgical proceduresPharmaceuticals
• Assessment scales

3.2 New and Updated Content

Concept statistics

New concepts: 217165

Table 1 New concepts by hierarchy

Inactivated concepts from the Swedish extension: 24

Changes to existing concepts in the Swedish extension: 461

Descriptions statistics

During this cycle a number of batch corrections of translations have been made, e.g. now all drug concepts are uniformly translated and according to the updated drug concept model.

New synonyms added: 2411 312
Inactivated descriptions: 19417 710
New translations: 4 63427 445

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

Thirty-three Three reference sets were added in this release, including reference sets supporting medical alerts, reference sets for the National Medication List (Nationella läkemedelslistan), reference sets supporting the Inera laboratory medicine information specification, as well as reference sets for National Information Modelsreporting of COVID-19 symptoms. Some reference sets have been updated with new content, including the alert information reference sets and reference sets for the National medication list.

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

4.2.1  Deprecation of 2 obsolete Refset files

The following 2 Refsets have been confirmed to be obsolete, and are therefore being removed from the SE Extension Release.  The following files will therefore be removed from the Release package as of this May 2020 release onwards:

• der2_Refset_provtypLaboratoriemedicinSimpleRefsetFull_SE1000052_[date].txt

• der2_Refset_provtypLaboratoriemedicinSimpleRefsetDelta_SE1000052_[date].txt

• der2_Refset_provtypLaboratoriemedicinSimpleRefsetSnapshot_SE1000052_[date].txt

• der2_Refset_lokalisationLaboratoriemedicinSimpleRefsetFull_SE1000052_[date].txt

• der2_Refset_lokalisationLaboratoriemedicinSimpleRefsetDelta_SE1000052_[date]txt

• der2_Refset_lokalisationLaboratoriemedicinSimpleRefsetSnapshot_SE1000052_[date].txt

The refsetDescriptor records will, however, be retained in the release package (though inactivated), in order to retain a clear historical audit trail.

4.2.1  Addition of 3 new Refset files

The following 3 Refsets have been added to the SE Extension Release.  The RF2 Refset files will therefore be added to the Release package as of this May 2020 release onwards:

• 64641000052102 - urval allvarlig psykisk störning
  
• 64511000052102  - urval covid-19-symtom
  
• 60661000052106 - urval smittsamma sjukdomar, uppmärksamhetsinformation